Blood Flow Restriction Training 101

In order to understand how BFR works, it’s important to do a quick debriefing on how your circulatory system (also called vascular or cardiovascular system) works. Your arteries are blood vessels that carry oxygenated blood away from your heart to your body. Your veins are blood vessels that carry mostly deoxygenated blood from the body back to the heart.

The goal of blood flow restriction training is to restrict venous return while still allowing arterial flow by strategically wrapping the topmost portion of your limbs. By restricting the veins and not the arteries, blood can keep pooling into a working muscle and it stays trapped there. It’s like filling a water balloon to max capacity (without it popping, of course).

By bringing in all of that blood to the working muscles without letting it leave, a couple key things happen.

One, you get a crazy pump. Seriously, your muscles become supersized. The theory is that this leads to cellular swelling which shocks the muscles into new growth.

Two, it’s gonna burn like hell. Your muscles quickly become deprived of oxygen and can’t get rid of accumulating waste materials and this creates a lot of metabolic stress or acidosis. Metabolic stress is one of the three major mechanisms of muscle growth and should not be overlooked.

Dr. Brad Schoenfeld is a regular Men’s Health contributor and one of the leading authorities on hypertrophy (the scientific term for muscle growth).

In his book Science and Development of Muscle Hypertrophy, he says: “The prevailing body of literature shows that BFR training stimulates anabolic signaling and muscle protein synthesis and markedly increases muscle growth despite using loads often considered too low to promote significant hypertrophy.”

Brad goes on further, saying that “it has been speculated that metabolic stress is the driving force behind BFR-induced muscle hypertrophy.”

Another really cool thing that happens with BFR is since your oxygen-dependent slow-twitch fibers fatigue way faster than normal, you have to quickly start tapping into your fast-twitch muscle fibers, which have the biggest potential for growth.

What’s crazy about this is your fast-twitch fibers typically don’t get hit unless you’re using heavy loads or moderately heavy loads performed explosively. But BFR allows you to go fast-twitch with loads less than 50 percent of your one-rep max. In fact, one study from the Journal of Applied Physiology showed increased muscle cross-sectional area with BFR training using loads as light as 20 percent of one-rep max. That’s the equivalent of pink baby weights in some cases.

What this means for you is that with BFR you can use lighter loads to build muscle while sparing your joints from heavy loading and without overly fatiguing your central nervous system. It’s also important to note that research has shown the gains aren’t just for the arms and legs below the wraps but also for adjacent muscle groups above the wraps.
How to Wrap For BFR Training

There are some high-end pressure cuffs that can be used to wrap your limbs for BFR, but any wraps will work. Some people use ace bandages or knee/elbow wraps. Others use run-of-the-mill hospital tourniquets.

I prefer to use voodoo floss bands from MobilityWod.com. (Note: BFR wraps come with my new MetaShred Extreme program from Men’s Health).

For the upper body, wrap it just below the shoulder at the top of upper arm so that the wrap is nestling into your armpit.

For the lower body, wrap just below the gluteal fold from the back and just below the hip flexor from the front.

For both the upper and lower body, you want to wrap at about a 7 out of 10 on the tightness scale (10 being as tight as possible).

You shouldn’t feel any numbness or tingling sensations. If you do, that means you wrapped it too tight. Wrapping it too tight will restrict arterial flow and prevent blood from pooling in the muscle, so it defeats the purpose. When in doubt, wrap on the looser side of the spectrum, especially in the beginning.

How do you know if you wrapped it right? If you get the best muscle pump of your life!

Remember, if it feels sketchy just take the wraps off and re-wrap a little bit looser. There’s a bit of a learning curve in the beginning so don’t put too much pressure on yourself to nail it on the first try.
How to Use BFR Training to Build Muscle

The key to effective BFR training is using light loads (40 to 50 percent of your one-rep maxor less), high reps (10 to 15 reps or more), and short rest periods (30 seconds or less).

It’s also important to note that BFR doesn’t replace your regular training—it just enhances it. Here are my three favorite ways to implement BFR training:

1. BFR Finishers

After performing your main workout, hit a BFR finisher.

If you performed an upper-body workout, hit an upper-body BFR finisher. If you’ve just completed a lower-body workout, hit a lower-body BFR finisher. If you do total-body sessions, hit one for both the upper and lower body.

I’ve provided four finishers for both the upper and lower body below to get you started. But the options are endless! Follow me on social media (@bjgaddour) for more ideas.

2. Extra Training Volume and Frequency

BFR is a great way to increase training volume (how much work you do) and training frequency (how often you train) without impairing your recovery.

For example, to bump up your training volume, if you did 3 regular sets of an exercise with heavier loads, try adding in an extra couple sets of BFR training for the same movement pattern or muscle group with a lighter load for higher reps and shorter rest periods between sets.

To bump up your training frequency, do any of the fast finishers outlined below on what is typically an “off-day.”

3. Active Recovery and Deloading

Because BFR training requires using lighter loads, it’s significantly easier to recover from than heavier training. This makes it a great method to employ on days you’re feeling worn down but still want to train.

It’s also great to use if you incorporate frequent deloads—or periods of decreased loading or training volume—into your training schedule.

It’s worth mentioning that BFR is being used with remarkable success in rehab settings, particularly with wounded warriors. Being able to work and grow atrophied muscles after an injury or surgery with lighter loads is truly a joint-sparing feature unique to BFR training. As always, consult your physician or physical therapist to see if BFR training is right for you in these circumstances.
4 Great Upper-Body BFR Workouts

Upper-Body BFR Workout #1

Perform the following exercises in the order shown for the prescribed amount of time.

Seated biceps curl, 30 seconds
Overhead triceps extension, 30 seconds

That’s 1 round. Do 5 rounds for 5 minutes of continuous work.

Upper-Body BFR Workout #2

Perform thedumbbell triple crush complex (hammer curl to overhead press to overhead triceps extension) for 2 minutes. Rest 30 seconds.

That’s 1 round. Repeat for 2 total rounds.

Upper-Body BFR Workout #3

Perform the single-arm overhead press for 20 seconds. Then hold the top of the exercise for 10 seconds. Switch sides and repeat.

That’s 1 round. Do 5 rounds

for 5 minutes of continuous work.

(Hold a dumbbell in the non-working hand at shoulder level so you can immediately switch sides.)

Upper-Body BFR Workout #4

Perform the following exercises in the order shown for the prescribed amount of time, with no rest between exercises.

Reverse-grip curl, 40 seconds
Zottman curl, 40 seconds
Underhand-grip curl,40 seconds

Rest 1 minute, then perform the following exercises in the order shown for the prescribed amount of time, with no rest between exercises.

Triceps extension, 40 seconds
Rolling triceps Extensions, 40 seconds
Chest press, 40 seconds

4 Great Lower-Body BFR Workouts

Lower-Body BFR Workout #1

Do split squatsnonstop for 5 straight minutes, switching sides every 30 seconds.

Lower-Body BFR Workout #2

Do constant tension squats for 40 seconds, then hold the bottom of the exercise for 20 seconds. Repeat for 5 minutes.

Lower-Body BFR Workout #3

Do shoulders-elevated hip thrusts for 20 seconds, then hold the top of the exercise for 10 seconds. Repeat for 5 minutes.

Lower-Body BFR Workout #4

Do extended-range of motion calf raises for 20 seconds, then hold the top of the exercise for 10 seconds. Repeat for 5 minutes.

I hope I’ve inspired you to give BFR training a test drive. Personally, I credit it for increased muscle size, vascularity, and endurance over the past year and I continue to incorporate it into my training on a weekly basis.

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