By Dev Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- “Blood flow restriction” training is a new way to harness the body’s own ability to produce muscle building hormones, while training safely with low resistance loads
- This training may revolutionize the way we are able to add muscle strength without the risk and potential pain associated with high load traditional strength training
- People with conditions such as Osgood-Schlatter, patellofemoral pain, ACL surgery rehab, and knee arthritis can benefit from this, as can any healthy athlete
As an orthopedic surgeon and sports medicine specialist I see a lot of folks who need to gain strength to recover from injury, or as part of an overall rehabilitation program. The problem we often run in to is that the traditional way to build strength is often very difficult for these folks either because it will increase joint pain or because there are specific loading limitations that are part of their rehab plan after surgery.
What anyone in this situation really needs is a safe way to build strength that does not lead to joint pain or risk a surgical repair. What if there was a way to effectively build strength using much lower resistance loads than those associated with traditional strength building methods? Recently I’ve started using a technology called “blood flow restriction” bands that I believe could open up an entirely new pathway for strength gains in these situations.
As part of my orthopedic surgery residency at UC San Diego I did a research fellowship in muscle physiology under the direction of Dr. Rick Lieber, a world renowned muscle expert. There are several key components to muscle strength generation. The components have not changed but the way we can utilize them has. I’d like to very briefly introduce you to a simplified description of the components here, with some emphasis on the benefits of blood flow restriction therapy.
The exact mechanisms that cause muscle strength gains are complex with several interactions. Overall, two processes appear to be involved: neural adaptations that enhance nerve-muscle interaction, and “hypertrophy”, or the enlargement of muscle cells.
The nerve related pathway to muscle strength enhancement primarily involves the ability to recruit more muscle cells in a muscle. Essentially this means you’re improving the efficiency of the signal to the muscle. This process generates significant strength gains but without too much increase in muscle size and is responsible for much of the strength gains seen in women and adolescents who exercise. It also utilizes nerve and muscle cells already present and accounts for most of the strength increases recorded in the initial stages of all strength training.
The second main process to increase muscle strength occurs through increases in size of the muscle cells. This is called “hypertrophy” and means that the muscle gets larger. There are several factors that contribute to muscle growth, including nutrition (especially protein intake), hormones (such as human growth hormone, testosterone, IGF, VEGF, insulin, and others), genetics (specific genes such as ACTN-3 and MSTN), and of course resistance training exercise. I’ve overloaded you with too many initials!
The classic strength and muscle building weight lifting pattern is to use heavy loads and a small number of repetitions. Without a doubt this time-tested method works. But the problem is that for folks with some joint conditions it can cause a lot of pain to exercise this way, or it would potentially harm a surgical repair.
And this is where blood flow restriction therapy comes in. With this type of training, an air-filled strap is placed on each upper arm and each upper leg. The strap cause the blood vessels to increase in size during exercise (called “dilation”) and through a complex series of events the blood vessel dilation leads to increases in the body’s natural growth hormone, testosterone, IGF-1 and VEGF. You’re harnessing the body’s own healthy hormone production.
The hormones are helpful to muscle building, which means that during blood flow restriction exercise you can exercise with much lower loads and get the same – or better- strength gain that you could with traditional strength building programs. But you do all of this without the stress that can cause joint pain, and it can even be done very early in postoperative rehab, such as for example an ACL reconstruction.
I went into some scientific detail today to set the stage for some future posts. I’m a big believer in this therapy and use it myself. I’ll present a discussion with Dr. Jim Stray-Gundersen, one of the founders of the blood flow restriction therapy company BStrong where we’ll dig deeper into safety and benefits. I’ll later outline possible uses in conditions such as Osgood-Schlatter syndrome, patellofemoral pain, ACL reconstruction, and knee osteoarthritis.
I believe these blood flow restriction bands can be a huge benefit to anyone looking for an effective, safe, and low load way to build strength.
For more information:
Please have a look at the BStrong website, and when you’re interested in purchasing a set please use the discount code “sideline” to receive a 10% discount.