Blood Flow Restriction

Blood flow restriction training involves exercise whilst using a pneumatic cuff to restrict blood flow, similar to a blood pressure cuff. The decreased oxygen to the muscle, in combination with reduced ability to get rid of waste products from the exercise (e.g. lactic acid), causes the muscle to work a lot harder than without occlusion.

The muscle is forced to adapt to the strenuous conditions, by increasing in size and strength, irrespective of the lighter weight being used. The advantage of this approach is that to improve muscle strength you don’t have to use heavy weights, which can often aggravate injuries due to the high load through the joint.

Blood flow restriction may in theory be very beneficial in people with musculoskeletal pain who need to get stronger to improve the management of their condition but pain stops completing an adequate gym program.

A team from the La Trobe SEM Department, headed by Lachlan Giles, performed a double blind RCT looked into the effect of quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain. This was published in the British Journal of Sports Medicine (BJSM) 12th May 2017


  • Blood flow restriction (BFR) training at 30% 1RM reduced pain with daily activity more than standardised quadriceps strengthening (70% 1RM) over 8 weeks in people with patellofemoral pain (PFP). There was no significant difference in worst pain or Kujala Patellofemoral Score.

  • People with PFP who have pain with resisted knee extension achieve greater improvement in quadriceps strength by performing exercises with BFR than standardised quadriceps strengthening.

Clinical implications:

  • Both standardised quadriceps strengthening and BFR can be used to reduce pain from PFP and increase quadriceps strength.

  • BFR may be a useful alternative for people with PFP who are not tolerating the load of standardised quadriceps strengthening programmes due to pain.

For more information read the full-text article: Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial

  • One training method that may further enhance the physiological and functional benefits of walking training is to combine walking with blood flow restriction (BFR) to the lower limbs
  • The increased strength and musclemass from low-intensity walking with BFR appears greater than fornon-BFR walking training
  • BFR walking increases˙VO2max beyond that of non-BFR walking
  • Augmenting simple walking exercise with BFR may provide an alternative exer-cise to improve physical function for older adults.
  • This study examined the effect of BFR walking training on arange of tests of physical function compared with non-BFR walking among older adults, and demonstrates BFR walking to improve performance on the Sit to stand, Six minute walk test, timed up and go test and a modified Queens college walk test to a  greater extent than non-BFR walking.
  •  Blood flow restriction walking provides a low-load alternative to resistance training for improving the physical function of older adults who may be contraindicated to high-load resistance train-ing.
  • Blood flow restriction walking improves physical function beyond that of traditional walking exercise.

For more information read the full-text article: Clarkson, M. J.,  Conway, L., Warmington, S.A.(2017) Blood flow restriction walking and physical function in older adults: A randomized control trial. Journal of Science and Medicine in Sport. Volume 20(12) 1041 – 1046.