Blood Flow Restriction Training 2024: Ultimate Beginner’s Guide to BFRT

Imagine a gym portable enough to fit into your carry-on luggage, but versatile enough to build muscle and cardiovascular endurance, amplify workout recovery, and even accelerate injury rehabilitation.

All at the same time, safely, and completed within mere minutes.

That reality is here, and it’s called blood flow restriction training.

This breakthrough has actually existed since 1966, and it’s rapidly gaining popularity. This article will explore the science of occlusion training, its pros, and cons, how you can use blood flow restriction training for maximum results, and why I recently upgraded to the best BFR brands on Earth.

What is Blood Flow Restriction Training?

Blood flow restriction training is a special technique used since the 1960s to rapidly build muscle, strength, and cardiovascular health while using light loads (even body weight). Essentially, it allows users to enjoy the benefits of high-intensity exercise while performing a simple and safe low-impact routine.

Its original use by Dr. Sato was to help hospital patients recover safely and faster. It worked so well that the world took notice and a special, clinical form of BFR began to spread.

Here’s how it works.

How BFR works

It works by slowing blood flow from the muscles to the heart. This simple action stimulates many of the same profound full-body systemic benefits as heavy weight lifting but without the major injury risk. BFRT and conventional strength training are the only two known ways to get these beneficial metabolic adaptations.

Trainees wrap an elastic band or pressure cuff around extremities and apply a specific custom pressure. This prevents blood from flowing normally and causes it to “pool” in the muscle. It also induces a low-oxygen (hypoxic) state. Hypoxia fatigues the Type I (endurance) muscle fibers and forces the body to recruit Type 2 (power) muscle fibers instead. Normally, Type 2 fibers are only accessible during high-intensity exercise.

Muscle stem cells proliferate (up to 300% increase) and metabolites accumulate.

Afterward, removing the bands floods the body and brain with nutrient-rich blood. Metabolites, hormones, lactate, VEGF, and brain-derived neurotrophic factor (BDNF) act as biological hardware upgrades.

Dr. Doug McGuff shattered the aerobics myth with the super-slow resistance training system

While best known for muscle and strength building, BFR training (BFRT) is getting other use:

• Stroke and cardiac rehabilitation
• Sports injury rehabilitation
• Enhancing cognitive performance & neuroplasticity
• Facilitating body composition changes
• Exercise warmup and cooldown
• Anti-aging protocols

I stumbled upon it in 2011 while training for collegiate American Football. I sought any legal advantage I could find. I read up on the science and cautiously integrated the hack into my strength-building routine. The results spoke for themselves.

Today, I still use BFRT multiple times per week.

Dr. Mercola keeps up to date with the latest research, trends, and biohacks from around the world. Here’s what he has to say about BFRT (emphasis mine):

“Without a doubt, in my opinion BFR is the most incredible innovation to improve your health that I have learned about in quite some time. It has the most significant potential to increase your healthful life span and help you maintain full range of your mental and physical capacities than anything that I know of.”

What makes it so exciting?

The Science of Blood Flow Restriction Training

We know that it works, but are still grappling with exactly how. While we wait for researchers to fill in the unknowns, here are the primary mechanisms of action:

• Mechanical tension. Pushing against resistance puts the muscles under tension similar to conventional strength training.
• Metabolic stress. Causes a cascade of wonderful, beneficial metabolites such as lactic acid, reactive oxygen species (ROS), nitric oxide synthase (NOS), heat shock proteins (HSP), and others.
• Tissue hypoxia. Creates a low-oxygen environment in the muscles. This stimulates anaerobic adaptations usually only activated through intense exercise or altitude training.
• Cellular swelling. Promotes protein synthesis in various types of cells.

Practitioners are hard at working sleuthing out all possible use cases.

Physical therapists were quick to introduce BFR to their injured, muscle-atrophying athletes:

Health & Performance Benefits of Blood Flow Restriction Training

Today, there are hundreds of studies on how BFR positively impacts human health.

Benefits of occlusion training include:

• Bigger and stronger muscles
• Cardiovascular health
• Aerobic and endurance capacity

All with little impact on the body, extreme portability, little soreness, and impressive safety.

Let’s explore each.

Systemic full-body health

Once I overcame the hurdle of trusting a new paradigm, I sought to answer one question:

How can occluding my arms or legs strengthen non-wrapped central muscle groups?

Surely BFRT wouldn’t work on my pecs, shoulders, back, core, and posterior chain.

It does, but indirectly.

Blood flow restriction training produces the metabolic and hormonal environment ideally suited to full-body muscle growth.

Researchers have demonstrated BFRT strengthens central non-wrapped muscles too.

In 2008, 15 untrained men performed arm curls twice and leg exercises weekly for ten weeks. Eight of them also performed a BFR-enhanced leg exercise. Of the 15 participants, only the eight also performing BFR-assisted leg exercises improved both.

A 2010 study divided ten young athletes into a BFRT group and a control. Two weeks later, only the BFR-banded group increased their bench press (chest) strength.

Together these studies suggest that occluding the limbs with blood flow restriction training benefits the entire body.

Hypertrophy, bodybuilding, & muscle size

Hypertrophy refers to the phenomenon of increasing muscle tissue size. Traditionally, it takes many sets, of many reps, with an intense lactate burn. It also heavily strains tissues with metabolic stress, mechanical stress, and muscle damage.

BFR can simulate a similar outcome with much lower loads and discomfort. A meta-analysis of 19 studies found greater muscle gain while also less muscle damage.

Talk to any user, and they’ll surely comment on the unparalleled pump caused by BFRT. Yet the next day, the soreness isn’t there.

The muscle-building benefits of BFRT are among the top reasons people use it.

Muscle strength

Big-looking muscles don’t always work better. For those interested in functional fitness, strength, and power matter more than size.

Well, that same meta-analysis of 19 studies also found improvements in muscle strength from consistent BFR.

Another study of healthy young men lifting light weights found the BFR group increased their bench press strength by 6%, while the control group lifting normally lost 2%.

BFR seems to improve muscle protein synthesis, mTOR, and many parameters of building muscular strength.

Cardiovascular health & endurance

Few modalities build more strength and cardio simultaneously.

That’s because the muscle fibers used for each ability fatigue at different rates.

BFR improves the heart and cardiovascular system in ways traditional lifting cannot.

First, it increases levels of a protein called VEGF, which directly grows blood vessels and improves their ability to acquire nutrients and remove waste.

Blood flow restriction exercise also increases levels of the Nobel-prize winning cardiosupportive super gas called Nitric Oxide.

Together, this boosts the body’s ability to deliver nutrients to and from muscle tissue and improves vascular health.

Faster injury recovery

The biggest obstacle to long-term fitness is injury. Consistency is the backbone to progress and beneficial metabolic adaptation, and nothing derails faster than injury.

Injuries generally come with inflammation and pain, and returning to training can take weeks or months. At the same time, inactivity can reduce blood flow, nutrient delivery, and oxygenation, and dramatically slow the healing process.

Traditional bodyweight exercise is often better than nothing, but BFR is far superior. Using occlusion training to stimulate the same pathways and fibers as heavy training kickstarts the repair process.

Multiple papers show it’s both a powerful injury rehab tool and safe.

Optimized hormones

Fitness majorly impacts the endocrine system. Long, drawn-out workouts (especially running) lead to sympathetic dominance, catabolism, and net tissue destruction.

High-intensity exercise, on the other hand, leads to a net growth state post-workout. Since BFR replicates the effects of heavy strength training, it leads to a similar beneficial anabolic rebound.

Multiple papers have shown that BFR creates a massive growth hormone surge post-session. It also increases intramuscular IGF-1. Unlike systemic IGF-1 which may contribute to cancer growth, local IGF-1 is a tool for optimal health.

I haven’t yet seen research on whether BFRT increases testosterone levels, but I wouldn’t find it surprising.

Decreased tissue stress

Although intense, heavy resistance training has all kinds of benefits, it can be tough on connective tissue.

It certainly isn’t low impact, and injury is an inevitability over the long term. Because occlusion training uses light loads or even body weight, doesn’t add much stress to joints, tendons, ligaments, and tissues.

This makes BFRT more sustainable and safe for frequent use.

Minimal recovery required

Most data around conventional training shows that tissues take significant time to recover and rebuild post-workout. Anywhere from 24-120 hours depending on the muscle group, type of workout, hormonal profile, etc.

Workout again too soon, and the satellite (stem) cells haven’t had the chance to regrow the muscle stronger.

Plus, connective tissue and muscle recover at different rates.

Several papers have shown rapid recovery from blood flow restriction workouts. Making it safe to train daily while allowing adequate anabolic tissue growth.

Minimal muscle damage

Intense exercise causes a cascade of oxidative stress and tissue degradation.

Building lean muscle comes down to creating a favorable balance between two factors: growth and breakdown.

In the right doses, and with adequate recovery, this can be okay and even a good thing. Yet modern living causes us to live persistently with a high degree of stress. Our allostatic stress load stays elevated. Most of us don’t fully recover between workouts.

Although I am a HUGE proponent of sprinting, the inevitable tissue breakdown and rampant metabolic byproducts can make some people feel awful.

BFR can effectively shift that balance towards the anabolic side without adding significant stress. Creating the conditions to net gain muscle.

Less soreness

Soreness usually results from exceeding the body’s familiarities and capabilities.

It can be a sign that we’ve pushed ourselves and are growing. Yet soreness can also hinder future workout performance. Soreness also makes pushing yourself to break personal records that much harder.

Have you ever worked out and felt painfully sore for days after? This phenomenon is called delayed onset muscular soreness (DOMS) and it can dramatically slow progress. As well as feeling a special kind of uncomfortable.

BFR training causes far less soreness and a less persistent form. Allowing you to get back to training faster and more often.

Stacks nicely

You can use BFR as a standalone fitness modality, combine it with other technologies, or use it as a “finisher” at the end of a workout.

It’s versatile and highly adaptable to any program or exercise. Occlusion training can help you get more results from shorter workouts.

BFRT stacks very nicely with slow strength training for a powerful 10-minute strength-building workout, anytime, anywhere. This is my go-to style while traveling or low on time.

This style of training also activates muscle fibers, pathways, and growth factors in atypical ways. A great tool for performance, rehab, and longevity.

How To Do BFR Training

You’ve decided to take the plunge.

While considered quite safe, individuals with underlying conditions should proceed with caution. Make sure to consult a certified specialist or doctor before starting.

With that out of the way, here’s what we’ll cover:

1. How often to workout with BFR bands
2. Warming up
3. How to properly wear BFR bands
4. Optimal BFR workouts

BFR Workout Frequency

BFR fits into any workout program. Warmup, complete workout, an exercise “finisher”, or as a cool down.

If used for intense training, your age plays a large role in frequency.

World-renowned physiologist, physician, and BFR expert Stray-Gundersen advocates a generally recommended frequency of:

• Age <20: BFR workouts every day
• Age 20-40: Five BFR workouts per week
• Age 40-60: Three BFR workouts per week
• Age 60+: Two BFR workouts per week

Those in great shape can get away with more. Injured athletes rehabbing often complete two to three sessions daily.

Dr. Mercola and many others practice BFR every day by varying the number or type of exercises.

Warming Up

The very first step to blood flow restriction training is to warm up. In my post on common workout myths, I dispelled the idea that pre-exercise warm-up is a waste of time. Warming up is completely necessary. Including BFR training.

Anything that elevates your heart rate will do. Even better if your warmup targets the same muscle groups. Yoga, walking, climbing stairs, mobility training, a barbell complex, or calisthenics are all good options.

Wearing BFR Bands Properly

Excitement and anticipation coursed through me when USPS delivered my first pair of BFR bands. The delay between ordering and arrival had tested my patience. I tore through the packaging in no time.

Until it struck me.

I had no idea how to use the new bands.

My first hurdle was where to place them. There are only two recommended places on the body to put them, no matter the workout. As high up as possible on either the arms or legs:

• Arms — where your bicep meets your shoulder
• Legs — at the intersection between your upper thigh and groin

I chose a leg workout first.

Putting the bands on is about what you’d expect.

The second thing that tripped me up was the tightness. Tightness really matters. You must know three things about getting tightness right:

• The pressure should feel like a 7 out of 10. Tight but not miserable.
• When in doubt, less pressure is always better.
• You can confirm proper tightness at any time by checking capillary refill time. Do so by pressing the index finger of your non-BFR hand into the palm of the BFR hand. Quickly release and count how long it takes to return from white back to pink. If your pinkish hand color takes longer than three seconds to return, loosen the bands.

Avoid using bands on both arms and legs at the same time. This can occlude too much blood.

You’re ready to go.

Effective BFR Protocol

Finally, we’ll cover the nuts and bolts of actually performing BFRT:

• Exercise selection
• How much weight
• How many reps
• How many sets
• Perceived exertion

Before we get started, only wear the bands for 15-20 minutes max. It’s more of a safety measure, just in case you tighten the bands far beyond the 7 out of 10. Again, lean on the side of too loose.

Exercise selection and intensity:

Virtually all exercises are fair game. The exceptions are short explosive bursts of movement. BFR sprints, no. But bodyweight squats, definitely.

The best exercises are the ones where you can slow down and control each rep. I wrote about a great 12-minute full-body strength-building routine called super slow. Similarly, the last few reps of every set should really burn. Choose safe exercises, or at least, have spotters.

Pushing yourself to failure each set puts a heavy burden on the central nervous system, so save failure for the final set.

How much weight:

BFRT requires little resistance. So little that novices often overdo it.

Depending on the study, research points to using between 20-40 percent of your one-rep maximum (1RM) for every exercise. The safety-to-effectiveness ratio has made the lower end of the range popular.

To emphasize just how incredibly low that number is, let’s take my bench press. If I can lift 300 pounds, 20 percent of that would make 60 pounds optimal for BFR training. I can easily get that resistance from body weight alone.

First time training BFR style?

Start even lighter at around 10 percent of your 1RM. Gradually work up to the above range over several sessions.

How many reps, sets, and rest time:

BFR is a form of high-rep hypertrophy training. Most people practice three to five sets of 10-30 reps. Start high and decrease reps with each set.

A typical blood flow restriction protocol would look like this:

Get Your BFR Straps Today

Since I started using BFR bands over a decade ago, all kinds of new options have appeared.

I’ve gone through several pairs before upgrading.

One myth, in particular, bothers me.

Despite what you hear…

BFR bands are not all the same.

Cheap materials aside, there are several main issues with most brands:

• Imprecise settings decrease their safety and effectiveness
• Constant pressure. The best systems allow for pulsing/cycling pressure which is key to healthy functional muscle tissue
• Improper bandwidth. Using two-inch wide BFR bands on the arms can cause ischemic injury. They also increase the chance of over-occluding arterial blood flow and causing damage
• Stretchiness. Bands that don’t stretch enough can spike blood pressure and potentially cause strokes

For these reasons, if you can afford it, I definitely recommend skipping the beginner bands.

Beginner BFR Bands

I had nearly a decade of use and success with my cheapo Amazon pairs.

They’re nothing flashy. Nor is their pressure precise. Most pairs are made of plastic and elastic. Each use slightly wears out the elastic. I didn’t mind the fraying. This is a decent option for beginners of a budget.

You can pick up a pair of decent $40 BFR bands.

When you start getting results, then move on to the premium option.

My two pairs held up for years. But they’re on their way out. Recently, I upgraded to the far superior option.

Best BFR Bands

I went from skeptic to convert quickly. NYC gyms were all closed down. Quarantine forced me to find alternatives to squat racks and free weights. BFR didn’t disappoint.

From talking to experts and current users, KAATSU makes the highest quality bands available. I used these back in 2011 at an elite facility and trained alongside professional NBA players.

These are the exact bands used in clinical research for their safety, effectiveness, and durability.

KAATSU released their newest B1 version in mid-2022. I finally upgraded and haven’t looked back.

They’re actually different and far more effective than typical BFR bands. More on that next.

BFR Bands vs KAATSU

BFR and KAATSU are not the same. Compared to BFR, KAATSU has more uses, is more effective, safer, and backed by clinical research, but it’s more expensive.

BFR bands are simply adjustable and stretchy cuffs that must be properly placed, tightened, and worn for precise amounts of time. Build materials and elasticity vary from one brand to the next. Because of the way it works, these bands are also significantly wider and the material rubbing against your skin gets annoying during certain movements (like squats).

KAATSU is similar but made of better materials and outfitted with an air bladder. This bladder allows KAATSU to be smaller and more comfortable to use. It also doesn’t slip while you’re in the middle of working out.

The technology within inflates it to the precise amount of pressure you need to occlude blood flow one way while maximizing safety.

This is the same system perfected through use in clinics and real-world research.

What makes them especially impressive, however, is something no BFR bands can do…

Cycles!

KAATSU has a “warm-up” mode that pulses between inflation and deflation, warming up your microvasculature. These cycles give you the cardiovascular, recovery, and longevity benefits of BFRT anytime, anywhere.

For more information on why there’s no comparison to traditional BFR Bands, click here to visit my full KAATSU B1 system review now.

Common Blood Flow Restriction Training Questions & Answers

Blood Flow Restriction: Fast, Effective, Safe Body Transformation

KAATSU and slow strength training are my two favorite fitness biohacks.

From the injured athlete to the elderly to the sick, to the healthy and strong, BFRT enables anyone and everyone to stay fit.

You can use BFR training to pack on slabs of muscle and strength or lose weight faster. It boosts the brain, accelerates injury recovery, optimizes hormones, and slows the aging process.

I think of BFR bands as a pocket gym. With the two small bands, I can have a world-class workout even while traveling. No other equipment is needed.

Best of all, you can dive into BFR training for next to nothing to see just how well it works for you.

Then, when you’re ready to safely accelerate your results, my KAATSU review explains how it’s the ultimate upgrade.

Have you tried blood flow restriction? How’d it work?