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Blood Flow Restriction Training (BFRT): Everything You Need to Start

Fitness hasn’t changed much throughout my life.

But, I’ve experience two paradigm shifts:

  1. First, Dr. Doug McGuff shattered the aerobics myth. I wrote a tutorial on how you can get the benefits of running from just one set of intense super-slow resistance training.
  2. Next, this lesser-known bodybuilding tactic called blood flow restriction training.
Blood flow restriction training is the ultimate body and brain-enhancing fitness biohack. Available to anyone, anywhere, for myriad uses. Click To Tweet

This new form of bodyweight training builds strength and muscle, enhances brain function, speeds up recovery from injury, improves energy generation, and is low-impact. Today we’ll explore this fitness panacea, its pros and cons, the best BFR bands on the market, and how you can start training for maximum results.

What is Blood Flow Restriction Training?

Blood flow restriction training is an effective exercise hack that slows the return of blood from the muscles to the heart. You can build strength and muscle mass with extremely light loads, or just bodyweight, making it far safer than conventional strength training. Blood flow restriction is a form of high-intensity training that “tricks” your body into producing beneficial adaptations that usually accompany heavy lifting.

Wrapping an elastic band around extremities at a specific pressure causes the blood to “pool” in the muscle, unable to escape. Afterward, removing the bands floods the body and brain with the once-trapped blood. Nutrient-rich metabolites, hormones, lactate, and brain-derived neurotrophic factor (BDNF) act as a biological hardware upgrade.

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 through changes in neuroplasticity
  • Stimulating body change with fast recovery
  • Exercise warmup and cooldown
  • Anti-aging protocols

I stumbled upon it in 2013. As a novice to collegiate rugby, 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.”

Dr. Mercola

Overview

Makes healthy people stronger and fitter

Shorter workout sessions

Combinable with most exercises

What makes it so exciting?

How Blood Flow Restriction Training Works: The Science

BFR Training Mechanisms of Action
Source

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 introduce BFR to their injured, muscle-atrophying athletes:

Systemic Benefits From Locally Wrapping Limbs

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.

The answer hid in plain sight: it doesn’t. At least, not directly.

BFR 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 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 their arm curl strength.

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

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

The Pros & Cons Blood Flow Restriction Training

BFR training is all about gaining more from doing less.

No tool is perfect. Weigh these options for yourself.

Benefits

Low-impact. Useful for sensitive body parts.

More benefit from low-intensity activities like walking

Cardiovascular benefits

Extremely portable

Non-taxing, can be used daily

Adaptable to any workout

Enhances the brain

Increases muscle strength

Huge growth hormone response to training

Increases hypertrophy (muscle cell size)

Quickly improves muscle endurance

Improves muscle protein synthesis

Reduces the muscle-limiting myostatin myostatin

Boosts nitric oxide

Activates muscles in atypical ways

Shortens workouts

Improves metabolic health

Drawbacks

Requires equipment

At least two sessions per week recommended

Important to get pressure right (trial and error with most devices)

Must push extremely hard to get maximum benefits and replace traditional workouts

Cannot target specific body parts

Kaatsu, the most studied form, is expensive

Dangerous for anyone with a history of blood clots

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 using 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 being short explosive bursts of movement. I wouldn’t do BFR sprints, but bodyweight squats are fair game.

The best exercises are the ones that 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 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 bodyweight 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:

SetRepsRecovery Time Between Sets
Set 130 reps20-30 seconds of recovery
Set 220-30 reps20-30 seconds of recovery
Set 315-25 reps20-30 seconds of recovery
Set 410-15 reps20-30 seconds of recovery
Set 510-15 reps (ideally to failure)20-30 seconds of recovery
An intense BFRT session

Get Your BFR Straps Today

Since I started using BFR bands in 2013, all kinds of new options have appeared.

I’m now on my second pair that’s serving me just fine.

One myth in particular bothers me.

Despite what you hear, BFR bands are not all the same.

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

  • Imprecise pressure decreases their safety and effectiveness.
  • Improper band width. 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.

Beginner BFR Bands

I’ve had great success with my cheap-o 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 don’t mind the fraying and recommend that everyone start with a basic pair.

You can pick up a pair of decent $20 BFR bands:

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

My two pairs have held up for years. But they’re on their way out. When they do, I won’t buy them again.

Best BFR Bands

I went from skeptic to convert quickly. Recently, 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, B Strong makes the highest quality bands available. I plan on upgrading and expect to pass these premium BFR bands down the generations.

You can skip straight to the best pair on their website here:

Common Blood Flow Restriction Training Questions Answered

Does blood flow restriction training really work?

Blood flow restriction training is a safe, low-impact form of exercise suited for injury rehab, strength & muscle building, bulking up, workout recovery, building cardiovascular fitness, and staying fit. It’s especially effective in the elderly and injured since they often cannot perform intense exercise.

Can you workout the pecs, shoulders, and back muscles with BFR bands?

You can workout (but not isolate) all muscle groups including the pecs, traps, posterior chain, shoulders, and back using BFR bands. Strength and muscle gains come from the systemic effect of hormones and metabolites rather than direct muscular tension.

Can I do BFR training everyday?

Yes. Your BFR training frequency depends on the type of workout, session duration, age, and fitness level. Perform intense sessions less frequently than activities like walking with BFR bands on. I personally use BFR training most days as either a workout or recovery strategy.

How long should you wear BFR bands?

While generally safe, BFR sessions should be short. Keep your upper body workouts to 15 minutes, and 20 minutes or less for lower body workouts. This prevents accidental damage in case your bands are too tight and they cut off circulation.

Is blood flow restriction training beneficial for athletes?

Athletes can benefit from blood flow restriction training in multiple ways. Faster recovery from strenuous workouts and practice. Muscle-building and maintenance in-season where recovery becomes critical. Strengthening the cardiovascular system. More easily training while traveling.

Can I still lift heavy & intense with BFR training?

Intense, yes. Heavy, no. Avoid combining BFR with heavy weight. Multiple studies show little benefit but increased risk of injury from increasing weight beyond 40% 1RM. I have a mental block around completely eliminating heavy weight training. I lift heavy separately from BFRT.

BFR: The Effective Cutting-Edge Fitness Hack

BFRT and slow strength training are my two favorite fitness hacks I’ve discovered.

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 needed.

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

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

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