What Is Blood Flow Restriction (BFR) Training?

The Ready State Guide to BFR (Blood Flow Restriction Training for the Masses)

Every day, tools new and old hit the market for improving our fitness and health. One thing becomes novel again while another falls to obscurity, and the cycle repeats. One of the newest and oldest tools gaining traction is Blood Flow Restriction bands/cuffs.

You might have seen this or that pro athlete with straps around their biceps or hips while hitting the dumbbells. These are BFR bands.

Though by no means new, BFR bands are surging in popularity for many good reasons. In the past, they’ve been overlooked or even avoided due to false-fears surrounding the idea of restricting blood flow.

With modern research, however, BFR has proven to be not only effective, but wildly safe. But why would you want to restrict blood flow?

The reasons are many. In the world of fitness, BFR has shown itself to be incredible for building muscle and strength fast with minimal resource requirements from the body. This is awesome both for professional athletes as well as newcomers or the elderly.

But usually this is where the conversation stops: fitness. Here at The Ready State, we aim beyond looking good in the mirror. We also want that beach bod to function.

So in this guide, we’re going to give you our low-down on BFR bands. How they can be used for fitness, sure, but also the incredible ways they can be used for health and mobility (at all ages.)

Without further adieu, let’s chat about BFR.

A Brief History Lesson (How BFR Training Works)

We’ve got a lot to cover on how to use BFR training and we’re going to get to that quickly but first I want to take a moment to teach you the history of BFR so you can understand how it works.

BFR stands for Blood Flow Restriction, as you probably already caught. In simple terms, that is exactly what it is and how it works. BFR Training involves wearing cuffs on the arms just below the shoulders and/or on your legs just below your hips, which are tightened to restrict blood flow.

The first BFR bands date back as far as the 60s with the KAATSU system from Japan. Dr. Yoshiaki Sato envisioned a way to build strength and heal injury with minimal wear and tear back in 1966. His vision would come to fruition in 1973 when he developed the KAATSU training method.

Since then, BFR training has become wildly popular in Japan, where whole gyms are dedicated to the use of KAATSU devices and there is now a long history of use and research.

It’s been much slower to take in the west, partially due to a misconception that BFR could be dangerous, but Dick Hartzell really brought the technology to the forefront with his jump stretch bands in 2009. Since then, fears around BFR bands have been proven false, and the devices have grown in popularity across rehab and professional sport.

BFR Is So, So Safe.

There’s a phenomena which often occurs in science where safety (or danger) is over-simplified based on logical fallacies. For example, Ancel Keys’ entire diet-heart hypothesis which led to the nation-wide demonization of dietary fats was based on the fact that lard would clog a kitchen sink. His belief was that eating lard would similarly clog the vessels of the body.

This notion completely ignores the fact we are not a kitchen sink. Our body is full of enzymes which break down our food, including fat.

The caution around BFR is a bit like that.

Wearing a BFR cuff restricts blood flow. Logically, fears emerged around the potentially damaging effects of this.

However, our bodies are more complex than that. No one ever talks about raises in blood pressure in a local tissue from lifting weights, yet that is also occurring.

And just like lifting a weight, your body will signal you well and truly before you hurt yourself with BFR. These days, BFR devices are prolific to say the least, and have been thoroughly researched. There are over 10,000 direct to consumer BFR products on Amazon alone, rife with even more tens of thousands of reviews.

In practice, the few cases of cardiac or clotting-related issues from BFR come from gross misuse, such as wearing the bands at tight pressures for hours a day, multiple days a week.

The blood-clot fear has been proven false.

Now, that’s not me saying there are no risks, but use your noggin on this. As with anything, maybe don’t mess around with BFR if you have a heart or blood pressure condition. Take caution if you have clotting issues like sickle cell anemia or other problems, and always consult your doctor.

But if you are healthy, know that it takes quite the extreme bit of user-error to hurt yourself using BFR.

A couple good rules of thumb:

  • Don’t wear BFR bands at tight pressures for long periods of time or all day long
  • If you feel tingling or numbness, take them off
  • You should not feel extreme discomfort using BFR bands. Lighten up.

Picking Your Bands

If you hop on Amazon you’ll find tons of BFR bands. Once upon a time the only way to access this technology was through physical therapists using multi-thousand dollar devices.

Now, you can get manual cuffs for as little as $50 or monitored cuffs of medical grade quality for a few hundred.

As with anything, we believe it’s best to go with what you can access and not worry about the higher-end options if it makes a difference between starting or not.

With that said, we have specifically partnered with Suji BFR bands due to our estimation of their combo of affordability and quality. Suji’s bands are electronically monitored, medical grade BFR cuffs for a reasonable and accessible direct to consumer price point. We also have a special discount for The Ready State followers! Use code: TRS5 for 5% off your Suji BFR bands.

Usage Protocols

When it comes to using BFR, there are two types of consumer products available:

  • Manual Cuffs
  • Medical Grade Electrically Monitored Cuffs

Manual cuffs are as the name implies: Manually tightened. Often these cuffs use a tightening knob or latch or pumped up by hand.

Electrically monitored cuffs directly measure the level of occlusion, a fancy word for blood flow restriction, as you wear them, and will lower or raise pressure to maintain a very specific level of restriction.

Both are valid methods of BFR use, with advantages and disadvantages for each. Whichever you choose, training protocols remain the same. As follows are some use guidelines based on how we utilize BFR at The Ready State.

When using BFR bands, we consider there to be two levels of pressure. High occlusion, and low occlusion. High occlusion is when you wear the band at a higher pressure, upwards of 80% limb occlusion. (without causing tingling.) Most BFR use makes use of high occlusion. Low occlusion is more akin to wearing a compression sleeve, where your band is snug but not tight and can be worn for long periods.

Warm-up

Using BFR bands for warmups is fairly straightforward. One of our goals in “warming up” is to increase blood flow through the tissues to open up and integrate our range of motion.

This brings us to one of BFRs greatest applications: amplification.

In essence, you could just wear the bands during your usual warm up sequence for up to 3-5 minutes. You could also perform a simple 30 seconds on/off (work rest) in a movement or tissue you want to prep. This can be at any load or movement speed. You don’t have to be locked into lots of reps. It’s that simple.

Use a medium occlusion level (this might be as low as 60% occlusion or upwards of 80% if you are experienced) since you’ll likely wear them for longer than 3 or 4 minutes, and loosen or remove the bands if you feel tingling.

Workout Finisher

There are tons of programs, articles, and protocols out there already for using BFR in fitness. In this article I want to focus a lot more on the mobility and health applications, but I won’t go without throwing you a method to start things off.

BFR finishers are add-ons to your regular workouts using BFR bands to gas-out an exercise or muscle. This is one of the most popular ways to use BFR bands, and here at The Ready State we have a particularly effective protocol.

30 seconds on, 30 seconds off for 5 rounds at up to 80% measured limb occlusion pressure.

You can learn more about my Every Thirty on Thirty, or ETOT, method in this article: Every Thirty on Thirty

This method is highly effective for getting all of the fitness benefits of BFR rapidly. You can do it as a finisher at the end of a workout, or you can simply make up a workout. I don’t suggest doing more than one exercise per muscle group if you do and limit your total time under occlusion to 15-20 minutes. However, one exercise is also all you’ll need. You can make very short very effective workouts by utilizing this method.

Pain & Recovery

This is where the rubber really meets the road in terms of BFR’s ability to improve the lives of the most people.

One of the most surprising aspects of BFR is the ability it extends to us to continue to move and load injured or painful tissues while working with much lighter loads. There is excellent research to support significant physiologic changes (strength, tissue development) with light loads and BFR. The most studied protocol is to perform 30 repetitions of a movement, followed by 30 seconds of rest. This is followed up with three more working sets of 15 repetitions partitioned by 30 second rest periods. As you can tell, 75 reps in roughly 5 minutes of work could be a ton. To this end we’ve even applied our 30 second work/rest protocol with tissues that need to be moved more slowly and had amazing outcomes.

The widespread use of BFR has led to other great applications as well. The first is just a recovery flush that’s akin to getting a good pump before leaving the gym while simultaneously developing vasculature and even improving VO2 max!

Simply apply the cuffs to the upper OR lower body and choose a lower end pressure, like 60%. Jump on your cardio machine of choice (or even go for a walk) and set the timer for 15-20 minutes. If you’ve ever felt stiff or had discomfort after a run, bike, or gnarly pickleball session, give this a try.

The second recovery application can be done on your couch! Simply apply your bands to 80% occlusion pressure for 3 minutes. Then, deflate them and let your tissues come back up to feeling “normal” for 5 minutes. Repeat this cycle for 3-5 rounds of occlusion! As always respect your tissues, if you feel tingly or numb, your pressure is set to high!

Wrap Up

In conclusion, BFR is a powerful tool that has been around for a long time but whose time has come.

From warmups to recovery, from training with pain or loading after surgery, BFR is proving to be affordable and accessible. We have been teaching BFR in our courses for over a decade. We are thrilled that the technology has advanced to a point where we can offer people biomedical grade precision and safety in our homes and gyms!

This is one of the most exciting tools in the modern arsenal for improving and maintaining your Ready State.

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