By Dr Chris “Marv” Marvin DC

Blood flow restriction (BFR) training has become quite the rage as of late, but is it worth considering adding this to your own training routine?

If you want a spoiler alert, then I will just say…most definitely.

Before we cover those benefits and how you can incorporate it yourself, let’s look at its history.

The initial research on BFR training, also known as occlusion training, can be traced back to the late 1960s and early 1970s in Japan. The technique was initially developed by Yoshiaki Sato, a Japanese bodybuilder and weightlifting coach. Sato observed that wrapping a band or cuff around the limbs during exercise could lead to significant muscle hypertrophy and strength gains even with lighter loads.

However, it’s important to note that the scientific exploration of BFR training really gained momentum in the early 2000s, when researchers began to systematically investigate its physiological mechanisms and potential benefits.

I personally have been using this since 2010 during my personal trainer days running my own independent training studio and online platform before becoming a performance chiropractor. To me it’s the perfect blend of highly proven “meathead” performance benefits and legit rehab benefits – which is my happy place.

Here are 7 proven benefits of many with BFR (trust me there is more but focusing on meathead applications more than rehab):

1. Increased Muscle Growth
   -BFR training allows you to achieve significant muscle growth even with lighter weights. By restricting blood flow to the muscles, it creates a metabolic stress response that stimulates muscle hypertrophy and strength development.


2. Improved Strength:
   -BFR training enables you to increase strength levels using lower resistance. It activates fast-twitch muscle fibers and enhances neuromuscular adaptations, leading to improvements in strength and power.


3. Time Efficiency:
   -BFR training can provide similar results to high-intensity workouts with shorter rest intervals. This time-saving advantage is ideal for individuals with busy schedules or those looking to optimize their training sessions.


4. Enhanced Endurance:
   -BFR training induces a cardiovascular stress response, simulating a high-intensity aerobic workout. This improves endurance capacity, cardiovascular fitness, capillary density, and lactate threshold.


5. Faster Recovery:
   -By increasing the release of anabolic hormones and growth factors, such as IGF-1, BFR training promotes muscle repair and recovery. It reduces muscle damage, inflammation, and post-exercise soreness, allowing for quicker recovery between training sessions. It also decreases pain signals for up to 24 hours which can be helpful in acute settings.


6. Joint-Friendly:
   -BFR training allows individuals to achieve muscle growth and strength gains without placing excessive stress on joints. By using lighter weights, it minimizes the load on joints while still eliciting muscle adaptation.


7. Rehabilitation and Injury Prevention:
   BFR training has shown promising results in rehabilitation settings with improved soft tissue healing rates (i.e. ACL surgical repairs heal faster utilizing BFR cuffs). It can even facilitate the same muscle activation and strength gains from above in individuals recovering from injuries or surgeries. Additionally, BFR training can help prevent muscle loss during periods of immobilization or detraining.

In terms of incorporating BFR into your own training, you have several options. It is important to note that BFR training should be performed under the guidance of a qualified professional to ensure safety, proper technique, and optimal benefits.

1. Novel Stimulus for Hypertrophy
   BFR training can be used IN ADDITION to your regular heavy, progressive overload training; NOT in total substitution. But when called upon, I find it incredibly helpful when used in a cyclic approach utilizing it for 4-6 weeks straight before taking a similar break for putting on new muscle while allowing both your central nervous system (CNS) & joints to recover from high loading demands.


2. Improving Mind to Muscle Connection/Max Motor Unit Recruitment
   The mind to muscle benefit is purely anecdotal after using BFR the past 14 years. But, if I ever have a training client/patient who says they can’t “feel” their hamstrings working even on a leg curl, they do BFR and they most definitely will connect to the muscle (usually it takes 2-4 sessions and BOOM! They can start to feel hammies working on their regular leg curl sets).
   Another approach is to do a BFR isolation movement prior to a big compound lift (i.e. leg extensions before a Pendulum squat). I PROMISE you will feel your quad muscle working in ways you never knew existed – just know that while you will have to lower the loading on that next compound set, you will absolutely know you got a good training stimulus.


3. Increase Strength Levels
   I found this helpful when someone is at a strength plateau. The key is to not do a full BFR protocol, or they will be excessively fatigued (I will outline what I recommend below). Instead, I’ll have someone do 2-3 rounds of 10-15 reps of a similar movement pattern (i.e. leg press if they are stalled on their BB back squat), take the cuffs off, wait 3-5 minutes, and then return to their compound lift they’ve been stalled on and BOOM! they will almost always hit a PR (I will sneak a tiny bit more weight on the bar when they aren’t paying attention so when they complete the rep they’ve officially added more weight – this approach works well with lower rep sets not high rep, WIdowmaker style sets).


4. Injury Recovery (or Exercise Substitute)
   I find BFR great at helping folks heal quicker from injuries and allow them to keep training the effected body part without causing harm (i.e. bicipital tendinitis with BFR curls, Achilles injury recovery with BFR calf raises from the floor once cleared to start loading it, etc). YOU MUST BE CLEARED BY A HEALTHCARE PROFESSIONAL TO MAKE SURE YOU ARE A GOOD CANDIDATE FOR THIS SO DO NOT ADD ON YOUR OWN


5. Vacation/Short Time Window Workouts
   If all you have is 15-20 minutes, BFR is great for vacation workouts or short window workouts. All you need is a set of bands for your arms and possibly your legs. I have my clients perform banded “pump” sets (i.e. 30-50 rep sets) for their chest and back after doing BFR sets for biceps, triceps, and legs (you can simply do a squat or separate quads and hams if desired). Just know that I strongly discourage you from doing standing calf raises that involve a stretch with the cuffs below your knees – every few years I think that’s a good idea on vacation and then spend the next 5-6 days hobbling around from CRIPPLING delayed onset muscle soreness (DOM’s). If you are insistent on doing BFR for calves, just put the cuffs up high on your thighs and avoid an excessive stretch if straight legged (bent knee I have no issues with personally, but I would still try it out first before on a vacation that requires lots of walking).


6. Cardio Gainz
   This has been great for my ultra-endurance patients as of late after research came out that BFR can literally increase your femoral artery diameter size. We have them put their BFR cuffs on their legs and do 10 minutes of easy steady state cardio (i.e. walking on treadmill, using a spin bike, etc). Sure, you could combine this with HI-IT cardio, but I think that’s a bit excessive and would rather folks split those up to maximize training adaptations.

Now, how do you perform BFR sets?

I officially only recommend the protocol that Dr Jeremy Leonneke made popular outside of cardio and strength plateau applications I outlined above. You can use very fancy setups that actually measure limb occlusion pressure (similar to a BP cuff – this is the only medical grade BFR cuff set that I recommend which you can even use your HSA/FSA funds to purchase – use promo code Dr Marvin Says for well over $100 off) or just use knee wraps, BFR or quick release medical tourniquets (if you don’t have the funds for the medical grade kit these are the quick release BFR bands I used for over a decade).

If you’re not actually measuring arterial pressure with a BP cuff like system, then the rule of thumb is 7/10 tightness for broader width instruments (3” knee wraps), 8/10 tightness for the medium width instruments (1-2” BFR quick release tourniquets linked above) and 9/10 tightness for thinner (.25” wide quick release tourniquets – I no longer recommend those).

Pick a load that is light, so 30% of your 1RM (most weight you can lift for just 1 rep).

30 reps followed by 30 seconds rest then 3 more sets of 15 reps each spaced with another 30 second rest interval, then CUFFS OFF!!!

Remember, BFR training is a specialized training method, and it’s crucial to consult with a healthcare professional if you are dealing with an injury or a certified strength and conditioning specialist if healthy before incorporating it into your fitness routine.

Dr. Chris “Marv” Marvin is a performance chiropractic clinician and co-owner of Coastal Performance Chiropractic in Seabrook, TX specializing in nutrition, fitness, human performance and rehabilitation.
Dr. Marv has been involved in health, wellness and fitness for over 16 years. He earned his BS in Exercise Science from Sonoma State University and his Doctorate of Chiropractic from Palmer College in San Jose, California as class valedictorian.

Dr. Marv acquired extensive experience in the physical therapy space, as well as in the corporate gym environment as a fitness coach and specialist. He owned and managed a private training studio, specializing in one-to-one and online training.

He has received notable media mentions from media outlets including Men’s Health Magazine, The Huffington Post, and The San Diego Union Tribune. In addition to his exercise expertise, Dr. Marv has spent over a decade learning about evidence-based nutrition and supplementation strategies for both the general population and the elite athlete, culminating into writing a book on nutrition.

In his personal life, he has competed as a sprint triathlete before falling in love with bodybuilding and beach volleyball.

If you reside within the Houston Bay Area, you can learn more about all he offers with performance chiropractic care and nutrition coaching here.

If you reside within the state of TX you can learn more about telemedicine video calls here.

Inquiries for online hypertrophy coaching and fitness/health consults can be made here.

The best way to reach out to him and see how he approaches performance chiropractic care and hypertrophy training is via his Instagram.