Recovering from an injury or surgery requires a period of rest followed by a period of rebuilding to regain strength and return to normal usage. Physical therapy helps patients strengthen their healing tissues so they can safely resume their usual activities. Blood flow restriction is a type of therapy that allows patients to work their muscles or joints at a higher intensity level without the risk of injury.
Blood Flow Restriction
As its name implies, blood flow restriction therapy (BFR) partially restricts blood flow in a particular area of the body to aid in tissue repair. The physical therapist places a band or cuff around the affected area, such as the leg or arm. The cuff applies pressure to the targeted area and acts as a tourniquet. The pressure allows blood to flow to the injured area but restricts blood flowing away from the tissue.
By restricting blood flow from certain tissues, physical therapists direct the tissues to work smarter, not harder. BFR increases the intensity of the work the recovering tissue is doing during therapy, without putting additional strain on the tissue. Without BFR, it can take a long time to rebuild tissues with low-impact, low-intensity exercises. BFR maximizes muscle gain by boosting the work done by the patient and speeds up the recovery process.
Mechanism of BFR
During BFR, blood flows freely through arteries to the affected tissues. Pressure partially blocks venous blood flow away from the tissues. Under these conditions, BFR mimics the effects of a more strenuous workout. BFR improves protein synthesis, which promotes muscle fiber growth. The therapist starts at a lower pressure and gradually increases the percentage of restriction over time as the tissues become stronger.
Candidates for BFR
Orthopedic patients recovering from sports-related or overuse injuries such as tendon and ligament tears, joint pain, joint replacement surgery, or shoulder repair surgery are ideal candidates for BFR therapy. Elderly patients can benefit from BFR because it allows them to gain strength while performing less vigorous exercises. Patients who suffer from osteoporosis or are recovering from bone fractures can also benefit from BFR.
Contraindications of BFR
BFR is not an appropriate therapy for all patients. Some conditions make it unsafe to apply pressure or restrict blood flow in certain parts of the body. Physical therapists should not attempt blood flow restriction therapy with patients who have:
- Wounds or incisions that have not healed.
- Cardiovascular issues.
- Poor circulation.
- Swelling in the affected tissues.
- Certain types of cancer.