|  4 min read

Four Evidence-Based Reasons To Include Blood Flow Restriction Training In Your Program

blood flow restriction training

This is a re-blog of a post written by Nick Licameli, DPT of the BFR Bros


We at the BFR Pros get asked all the time, “What ar the reasons to integrate blood flow restriction training (BFR) into a program?” You’ve got questions, we’ve got answers! Here are our top four evidence-based reasons (and the articles cited!) to include BFR training into your training regimen.

1. Increasing Muscle Hypertrophy and Strength Using Lighter Loads than Traditional Training (1, )2.

Low load training

For gains in muscle size and strength using traditional training, we typically have to use loads from 30-90% 1RM and & 70% 1RM, respectively. With low-load blood flow restriction training, we see similar gains in hypertrophy when compared to traditional heavy-load training. When it comes to strength, we see improvements in strength using low-load BFR when compared to traditional load-matched training. However, heavy-load traditional training typically outperforms low-load BFR, since strength is highly specific. The fact that we can illicit gains in muscle size and strength with light loads makes BFR a GREAT option for those who are load intolerant, such as when recovering from injury or surgery.

2. Increased Max Aerobic Capacity at Lower Intensities (3, 4, 5.)

Improved aerobic capacity

Think BFR training is only for strength training? Think again! When performing aerobic exercise with BFR, we see improvements in VO2 max in healthy young adults, but also improvements in strength, power hypertrophy, and functional outcomes in the elderly.

3. Pain Relief (5).

Pain relief

Not only can BFR training help patients and athletes train with lighter loads to work around pain, it can also decrease the actual pain itself! We’ve seen improvements in pain following ACL surgery as well as in those with generalized knee pain.

The Power of Blood Flow Restriction Training
  • A Peek Into the Power of BFR training
  • The Science of Fatigue

4. Ensuring Recruitment of Type 1 and Type 2 Muscle Fibers (6).

Muscle fibre recruitment

The nervous system activates muscle fibers based on how much force you need to produce. It starts with Type 1 muscle fibers, activating more and more until it needs to call upon Type 2 muscle fibers, activating more and more until you eventually can’t produce any more force. High threshold motor unit recruitment, and subsequently type 2 fiber stimulus is a MECHANISM through which BFR induces hypertrophy with lower loads than would normally be effective.

Learn more

Are you curious about Blood Flow Restriction Training (BFR)? Then we can offer you various free resources to deepen your knowledge:

Our podcast host Sunny had another more recent talk with Nick Rolnick that you can check out here.
If you prefer a summary of this podcast, check out the following video:

A recent research review by Karanasios et al. (2022) compared blood flow restriction training to sham on pain intensity, disability, and strength gains. Check out our research review here.


1 Gronfeldt et al. (2020). Effect of blood‐flow restricted vs heavy‐load strength
training on muscle strength: Systematic review and meta‐analysis

2 Lixandrao et al. (2017). Magnitude of Muscle Strength and Mass Adaptations
Between High-Load Resistance Training Versus Low-Load Resistance Training
Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis.

3 Abe T, Kearns C, and Sato Y. (2006) Muscle size and strength are increased
following walk training with restricted venous blood flow from the leg muscle,
Kaatsu-walk training. J Appl Physiol 100: 1460–1466.

4 Abe et al. (2010). Effects of low-intensity cycle training with restricted leg blood
flow on thigh muscle volume and VO2max in young men. J Sports Sci Med 9: 452.

5 Formiga et al. (2020). Effect of aerobic exercise training with and without blood
flow restriction on aerobic capacity in healthy young adults: a systematic review
with meta-analysis.

5 Hughes et al. (2020). The effect of blood flow restriction exercise on exercise-
induced hypoalgesia and endogenous opioid and endocannabinoid mechanisms of
pain modulation.

6 Bjørnsen et al. (2019) Type 1 Muscle Fiber Hypertrophy after Blood Flow-restricted
Training in Powerlifters.

****Remember, the decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.

Nick believes in improving quality of life and inspiring healthy living to make the world a happier, healthier, and more loving place. Bodybuilding and physical therapy just act as ways to give back and carry out that cause. He sees himself never as an expert, but always as a student starving for knowledge and improvement. Nick wants to be an impactful and positive resource from which his younger self would have benefitted and of which his older self would be proud. Nick graduated summa cum laude from Ramapo College of New Jersey with his bachelor’s degree in biology, then furthered his education by completing his doctoral degree in physical therapy from Rutgers School of Biomedical and Health Sciences (previously the University of Medicine and Dentistry of New Jersey) at the age of 24. He is a doctor of physical therapy, a professional natural bodybuilder, and the director of an outpatient physical and occupational therapy clinic. Dr. Licameli is also the Injury Reduction and Management Specialist for 3D Muscle Journey and has his own online physical therapy and wellness company, Strength Together Inc.
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