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Published on August 28, 2019

closeup of mans legs during blood flow restriction therapy

Physical Therapy Approach Restricts Blood Flow to Build Muscle Faster

It’s time to rethink the tourniquet – especially for post-surgical physical therapy.

New techniques that incorporate blood flow restriction (BFR) – using specialized tourniquets and monitors -- can help many patients strengthen muscles during recovery. The process also can reduce scarring and atrophy. People can work muscles while incisions heal and be closer to “ready for action” when their doctors say they have improved.

“We’ve used it for about a year and had good results, and it allows patients to increase muscle mass while exercising with lighter loads,” said Ben Nebelsick, PT, DPT, a physical therapist at Avera Therapy in Mitchell. “We use a special tourniquet that restricts blood flow so patients can complete more exercise of different types as they work through their recovery time frame.”

How It Works

The human body has a specific ratio when it comes to muscle-building that is necessary to increase muscle mass. If you can lift 100 pounds, for example, you’ll need to do exercises with at least 65 pounds to get muscles to grow.

Unless you are using BFR.

“In the 100-pound example, using BFR a patient could get muscle growth with a load as light as 20 or 30 pounds,” he said. “They can do more exercises sooner and get those muscles moving, growing and avoiding the degeneration that comes with inactive recovery.”

Not a Typical Tourniquet

Most of us probably think of the last resort stop-the-bleeding nature of a tourniquet that might be used in an emergency – or in a movie. BFR tourniquets are not like that.

“It restricts blood flow but only by about 80% in the legs and 50% in the arms,” he said. “The cuffs we use are specifically designed. They are safe and fit comfortably, and they are attached to a monitor so we can measure the rate at which blood flow is restricted.”

Professionals Needed

It’s important that patients work with a physical therapist to apply BFR, as they have the expertise and equipment to avoid putting too much pressure on a limb. The technique is not something anyone can do, even though the idea of building muscle appeals to so many.

“We can use it for non-weight-bearing limbs, in surgical recovery, and it helps on many levels including protein synthesis and opening pathways in muscles,” said Nebelsick. “It can help endurance athletes who are recovering from injuries like hamstring strain, too. Not all therapy clinics can offer BFR, though. It requires certification and proper equipment.”

One Portion of an Approach

Patients will use BFR a few times a week, along with other traditional therapy approaches, as they rebuild muscle and recover. Professional athletes may use the method several times a day – because it works. “We get many referrals and hope to make the use of BFR more common to help people who face pain, injury or recoveries,” said Nebelsick.

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