The Official KAATSU Episode: Everything You Need To Know About How To Use Blood Flow Restriction For Muscle Gain, Injury Recovery, Testosterone, Growth Hormone & Much More!

KAATSU eliminates multi-day recovery time

Ben Greenfield introduces KAATSU by highlighting that it eliminates the typical 3-4 day recovery period after hard leg training, allowing you to train the same muscles again the same day or next morning.

"Gone are the days of, hey, I'm going to work legs hard today, and I can't do them again for three or four days. You can do them again the same day or the next morning, no problem."

How KAATSU differs from standard BFR

Munatones explains that KAATSU was developed with cardiologists over 13 years focusing on vascular elasticity, not just muscle building. The equipment is specifically designed to allow arterial flow while slowing venous return.

"But now I think probably we should hit the rewind button here for folks because we have not yet really laid this down. Define Katsu for me. What exactly is Katsu? Well, it's a Japanese word, ka, which means increase, and atsu, which means pressure. And Dr. Sato, his idea with katsu was to increase pressure, thereby expanding and contracting the vascular system and all the hormonal and metabolic and metabolite changes that come with expanding and relaxing vascular tissue. But it's a Japanese word. Okay. So in terms of the actual mechanism of action, we can take as deep a dive as you want. Explain to me, as I'm standing here with these two bands on my legs right now, and, of course, they could be using the arms, and I know some real cowboys, myself included, will occasionally, although this is against recommendations, put them on both the arms and the legs simultaneously. What is going on right now on a deep physiological level to my body as I have this thing running, either while I'm standing here or while I'm exercising? I think maybe we come back to that forelimb topic a little bit later, but from a mechanism perspective, you have the leg bands on right now. And I think it's important for your listeners to understand these are not tourniquets, right? These are elastic, pneumatic bladders inside these bands. Meaning to differentiate, sorry to interrupt here, but to differentiate what you mean by that is I have in the past, and I'm not necessarily opposed to this. I think you should get some value out of them, sent people to buy like blood flow restriction bands on Amazon. You know, there's like 40 to 60 bucks. You can get these bands that you can use almost like tourniquets to wrap around the limbs, which actually when I was a bodybuilder, we used to use like big gym towels or the resistance elastic bands at the gym to do this way back in the day. So like 20 years ago, I was kind of messing around with some of this stuff. But what you're saying is these katsu bands are different in a way. Yeah, exactly. The idea is never to occlude, to fully occlude. And what does that mean to occlude? So we don't want this to act as a tourniquet. So a tourniquet will fully stop blood flow, right? You know, you're on a leg cycle right now. You're on a pro, you're probably around 250 millimeters mercury, maybe a little higher. Let's see right now. I turned it up actually. I'm at 360 millimeters of mercury now. Okay, perfect. So if you had on a surgical tourniquet right now, and remember, a tourniquet doesn't give at all, and you were at 360 millimeters of mercury, you would be very close. And again, I'm not a researcher or doctor, so I don't know the exact pressure. But I know on me, for example, when I had a total knee, they never got my millimeres mercury on my leg tourniquet. That never got above 400. I think it was in the 300s and it was full occlusion. So it was time to do surgery, right? So that's full occlusion. These bands will actually not occlude at all. They're designed to give, and when the muscle moves, you know, when your quads and your hammies move and expand and relax, the band moves with the muscles, moves with the limb. So if you're moving, doing any kind of muscular pumping action, the blood's moving in and out. If you're totally passive, you still can't fully occlude or use it as a tourniquet. The blood's always moving. I think that's a key mechanism of action, key point as we kind of dive into this a little bit. Okay. So the tubing is actually allowing the blood to move in a different manner than something like a full-on tourniquet would, and that's important. Why? Well, we don't want to stop blood flow. Even if you have the leg bands as tight as they'll go, if you just take your thumb, let's say if you're wearing shorts, and just press into the meat above your knee, you'll always see that capillary refill. You'll never see that skin tone stay white. You're always going to have blood flow no matter how tight you make these things. Okay. All right. Got it. So you want to maintain blood flow so that you're not completely occluding a limb. And is that because you're able to actually achieve a better muscle contraction when venous flow is not completely restricted?"

Blood engorgement versus blood restriction

Munatones clarifies that KAATSU means "additional pressure" in Japanese and was never about restriction. The key mechanism is blood engorgement in the limb, which triggers deoxygenation during light movement and a robust hormonal response.

"So there's a variety of things that go on in the body, both locally in the working muscle. So in your case, your quads, your hamstrings, and your calves. And then also it's happening up at your brain with the release of growth hormone, adrenaline. Okay. A few questions here. Is this why when I do – so I've talked about on the show before how I have one of these Vaspers, which is, which is actually, it's like a cardio workout machine, like a full body cardio workout machine that has blood flow restriction, uh, almost like, uh, um, wrap around. I don't know if they're, if they're tourniquets, I suppose you would define them as that, that circulate cold water through the actual device. Or when I use these katsu training bands to train, is this why I feel almost like this really intense pick-me-up in mood and alertness after? Would that be the VEGF, or is that the IGF secretion? Is it the growth hormone? Do you guys know why there's such a, almost like a psychological effect of these things? Yes, that's actually endorphins, adrenaline. This is why athletes do this immediately before a world championship race or Olympic final. This is why an executive would do this right before a major presentation. Oh, yeah. That's one of my favorite things, by the way, to have this in my hotel room and do like a bodyweight workout before I go down to a conference room and give a talk when I'm at a hotel. It's my go-to workout because I feel like I'm just smarter afterwards. It's like an-to workout because I feel like I'm just smarter afterwards. It's like an exercise smart drug. Yes. We've done tests at the University of Tokyo Hospital where we placed actually people in MRI machines, had them have the katsu bands on. Of course, they're still."

Hormonal cascade from KAATSU including growth hormone timing

Munatones describes how KAATSU triggers beta endorphins, growth hormone, IGF-1, VEGF, nitric oxide, and plasmalogens. Growth hormone peaks 12-15 minutes after moderate exercise, enabling strategic timing before athletic performance.

"I think a key piece here is the cycle aspect. You know, when you think of what's happening when the bands contract like this, everything distal of the bands is, I look at it as almost like a physical stretching, right? You're stretching all the way down to the capillaries. You're stretching out open. You're holding it for 30 seconds. Your machine right now is going 30 seconds on, 5 seconds off. And each time it comes up in pressure, arguably, you're stretching capillary tissue, which means you're stretching all that tissue nice and wide open. You're essentially improving blood flow by opening those pipes up some. Does that get to your question? So my understanding is that you get this stimulation of muscle protein synthesis and satellite cell activity that's somehow occurring when the blood flow is actually restricted because there's a greater mechanical tension in the actual muscle belly itself. And when you combine that with the slight hypoxia, the buildup of lactic acid and kind of that acidotic state, the mitochondria, in addition to the muscle fibers, respond by growing in density. So essentially what you're doing is tricking the muscle, so to speak, into a hypertrophic state via hormonal trigger and also a blood flow trigger without the same type of cytokine-based inflammatory response that would normally occur when you heavily damage tissue. So it's almost like you're sending a signal that would normally be sent during like heavy eccentric training or highly inflammatory training and instead getting that signal sent via metabolic stress and hypoxic stress and some amount of acidic stress without the actual loading, which is why somebody who is, say, injured or elderly or doesn't have access to heavy weights or even doesn't want to produce like an inflammatory firestorm, which is one reason why I've been using it during this coronavirus thing, just because I want as little inflammation as possible while still getting the exercise response. I think that's kind of sort of what's going on here as far as the actual muscle response to this stuff. And when you look at a guy like Dr. Sato, from what I understand, he's actually kind of developed specific routines that maximize that response. What would be the best way to actually use something like this if someone's goal were, say, muscle gain? Like, what would an actual workout look like? Or how is Dr. Sato implementing these katsu cycles in his own training? So this is John. We were just in the backyard this morning during this, this modified lockdown. And, and we did a Dr. Sato chest and pull workout with, with Katsu. He will take, and you look at the guy and it looks like he throws around 300 pounds, no problem. And he can, but that's not how he works out. So he'll take the 45-pound bar and he'll do a set of somewhere between 60 and 90. And if he's able to hit those numbers, no problem. He doesn't increase the weight. Wait, he'll do 60 to 90 reps in one set? Yeah. Yes. Yeah. Really? Okay. With 40, 45 pounds. And if he can hit that, no problem. He doesn't add weight. And this is kind of his key, right? He adds pressure. And his reps go immediately down significantly after that first set. But that's how he works. He does very, very low weight. And a lot of times, uh, he does, uh, no weight. And that's the, and that's one single set that he's doing. Correct. Okay. And what about the tempo? Is he doing like super slow training? Uh, because I, you know, I talked in a recent podcast about how I found some success combining like kind of like the Doug McGuffuff Body by Science super slow training approach while wearing the BFR bands and found a great deal of efficacy in that. But how exactly is Dr. Sato approaching the tempo piece of things? If he's looking at muscle growth, he'll do three or four sets. Let's say we'll just take his arms, for example."