Ep. #443: Does Blood Flow Restriction (Occlusion) Training Really Work?

Three mechanisms by which BFR promotes muscle growth

Mike Matthews explains the three key mechanisms of BFR muscle growth beyond metabolic stress. BFR increases mTOR signaling (which says grow), decreases myostatin (which says shrink), and enhances autocrine signaling by keeping muscle-produced hormones in contact with cells longer.

"studies show that blood flow restriction training increases levels of mTOR and lowers myostatin levels, which creates an environment in your body that is more conducive to muscle growth."

BFR is safe when done correctly and you would need 2 hours of complete occlusion to cause damage

Matthews addresses safety concerns, explaining that BFR only reduces blood flow out of muscles rather than stopping it from entering. Studies on medical tourniquets show you would need to completely cut off blood flow for about two hours to cause nerve and muscle damage.

"studies on medical tourniquets have shown that you would have to completely cut off blood flow to a limb for about two hours to cause nerve and muscle damage. So basically to get hurt with BFR, you have to deliberately try to get hurt."

Save BFR for accessory exercises after heavy compound lifts with specific programming

Matthews provides concrete programming advice for BFR. Start workouts with heavy compound lifts, then add 3-5 BFR sets on isolation exercises at 50% 1RM for 20-30 reps with a 2-0-2 tempo. BFR should supplement traditional training, not replace it.

"And by keeping blood pooled in the muscles for longer periods, these hormones have more time to interact with muscle cells. And yet another way that BFR can help you gain muscle faster has to do with what happens when you push your muscles to the point of failure, where you simply can't get another rep. Not technical failure, which is the point where you can't perform another rep with good form, but true muscle failure. You've probably heard that muscles only grow in response to the last few reps of your sets, you know, the grinders that really light your muscle bellies on fire. And while that is not exactly true, it's not entirely off base either. You see, one of the easiest ways to ensure you continue to overload damage and fatigue your muscles is to frequently push them to failure or close to it. Of course, that's my general recommendation for training is close to it. One to two reps shy of failure is a good rule of thumb. When you do this, you activate much higher amounts of muscle tissue than with easier sets. If you were leaving, let's say five reps in the tank on your hard sets or your working sets, you wouldn't activate nearly as much of the muscle tissue as if you were leaving just one to two reps in the tank. And that alone positively influences muscle building. And that is why regularly pushing your muscles to the point of failure or just shy of it is a very important aspect of gaining muscle and strength. It's really one of the fundamentals. Now with a normal weightlifting set, you only reach this point of muscle failure or at least close to muscle failure at the very end of the set after you've done several reps. Therefore, if you wanted to increase the number of times your muscles taste failure in a workout, you just have to do more and more sets and more and more reps. And that's well and fine, but you can only do so much work per major muscle group, per workout, and per week before you reach the point and exceed the point of diminishing returns and before your body starts to fall behind in terms of recovery and then symptoms related to overtraining can set in and so forth. And that's especially true if you are doing a lot of heavy compound weightlifting like you should be. Blood flow restriction training is helpful in this regard though because while it doesn't inherently boost muscle activation levels more than normal training, it does allow you to achieve higher total levels of muscle activation in a workout with less muscle damage than would otherwise occur. In this way, BFR is similar to rest-pause training and, in a sense, kind of tricks your muscles into thinking that you are using much heavier weights than you really are. Hey, quickly, before we carry on, if you are liking my podcast, would you please help spread the word about it? Because no amount of marketing or advertising gimmicks can match the power of word of mouth. So if you are enjoying this episode and you think of someone else who might enjoy it as well, please do tell them about it. It really helps me. And if you are going to post about it on social media, definitely tag me so I can say thank you. You can find me on Instagram at Muscle for Life Fitness, Twitter at Muscle for Life, and Facebook at Muscle for Life Fitness. So let's summarize here. Let's summarize the benefits of BFR. By using lighter weights, your tendons, ligaments, and joints are not placed under as much strain, which allows you to do more volume with less risk of injury or overtraining. And this can also be helpful if you are injured or you are dealing with some nagging aches and pains. BFR allows you to train more effectively with lighter weights that hopefully don't aggravate the problems that you are having. BFR is also nice when you are training in a poorly equipped gym because it allows you to produce a decent muscle building stimulus with lighter weights like a hotel gym, for example, that just has a bunch of lighter dumbbells. Another benefit is assuming you are not a new weightlifter, research shows that adding BFR sets to heavy traditional sets can increase strength more than just heavy training alone. Another benefit on the list is if you are deloading or you're taking a longer break from training, you can use BFR to better maintain your conditioning with much less muscle damage and fatigue. And last but not least, if you're just not feeling up to a heavy workout for whatever reason, you can use BFR to have an effective but less stressful training session. So as you can see, there are plenty of reasons to dabble with this rather unusual training method, but is it safe or should I say, is it dangerous? That's the question that I often get asked. And I understand because stinting blood supply to muscles while working out definitely sounds like a bad idea. It sounds like something that probably has a long list of nasty side effects, something that WebMD would not recommend. Surprisingly, though, research shows there is no evidence that blood flow restriction training is dangerous when it's done correctly, of course. Now, when you dig into the details, when you get past the first impression, this actually does make sense because remember, it only involves reducing blood flow out of the muscles, not stopping it from entering the muscles, which would be dangerous indeed. Now, this means, of course, you have to make sure that the cuffs or the bands that you're using are not too tight, but as you will soon learn, this is pretty easy to do. If they are tight enough to cause problems, they are going to be very uncomfortable, and you are going to start losing feeling in your limbs, which, of course, is impossible to miss. And even if you're the real gung-ho, no pain, no gain type, studies on medical tourniquets have shown that you would have to completely cut off blood flow to a limb for about two hours to cause nerve and muscle damage. So basically to get hurt with BFR, you have to deliberately try to get hurt. You have to really make a big mistake to mess it up. Now, one other common concern with occlusion training is that artificially increasing muscle pump and swelling is going to damage your muscles in some way. Some people claim that, and that is untrue. This will not happen. Remember, the same effects happen when you do a lot of reps to failure. BFR just makes those effects last a little bit longer. All right, so let's talk about how to do this correctly. How do you do blood flow restriction correctly? Well, the first thing you need to know about BFR is it is just for arm and leg training. There is no practical way to restrict blood flow in any other major muscle group. And the first thing you are going to need to actually do it is a way to reduce blood flow. Now, quick release medical tourniquets tend to be the best for the arms and elastic knee wraps or exercise bands are usually easiest for the legs. Next up is learning how to wrap your arms and legs properly. Now, if you're wrapping your arms, you got to make sure that the band is tucked into your armpit. If you're wrapping your legs, the bands should be nudged up against your crotch. Now, in terms of tightness, you should be going for a nine out of 10 for the arms and a seven out of 10 for the legs. If you want to find a good video on this, just head over to the YouTubes and search for bodybuilding.com blood flow restriction, and you'll find a video. The title is diametize project mass blood flow restriction, and it's a good breakdown of how to do it. So once you have the right tools and you know how to use them, you are ready to go from here. all you need to know is one, you should just continue with your current strength training or weightlifting plan. Remember that BFR is something to be worked into a well-designed workout program. It should not be all that you do or even the emphasis. Think of it as supplementary. You should also save blood flow restriction for your accessory exercises. So I still recommend that you begin your workouts with your heavy compound lifts, your hardest lifts. That's generally the best way to program. Of course, you can deviate from that for various reasons, but if you're like most people who are just wanting to gain whole body strength and size, you're going to want to start your workouts with your hardest sets. And those are the core muscle and strength builders, right? And so save the BFR for later in your workouts. And specifically, I recommend that you use it on your accessory exercises as they are generally called, you know, the isolation exercises that you can safely take to muscle failure, the dumbbell curl and triceps press down and leg extension and hamstring curl and so forth. Now, as far as programming it goes, I recommend that you start with three to five BFR sets per workout and at the end of your workout with a weight that allows you to do about 20 to 30 reps. So it's going to be somewhere around 50% of your one rep max if you are an experienced weightlifter. And I also recommend a 202 rep cadence, which means two seconds down, no pause, and about two seconds up. And that's really all there is to it. Now, before I sign off, I have to share four mistakes, four BFR mistakes that people make that I do not want you to make, because while it is pretty simple, there are definitely ways to mess this thing up. So here are the four most common mistakes that I see people make. So the first one is using blood flow restriction before it can really benefit them. So studies show that beginners actually don't benefit as much from BFR as more advanced weightlifters. And the reason for this is very simple because when you are new to weightlifting, your body is hyper responsive to it, right? So it reaches its anabolic ceiling, so to speak, fairly easily with the simple stuff, proper diet, progressive overload, heavy compound weightlifting."

Four common BFR mistakes including using it too early as a beginner

Matthews outlines four mistakes to avoid with BFR. Beginners should wait at least a year since their bodies are hyper-responsive to basic training already. Other mistakes include wrapping too tight, using too much weight, and replacing heavy training entirely with BFR.

"if you have less than a year of proper weightlifting under your belt, shelf BFR for now, just stick with traditional lifting and get into your intermediate phase before you dabble with it."