Blood Flow Restriction training is a technique that allows patients to achieve greater strength training improvements while lifting lighter loads. This reduces the overall stress on the limb, making blood flow restriction an attractive option for a variety of treatment options. The technique involves applying the appropriate amount of external pressure to an extremity (arm or leg), which helps maintain arterial inflow while occluding venous outflow distal to the occlusion site.

Blood Flow Restriction (BFR) training involves the use of a tourniquet or cuff system on either the arm or leg, or both simultaneously. To ensure safe application of BFR, a personalized limb occlusion pressure (LOP) calculation must be made. This can be done manually, but certain devices available on the market can automatically calculate this, improving accuracy and eliminating guesswork. Exercises are then completed using a particular percentage of the personalized limb occlusion pressure, depending on factors such as arm vs. leg, user tolerance, and desired outcomes.

For muscle growth with BFR, it is recommended to use 20% to 40% of 1 repetition maximums in combination with BFR cuff pressures set between 40% and 80% of limb occlusion pressure. The most commonly used practice involves four sets of repetitions (30, 15, 15, 15), which produce the beneficial adaptations noted in BFR. It is generally recommended to rest between sets of 30 to 60 seconds. It is recommended to have two to three BFR sessions per week, in line with the recommendations for skeletal muscle hypertrophy in standard resistance training of 2 to 4 times per week.

In addition to appropriate programming and the use of blood flow restriction, it is crucial to consider the characteristics of the blood flow restriction device being used. While research continues to demonstrate the effectiveness and versatility of blood flow restriction as a treatment method, attention has shifted to the devices themselves. It's important to note that not all devices are equal in terms of their features and capabilities. Features such as active pressure management (autoregulation), cuff width, and the ability to accurately and automatically calculate limb occlusion pressure can have an impact on the accuracy and safety of blood flow restriction delivery.

Limb occlusion pressures are typically measured at rest without taking into account the effect of muscle contractions on that measured value. When using a device with active pressure management, the pressure increase caused by muscle contractions is considered, leading to a more comprehensive understanding of the pressure being applied to the limb from the device. In contrast, a device without an active pressure management feature may result in a higher pressure reading than what would be expected during exercise conditions, potentially leading to a less clear understanding of the actual pressure.