top of page

Maximizing Muscle Growth: The Science Behind Blood Flow Restriction Training in Physical Therapy Rehab

Updated: Mar 29

Blood Flow Restriction Training: A Cutting-Edge Technique for Physical Therapists

Blood flow restriction training (BFRT) is a novel technique that involves applying a tourniquet-like device to a limb to partially occlude blood flow during exercise. This creates a hypoxic environment in the muscles, which stimulates metabolic and hormonal responses that enhance muscle growth, strength, and endurance.

BFRT has been shown to have various benefits for different populations, such as athletes, older adults, and patients with orthopedic injuries. In this blog post, we will focus on how BFRT can be used by physical therapists to help patients recover from knee injuries, such as anterior cruciate ligament (ACL) tears and meniscus damage.

How BFRT Works

BFRT works by creating a low-oxygen environment in the working muscles, which triggers the release of growth factors and hormones, such as human growth hormone, insulin-like growth factor-1, and vascular endothelial growth factor. These substances stimulate muscle protein synthesis, angiogenesis, and stem cell proliferation, which lead to increased muscle size, strength, and function.

BFRT also reduces the amount of mechanical stress and load on the joints and tendons, which can be beneficial for patients who have pain or limitations in their range of motion. By using low-intensity exercises (such as 20-30% of one-repetition maximum) with BFRT, patients can achieve similar or greater results than with high-intensity exercises without BFRT.

How BFRT Can Help Patients with Knee Injuries

Knee injuries are common among athletes and can result in significant impairments in mobility, function, and quality of life. One of the most challenging aspects of rehabilitating knee injuries is preventing muscle atrophy and weakness, especially in the quadriceps muscle group. Muscle atrophy can lead to decreased joint stability, increased risk of re-injury, and poor outcomes.

BFRT can help patients with knee injuries by preventing or reversing muscle atrophy and improving muscle strength and function. BFRT can also improve blood flow and oxygen delivery to the injured tissues, which can facilitate healing and reduce inflammation. BFRT can be applied to either the injured or the uninjured limb, depending on the goals and preferences of the patient and the physical therapist.

A Case Example of BFRT for a Patient with a Severe Knee Injury

To illustrate how BFRT can be used by physical therapists, let us consider a case example of a patient who had a severe knee injury. The patient was a women’s Division I basketball player who had a massive meniscus and ACL tear after a routine pivot. She underwent surgery to repair the cartilage and reconstruct the ligament.

The physical therapist decided to use BFRT as part of the patient’s postoperative rehabilitation program. The therapist applied a pneumatic cuff to the patient’s thigh and inflated it to a pressure that reduced the arterial blood flow by 50%. The patient then performed low-intensity exercises, such as knee extensions, leg presses, and squats, for 15 minutes, four times a week. The therapist monitored the patient’s pain, fatigue, and perceived exertion levels throughout the sessions.

The patient reported that the exercises with BFRT were challenging but tolerable. She felt a burning sensation in her muscles, but no pain in her knee. She noticed improvements in her muscle size, strength, and function after four weeks of BFRT. She was able to progress to more advanced exercises and activities, such as jogging, jumping, and cutting. She eventually returned to playing basketball at her previous level of performance.


BFRT is a cutting-edge technique that can be used by physical therapists to help patients with knee injuries recover faster and better. BFRT can prevent or reverse muscle atrophy, improve muscle strength and function, and enhance tissue healing and blood flow. BFRT is safe and effective when applied by a trained professional and tailored to the individual needs and goals of the patient. BFRT is part of the professional scope of practice for physical therapists and can be a valuable addition to their toolbox.

For those of you that got value from this blog post and are looking to take the next step in becoming a certified BFR specialist so that you can get your patients better and faster results, we've partnered with The BFR Pros to offer you one of the best certification courses available.

Here are some of our upcoming options:

29 views0 comments


bottom of page