The most effective strength training program in the world: Blood Flow Restriction Training

Workout Anytime
Greg Maurer

Blood Flow Restriction Training was first pioneered in Japan 50 years ago and was called “Kaatsu”. Ka means “additional” and atsu means “pressure.” In America the method is called “blood flow restriction training,” (BFRT) and involves performing strength training exercises while restricting blood flow to the extremities.

One of the many benefits BFRT is that you can use just 30 to 50 percent of the weight you’d normally use while still obtaining the maximum benefits of heavy resistance training.

Cuffs or bands are used that are just tight enough to allow arterial blood flow but not venous flow. The cuffs are placed on the upper arm between the shoulder and top of the bicep and at the top of the thighs right under the gluteal muscles.  BFRT causes lactic acid and other waste products to build up triggering a local and systemic response that provides you with all the benefits of lifting heavy weights without the associated risks and stresses on joints and tissues.

For this reason, it’s a great strategy for those with injuries, older people who cannot safely tolerate loads, and those who are recuperating from an injury or anyone who wants all the benefits of heavy resistance training without the risks!

How does BFRT Work?

The concept idea behind blood flow restriction training is to restrict blood flow using a band around the upper portion of the arm or leg being worked. This creates a metabolic disturbance that has local and systemic effects:

  1. A safe decrease in oxygen along with an increase in the acidity of the muscle tissue stimulates protein synthesis through an adaptive response to the stressor.
  1. The central nervous system also senses the challenge and compensates by increasing sympathetic tone, heart rate, ventilation and sweating. This generates a tremendous cardiovascular response and benefits along with accentuated hormonal response.
  1. Although using light weights by reducing oxygen levels muscles are forced to use anaerobic pathways and Type 1 Endurance Muscle Fibers are quickly fatigued so muscles turn on the fast-twitch Type 2 fibers which is what is required to make significant gains in strength and muscle size.

The low oxygen conditions generated through BFRT causes the release of Vascular Endothelial Growth Factor (VEGF) and Hypoxia-Inducible factor-1 alpha (HIF1A).  These factors generate a systemic affect throughout the entire body causing a robust increase in micro-circulation and blood vessel growth and repair.   Through this mechanism BFRT has been shown to increase muscle stem cells by 300% after 8 days of training.


BFRT also results in a very significant boost in Growth Hormone on par with the response to very heavy weightlifting.

BFRT also lowers myostatin which puts the breaks on muscle growth, and it produces these many powerful benefits while inflicting much less muscle damage.

Unexpectedly muscle growth occurs throughout the body because of the systemic effects.      The systemic increase in Growth Hormone also drives overall muscle growth.

BFRT Training Protocol

A typical training session uses three sets of 20 – 30 repetitions per set for 3 – 4 sets using half or less of the resistance you’d normally use. Rest between sets is short with typical rest time being 20 – 30 seconds.

Could BFRT Cause Injury such as Deep Vein Thrombosis?

Properly executed BFRT uses special inflatable cuffs that do not allow arterial blood flow to be cut off, so this IS NOT the same as putting a tourniquet on and is quite safe.   In fact, it is heavily used for cardiac and stroke patients in Japan.   The systemic effects of circulatory growth factors often result in improved circulation and lower blood pressure.  It is important to use cuff’s designed specifically for this process.

High Quality BFRT Equipment

There are several great companies providing specially designed BFRT cuffs that fit any arm or leg and provide the ability to apply a precise amount of pressure through a simple, small hand-pump attachment.   These high-quality systems do not allow you to apply to much pressure which could shut down arterial blood flow.   High quality systems include: – an outstanding system at a much lower cost than the original Kaatsu system below – original BFRT System

Contraindications for BFRT

  • Women who have had a mastectomy with or without radiation and/or an axillary node dissection should not use blood flow restriction training.
  • People in hemodialysis who have arterial venous fistulas. Avoid doing blood flow restriction on the affected limb
  • Pregnant women should not use BFRT
  • Cuffs should never placed on injured sites.

For more information on Blood Flow Restriction Training check out this video with one of the leaders in this type of Training Dr. Jim Stray-Gunderson:

Workout Anytime – Greg Maurer

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