Occlusion Training/Blood Flow Restriction Training
What is it?!
Blood flow restriction training or Occlusion training is something I discuss with many of my gym going clients. But it’s not just to get a “crazy pump on”. There is actually a good to excellent amount of scientific backing to the use of occlusion training in muscle hypertrophy. Whether that is for strength gain, in preparation for competition, or part of rehab after an ACL reconstruction.
It’s commonly known that to achieve muscle hypertrophy (growth of muscle cells) under normal conditions a person must lift > 65% of their 1 rep maximum. Anything below this intensity is deemed to be inadequate to achieve muscle hypertrophy or strength gains . This is linked to the stress-strain curve of tissue load.
But what if I’m injured and can’t achieve this?
Being unable to withstand suitable loads is often a sticking point when it comes to the rehabilitation process, especially someone who is post-operative. Blood flow restriction training involves decreasing the blood flow to a specific muscle group, usually by the application of a “cuff” which evidence indicates that this type of training provides a positive training load adaptation equal to 10-30% of maximal load. Furthermore, muscle hypertrophy has been shown to occur during exercise as low as 20% of 1 rep maximum with a moderate vascular occlusion (~100mmHg). Obviously, this is a real benefit to someone who is yet able to achieve loads high enough to produce positive muscle gain results such as; knee reconstruction, ACL reconstructions and chronic osteoarthritis suffers .
What’s the science behind it?
The primary mechanism by which blood flow restriction training contributes to growth is; metabolic accumulation which stimulates a subsequent increase in anabolic growth factors, fast-twitch fibre recruitment and increase protein synthesis. Decreased expression of myostatins has also been observed . It can also lead to hypoxic and acidic environment resulting in lactic acid accumulation, which inhibits muscular contraction and recruitment of additional fast-twitch motor units to maintain force production. The additional fast-twitch fibre recruitment during occlusion training would be an additional factor contributing to increased muscle strength 
Does it actually work or is it just another gimmick?
A study in 2013 showed that low-load resistance training combined with either vascular occlusion or systemic hypoxia resulted in improved muscular strength and endurance. These results also where accompanied by substantial increases in cross sectional area and changes in voluntary neural activation. A 5 week standardised strength training programme, preformed only 3 times per week at very low resistance (20% or 1RM), led to large gains in maximal leg extensor strength and endurance with the use of occlusion training. A similar programme but at a higher resistance of 50% 1RM over an 8-week period with highly trained rugby players also resulted in a strength increase of 14.3% .
Occlusion training is something I use with certain clients and will continue to use with the correct populations. That may be someone returning from a certain operation that needs that assistance and muscle gain with low load, or it could be an elite athlete looking to achieve greater results from their strength programme. If you’re looking into implementing occlusion training into your regime make sure you have the advice and support from a clinician or trainer who knows what they’re talking about. Also, if you have any kind of vascular condition it is advised not to use occlusion training at any time.
Back to Sport. Back to Living.
 Loenneke, JP and Pujol, TJ (2009). The use of occlusion training to produce muscle hypertrophy. Strength and Conditioning. 77-84.
 Loenneke, JP, Wilson, GJ and Wilson, JM (2010). A mechanistic approach to blood flow occlusion. Sports Med Vol: 31:1-4.
 Manimmanakorn, A et al (2013). Effects of resistance training combined with vascular occlusion or hypoxia on neuromuscular function in athletes. Journal of applied physiology. Vol 113:1767-1774
 Yamanaka, T, Farley, RS and Caputo, JL. (2012). Occlusion Training Increases Muscular Strengthen Division IA Football Players. Journal of Strength and Conditioning Research. Vol 26:2523-2529.
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