When I first started my physio degree (~2014), I remember being incredibly pumped (pun intended) about BFR/Occlusion/Kaatsu training. I spoke with one of my lecturers about it and wondered why it wasn't implemented widely in physiotherapy practice, as it's a no-brainer; low joint
forces, while still getting strength and hypertrophy benefits.
Over the years, I have used it on and off myself, and have programmed it quite a few times for clients. In particular, I have programmed it most for
1) trainees doing a lot of volume already who want to add more arm training but find it boring / want to minimise time commitment / don't need extra heavy loading,
2) rehab clients (e.g. post ACL reconstruction to regain quadriceps mass), and
3) those who don't have access to loads heavy enough to get a potent training stimulus (e.g. lower body training with light weights).
So, I do have quite a bit of experience using it myself and programming it for others, and it can certainly be a very useful tool. However, with that said, there are a number of reasons for which I have become less excited about it over the years:
1) While you can get robust responses with very light loads, that is also the case by simply working to failure with light loads without occlusion (we have written extensively about this here). BFR training is *very* painful, and while some people enjoy that, others would rather simply work to failure with light loads without the occlusion, so while the responses may not be the exact same, it's not quite a case of being a magic solution to a problem that couldn't be solved with other methods.
2) Another consideration is the fact that it is not a risk-free intervention. In research, the cuff pressure can be carefully calibrated so as to occlude venous flow without occluding arterial flow. In practice, people use bands, straps, tourniquets, and basically just put them on as tight as possible a lot of the time. The risk associated with this is not clear; there have been concerns that this might adversely affect the development
of clots or precipitate extreme muscle damage (rhabdomyolysis), and some studies have highlighted certain individuals who have these extreme responses with certain muscle damage markers. This is one of those cases where I can't say with any degree of certainty whether or not there is any increase in risk for a given individual, but it's worth making yourself aware of these considerations nonetheless.
Have a good day.
- Gary
