Blood Flow Restriction Training: What Is It and Is It Right For You?
By: Dr. Jesse Espe, PT, DPT, CSCS, CIDN
So... What Is BFR exactly?
In order to fully understand what blood flow restriction (BFR) training is and how it works, first we need to brush up on how the cardiovascular system works. In a nutshell, your arteries carry oxygenated blood to your working muscles, then your veins carry the deoxygenated blood back to your heart. BFR was originally developed in the 1960’s in Japan, known as KAATSU training there, to play with this system and try to hack your physiology. Essentially it involves applying a band or cuff proximally to the muscle(s) being trained, typically upper arms and legs. The cuff is then inflated to a determined pressure. This pressure then will limit the amount of venous return out of the muscle while still allowing the arteries to carry oxygenated blood to the working muscles. Once applied, the athlete will complete a low load (20-30% of 1 RM), with high repetitions (15-30) with a short rest interval between sets (30 seconds).
Building From The Ground Up... Why The Foot and Ankle are so important for Injury Prevention and Performance!
We are currently in a day and age, where people want to know exactly what is going on with their body and the "why" behind it. We want answers and we want them now. Look at the increasing number of "wearable technology," DNA tests, rapidly accessible blood panels, and different imaging scans available. This is especially true when it comes to pain and lack of performance. Many times when an injury occurs in an area of the body or lack of strength or mobility is apparent in a certain area, we have tunnel vision in looking only at the area directly related to where the pain or lack of strength is located. Many times the area of pain or weakness is not the source of pain or weakness. Where should we be looking and why?
Think about this, 26 bones, 33 joints, and over one hundred small muscles and small tendons; and that’s just one of them. The human foot is one of the more intricate, complex and fascinating parts of the human body.
I mean we really only get 2 of these things to walk on for the entirety of our human existence. These are the two things that keep us in contact with the Earth. They are our main connection, but do we really pay attention to this connection? Are we in tune with foot/ground connection and how it plays a role in our every day function as well as performance in whatever sport we like to partake in.
There are many reasons why we need to pay attention to our foot and ankle in this kind of way.
Thanks for checking back in to the blog. I hope the last month has treated you well.
Today I wanted to talk about the topic of mobility, no not your ability to move around the country, but your ability for your body to move freely and without pain. Many of you have at one point in your life been told you are "too stiff" or "too flexible" or that you need to "Stretch more" or "stop bending like that." I, for example, had the nickname of "Gumby" because I was tall, lanky, and pretty flexible (which by the way lead to some injuries including chronic ankle sprains). Anyways, these are general terms directed at our physical "mobility." Now many different anatomical structures can effect our mobility such as our joints, muscles, ligaments, and tendons as well as other clinical conditions, but in general when people start to refer to your mobility, they are referring to how much range of motion you have in your joints.
Physical Therapists are trained professionals in assessing your mobility and how it is effected by all these different anatomical structures, but you for the most part are not and don't/can't have a physical therapist there for you to assess it every time. So it is a good idea to have a general understanding of where you are at on the "spectrum of mobility."
First off, It's been awhile since my last blog post. Almost 5 months to be exact. I apologize and am committed to getting back on track with my monthly blogs. I really have no excuse other than some mild disruption in my everyday life that occurred beginning in March. Like most of you, the COVID-19 pandemic created a significant shift in my work and home life for upwards of 3 months and is continuing today.
One of the main things I have noticed in my personal stay-at home experience is that I have been spending abnormally long durations of time on my computer and phone. This certainly was the case early on as I attempted to move my practice to telehealth and digital service offerings. This required a commitment to computer time that I knew would have a negative effect on my body, specifically on my spine and shoulders. Like most of you who were required to shift your work to the digital world, I began experiencing increased aches and pains through my low back and neck/shoulders and even at times began experiencing headaches, something I don't have a history of. This was obviously concerning to me, and as a physical therapist concerning for my patients and the general public.
Now as things have started to open up, and I am able to start seeing people again in the clinic, I am seeing a rapidly rising trend of low back pain and neck pain patients. Talking with many of these patients, the theme remains the same... "I began experiencing more back and neck pain as I have been working longer hours at home, in poor postural positions, with my laptop and phone, etc.."
I have no idea why??? Does this look familiar??
When many people hear the term "Out-of-Network," they generally assume that this is not the route for them, and that they must find an "In-Network" provider in order to justify all the money they pay for their health-insurance, and belief me I have also found myself stuck in that mindset at times, BUT...
In many instances, specifically with high deductible plans, people don't read the benefits of their plan that they have elected for. All these confusing words... Deductible, Co-pays, Coinsurance, Premiums…what does all this mean? Many times we assume insurance will cover "____." Hardly is this the case though.
In our present state of healthcare, there are significant disadvantages and expensive measures that insurances put in place to avoid paying for services. YES, Insurance will come in handy to save you from paying an exuberant $200,000 Hospital Bill following an unexpected health crisis, but with more an more emphasis being placed on company "profit margins" there is significant drive to avoid paying for the smaller things. The system is failing due to many issues.
In this day and age, where it pays to be proactive and not reactive in regards to your health, the focus should be on quality of care over quantity and convenience.
Thanks for checking back in to the blog. It's been about a month since my last post, and I've had a lot going on including starting a podcast (The Iron Strong Podcast). If you haven't checked it out, do so now! We're talking about optimizing health through performance, fitness, recovery, and mindset. We have already put out 3 great episodes already.
The podcast topic brings me in to my blog topic today "Consuming vs Doing." This is a hot topic right now, and one I have been wanting to touch on. Have you ever had someone brag about reading 1 book a day for a year, but are never able to implement the ideas from the book due to moving on to the new content (yep, it happens). There are many reasons we consume content at scale. "Consuming content" can feel like your are accomplishing something, and at times is a good thing but, it is a much easier route, than performing something consistently to solve a problem.
In today's world, with the infinite amount of information on the web and consistent stream of information coming from "experts" around the globe, we are inundated with suggestions of what we "should be" doing to fix specific ailments, what diets to perform, what to do with our money, how to start a business etc.... As you all know this can be paralyzing at times and lead to inaction due to "Fear of Doing The Wrong Thing" or even worse sometimes is "Giving up on the process to Early." Has anyone ever spent hours researching Google Reviews about something like the right massage tool, and then not purchased it, only to go back several days later to research further? This is all driven by Fear of selecting the wrong one based on others suggestions
Welcome back to the blog!!
Today we're we're moving up the chain from the knee to the hip. We're discussing femoroacetabular impingement a.k.a. "hip impingement." Anyone familiar with that "pinching" in the front of their hip with a squat, lunge, or while running has likely dealt with a "functional hip impingement" episode. If you have experienced this over a longer period of time, you should be evaluated for hip impingement syndrome.
Hip impingement has gained notice in the sports medicine community specifically over the last 15 years as advancements in diagnostics and surgical procedures has led to increased people going under the knife. This is a syndrome that can be defined in really 2 ways; intra-articular and extra-articular impingement. Extra-articular refers to soft tissue impingement outside the joint, which could be muscular or nervous system in nature. Most commonly though, we are refereing to intra-articular issues which are further classified in to 3 sub-diagnoses; a Pincer Lesion, Cam Lesion or Mixed Lesion. In a Pincer lesion the, there is bony overgrowth of the acetabular rim (the socket) that leads to decreased available motion for femoral head (ball) and increased "pinching" at the top of the joint with flexion. In a Cam Lesion, the overgrowth is on the neck of the femur and leads to an early contact between the acetabulum and head of the femur at end range. Both of these can lead to increased shearing at the joint. They are often diagnosed both clinically with certain special tests as well as with both x-ray and MRI. However, recent studies have show that clinical tests are not as specific as we would like them to be for diagnosis, and imaging does not seem to have a direct correlation between evidence of a Cam or Pincer lesion and the presence of pain.
Welcome back everyone!
I'm finally discussing some current research on the diagnosis and treatment of a specific injury. In this week's blog, I'm discussing the current Clinical Practice Guidelines for diagnosing and treating Patellofemoral Pain Syndrome (PFP). So if you have ever had knee pain related to squatting, running, descending stairs etc.. then this should be an informative read for you, providing you some direction in your ability to address your symptoms.
PFP is commonly referred to as "Jumper's or Runner's knee." This condition involves, typically, insidious onset of pain behind or around the knee cap. This is a very common syndrome with an estimated prevalence of 25% up to 50% in the general population over their lifespan and does account for anywhere between 2-7.5% of people presenting for medical care. This syndrome most commonly affects youth athletes between the ages of 12-19 but some studies indicate a higher prevalence in the 50-59 year old age group.
Symptoms usually present with no specific injury and can come on slowly overtime. Typically there is worsening of pain with lower-limb loading (eg, squatting, prolonged sitting, ascending/descending stairs, jumping, or running, especially with hills). There is poor correlation between internal derangement of tissue or cartilage damage and symptoms, and therefore a clinical diagnosis based on a cluster of symptoms associated with pain reports during squatting, descending stairs, and knee flexion positions like prolonged sitting should be used. Your medical provider and rehab specialist should be looking at these things as the best supported way to diagnosis this condition.
Welcome back to the Blog! Hopefully you have found useful information here in the past, or if this is your first time reading my material, well then, I hope you enjoy!
Today I am discussing 3 ways to optimize your ability to lift and load weight overhead. In addition to helping you lift more in the gym, this also has major implications for maximizing your function as you age. My goal with you reading today is for you to gain a better understanding of how you move with and without weight. So let's get started with the first Key!!
1. How well do you move without weight or load??
One of the most important points. Simply put, Can you move freely and smoothly without restriction when you are not holding weight?. If you can't move smoothly, then you can't load correctly. It's equivalent to attempting squat 150lbs when you can't move from sitting to standing. It's possible to do it once with compensation, but over time it will lead to a disaster. So you first need to understand your movement without load and what you need to do to improve it. A strength and conditioning coach, movement coach, or physical therapist is a great resource here.
What's going on everyone!!
If you've found my blog for the first time, Welcome! If you've read my material before, welcome back and I hope you enjoy. Today, I'm bloggin about optimizing recovery!!
We all know that recovery following high-level intensity exercise or athletic performance is one of the most important things to do to grow as an Competitive Athlete, Olympic lifter, CrossFitter or everyday person looking to excel in the gym or on the field. There's a ton of literature and research out there on how to recover properly, but a lot of it varies, and there's not really any set step by step system to tell you how to recover right. However, there are some very very common and well-supported things that you should be doing, and I'm going to tell you about them right now. These are three things you should be focusing on to optimizing your recovery following a high intensity workout that you can implement today!!!
1. Hydration Recovery. Hydrate and restore your electrolyte balance for the next 48-72 hours. During a long duration >30 minute workout you need carbohydrate and electrolyte replenishment. Following a high intensity workout where you sweat a great deal, you need to be consuming at least half your body weight in ounces for the day. This should be planned out before your workouts for the week. Don't try to play CATCH UP, it doesn't work. Once you start implementing a plan for that hydration recovery it will become a common part of your programming. On a very basic framework, that's hydration and fueling. We all know this, but we don't do it all the time, and I am just as guilty as the next person and continue to work to improve my hydration and nutrition.
Dr. Luke Greenwell is a Performance Based Physical Therapist with an extensive background in treating the injured athlete. He is passionate about returning people to the sports & activities they love. He has post-doctorate certifications in Manual Spine Therapy and Functional Dry Needling. He is also a NSCA Certified Strength and Conditioning Specialist. He has extensive experience in Dartfish video gait/running analysis, concussion rehab, & functional movement screening & correction. He is the owner of CrossFit based RecoverRx Physical Therapy