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).

​

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." ​

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. ​