Every four years, the Summer Olympics shows the world the latest training or recovery method the greatest athletes have taken up. In 2016, many athletes had red circular marks on their skin from “cupping,” an ancient Chinese practice involving suction on sore muscles and tendons. This year, the hot trend appears to be tourniquets, more specifically blood flow restriction therapy. While the Olympians may have made it mainstream, it’s a technique that physical therapists and trainers have been using since the 1960s for post-surgical patients and injuries involving muscle weakness.
How It Works

This training involves restricting blood flow to certain muscles for limited periods of time in a controlled manner by a physical therapist with specialty certification in blood flow restriction techniques. The therapy both enhances the effects of training and stimulates recovery. It requires the application of a device like a blood pressure cuff or tourniquet to safely compress the blood vessels underneath. The goal is to apply enough pressure to completely restrict the venous blood flow (blood leaving the muscle), while allowing arterial blood flow (blood going into the muscle). When done correctly, blood ends up pooling in the muscle beyond the tourniquet, creating a hypoxic environment in which the tissue is deprived of oxygen. This lack of oxygen is said to increase growth hormones, muscle hypertrophy, and muscle strength.
Who May Benefit?

While research demonstrates that blood flow restriction can decrease muscle atrophy on its own, physical therapists typically incorporate exercise with the use of the cuffs. The greatest benefit is that muscular gains can be attained without the stress of high loads, weight, or resistance. Simple, low-load exercises can produce a similar muscle burn to traditional heavier weight training.

Blood flow restriction therapy can affect improvement in muscle strength in patients who are unable to perform high-resistance exercise, have weight-lifting restrictions, or who have persistent extremity weakness despite traditional therapy. Patients who could benefit include those recovering from:
– Achilles repairs
– Fractures
– Inflammatory muscle wasting diseases, such as polymyositis and dermatomyositis
– Knee reconstructions, cartilage repairs and ACL reconstruction
– Muscle strains
– Rotator cuff repairs
– Musculoskeletal trauma
– Knee osteoarthritis
– Tendinopathies
– Total joint replacement
– Post-surgical weakness

Blood flow restriction therapy is not something patients should try on their own. If you believe you could benefit from the therapy, talk to your primary care provider or physical therapist. If deemed appropriate, a certified physical therapist will carefully consider your condition and work closely with your primary care provider to determine your plan of care.

Blood Flow Restriction Therapy Not Just for Athletes
By Devin Crebs, DPT
Physical Therapist, UPMC Rehabilitation Services

Devin Crebs is a physical therapist at UPMC Muncy, one of the three clinicians certified through Owens Recovery that can provide patients with blood flow restriction therapy. Zachary Kurtz, DPT, and Dylan Casale, PTA, are also certified and provide services at UPMC Muncy. For more information on blood flow restriction therapy services available at UPMC in North Central Pa., call 570-546-4291.