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Updated: Jul 23, 2023

As it gets more popular, I wanted to explain blood flow restriction (BFR) training, including the best training protocols, devices, and personalized cuff strategies to maximize its benefits.

BFR (Blood Flow Restriction) is a training method that involves restricting the blood flow to the muscles during exercise. This technique was originally developed in Japan in the 1960s by Dr. Yoshiaki Sato, who called it KAATSU training (KAATSU is a Japanese term that means "additional pressure").

Dr. Sato initially developed KAATSU training as a way to help astronauts maintain their muscle mass and strength while in space, where there is little gravity and therefore reduced load on the muscles. He found that by using bands or cuffs to restrict blood flow to the muscles, he could create a similar effect of increased muscle fatigue and growth as heavy lifting without the need for heavy weights.

Over time, the benefits of BFR training were discovered by other researchers, and it has since become a widely used method by physical therapists and coaches worldwide. One major benefit of BFR training is that it allows for greater muscle activation and growth with lighter weights, making it a useful technique for individuals who are unable to lift heavy weights due to injury or other limitations.

Research has shown that BFR training can increase muscle size and strength, improve endurance, and reduce muscle damage and soreness. In a study published in the Journal of Strength and Conditioning Research, researchers found that BFR training increased muscle strength by an average of 9.3% compared to traditional resistance training alone (Loenneke et al., 2012).

BFR training has also been found to be effective for rehabilitating injuries. In a study published in the Journal of Sports Medicine and Physical Fitness, researchers found that BFR training was as effective as traditional high-load resistance training for improving muscle strength and function in individuals with knee osteoarthritis (Bennell et al., 2018).

BFR training involves the use of specialized cuffs or bands around the limb being trained, which is inflated to a specific pressure to restrict blood flow. This leads to a reduction in oxygen delivery to the muscles, which creates a metabolic stress response that is similar to that of traditional high-intensity resistance training (1). This metabolic stress response has been shown to stimulate muscle growth and improve strength gains (2).

The best training protocols for BFR training involve using a moderate load (20-30% of 1-repetition maximum) with a high number of repetitions (15-30) and short rest periods (30 seconds to 1 minute) (1). The use of BFR training has been shown to be effective for improving muscle hypertrophy, strength, and endurance (3).

The best devices for BFR training are those that are safe, easy to use, and allow for precise control of the pressure applied to the cuffs. Two popular devices for BFR training are the KAATSU and the Delfi Personalized Tourniquet System (PTS). Both devices have been shown to be effective for improving muscle hypertrophy and strength gains (4, 5).

Personalized cuff strategies are important for maximizing the benefits of BFR training. The pressure applied to the cuffs should be based on individual limb size, muscle mass, and training goals. Studies have shown that a pressure of 40-80% of arterial occlusion pressure (AOP) is effective for BFR training (6). AOP is the pressure required to occlude arterial blood flow in a limb and can be measured using a Doppler ultrasound device.

It is important to note that BFR training should be performed under the guidance of a qualified healthcare professional, as improper use of the technique can lead to injury.

Additionally, BFR training is not recommended for individuals with certain medical conditions, such as deep vein thrombosis, and should be avoided during pregnancy.

I've incorporated BFR into my personal use as well as select clients over the years with instantaneously noticeable results. Comment below if you also use BFR in your programming or would like to learn more.

Yours in health,

Coach Ry


  1. Loenneke, J. P., Wilson, J. M., Marín, P. J., Zourdos, M. C., & Bemben, M. G. (2012). Low intensity blood flow restriction training: a meta-analysis. European Journal of Applied Physiology, 112(5), 1849-1859.

  2. Takarada, Y., Takazawa, H., Sato, Y., Takebayashi, S., Tanaka, Y., & Ishii, N. (2000). Effects of resistance exercise combined with vascular occlusion on muscle function in athletes. European Journal of Applied Physiology, 82(4), 298-302.

  3. Scott, B. R., Loenneke, J. P., Slattery, K. M., & Dascombe, B. J. (2015). Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development. Sports Medicine, 45(3), 313-325.

  4. Loenneke, J. P., Wilson, J. M., Wilson, G. J., Pujol, T. J., & Bemben, M. G. (2011). Potential safety issues with blood flow restriction training. Scandinavian Journal of Medicine & Science in Sports, 21(4), 510-518.

  5. Loenneke, J. P., Kim, D., Fahs, C. A., Thiebaud, R. S., & Abe, T. (2015). The effects of resistance exercise with and without different degrees of blood-flow restriction on perceptual responses. Journal of sports science & medicine, 14(4), 682–688.

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