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What is BFR (Blood Flow Restriction) Training?

BFR Training is a training technique that began in Japan in the late ’60s by Dr. Yoshiaki Sato who was a bodybuilder and powerlifter that had an epiphany one day after sitting for a very long period. Although he was immobile, once he began moving again his legs felt as if they had experienced a strenuous workout. He experimented for decades with different methods of limiting blood flow to improve strength and muscle tone. Dr. Sato developed a BFR Training system in a very traditional Japanese style which he called Kaastu. This highly effective training caught the attention of the fitness world and began being integrated into training for Olympians and high-level athletes around the world.

I was first introduced to BFR training while rehabilitating from a distal bicep tendon tear which required surgical reattachment in 2018. The physical therapy center that I went to used BFR to help restore strength in my arm without using heavy weights and preventing further injury while I healed. The first time I tried this I was amazed. Using only a five-pound weight and without experiencing any pain in the bicep, I experienced a feeling of doing a very (VERY) high-intensity workout. I knew there was something to this method of training. In a few short weeks, my strength came back by leaps and bounds and within about six weeks was almost to pre-injury levels. Unbeknownst to me at the time, the strength training was only a portion of the actual mechanism(s) at work in creating such a quick turn around.

The following details are from a great Bulletproof Podcast with Dave Asprey and Dr. Jim Stray-Gunderson, which I will reference at the end of the blog. I’ll try to slice and dice it to give you the most pertinent details but the podcast is with the listen or you can read the podcast in the link.

Comments from Dr. Jim:

BFR creates a condition of hypoxia in the muscle due to the limitation of the blood leaving the muscle tissue. This hypoxia is limiting the muscle fibers from getting all the oxygen it needs to replenish the ATP and the intracellular phosphates and the energy stores of the cell and at that point, a metabolic crisis is created. And this metabolic crisis then does a couple of things. One is it stimulates local mechanisms to build more and better muscle and blood vessels and all these sorts of things, but yet also we become aware of this metabolic crisis. When you've been on your bicycle and in a criterium and your thighs are burning, your thighs are let are letting your brain know that there's a metabolic crisis going on there. That signal of a metabolic crisis or disturbance of homeostasis then causes the brain to react and among other things put out a neurohumoral anabolic response.

This has been documented by increased levels of growth hormone after these kinds of workouts, but it's really a growth hormone is a marker for a whole constellation of anabolic hormones that are stimulated by these sorts of things. It's also not that strange in the order of the same kind of growth hormone stimulation or the same magnitude of growth hormone stimulation that you get with a super maximal intense workout where the metabolic crisis is caused by damage to the muscle. The difference here is that normally with these really intense or long-duration workouts, you get damaged that is the signal for this change where with blood flow restriction training we've just deprived it of the oxygen that it needs at the time and it's easily reversible but we've created that metabolic crisis that elicits this signal. So what we get is we've kind of biohacked the system by depriving the working muscle of all the blood flow and oxygen it needs. We're eliciting the body's response to maximal intense and damaging exercise.

So let me differentiate between local effects of blood flow restriction training on the muscle that you're actually working and then what I'm calling a systemic effect which is this hormone release. And the hormone release goes everywhere. So any tissues that have been working or any tissues that have been injured are going to enjoy this anabolic hormonal milieu that's been created. So for example, let's take the example of a rotator cuff that's been damaged. Now, that rotator cuff and that arm will not tolerate normal levels of training, but your legs and the other arm are perfectly good to do all sorts of things. So the general concept in rehab with blood flow restriction training is to exercise as much the body's muscle as possible to get the biggest systemic effect and then lightly in a way that doesn't negatively influence the healing structures, do some exercise with them, the consequence is that number one, you stay fit in all your other structures and number two is you optimize the rate of healing for the injured part.

Ok, enough scientific talk… Basically what Dr. Jim is saying is that BFR tricks the body into thinking it’s experiencing a maximal effort workout which in turn stimulates a whole host of hormonal responses. Couple this style of training with at-home training where you may not have access to the heavyweights of the gym and you can still have extraordinary results! I look forward to working the BFR training into my routine on alternate days over the next six weeks and reporting on the results.

Dr. Jim is a partner in the company whose system I’ve purchased. The company is BStrong training. After researching the different systems out there I truly feel that this is the best for the price. There are very inexpensive elastic bands used for BFR but they are difficult, if not impossible, to regulate and if not adjusted correctly will impede all blood flow during the exercise. Correct BFR adjustment significantly restricts but does not prohibit blood flow which can cause major complications like deep vein thrombosis or blood clots. The BStrong system utilizes inflatable cuffs and comes with comprehensive adjustment tutorial and training methods. I’m so stoked on the system that I’ve been able to get a 10% discount for anyone who uses the following link and my discount code HEALTHFUL. I hope after reading this and hearing the great content in the podcast you may want to give this killer system a try.

Bulletproof Podcast Link:

To your most Healthful Life,


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