Blood circulation restriction coaching has been such an awesome addition to what we do in bodily remedy.
Similar to all the pieces else, the extra we use it, the extra we refine what we’re doing.
Listed below are our newest ideas on how we’re utilizing BFR at Champion.
To view extra episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.
#AskMikeReinold Episode 347: BFR Replace for 2025: How We’re Utilizing Blood Stream Restriction Coaching
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Present Notes
• My online course teaching you how to use BFR
• The Best Blood Flow Restriction Bands
• Ultimate Guide to Blood Flow Restriction Training
Transcript
Devin Limerick:
Christine from the UK says, “I’ve been utilizing BFR for a number of years now and at all times questioning if I’m getting essentially the most out of it. How do you utilize BFR at Champion, and for what kind of affected person and the way do you utilize it?”
Mike Reinold:
I feel that’s an excellent query, and I feel clearly we speak about blood circulation restriction coaching a good quantity right here on the podcast and on the web site stuff. However I truly assume it’s good to simply have this periodic dialog as a result of I do assume how we use it’s evolving. We’re altering. How we use it, after we use it, why we use it. There’s a lot of stuff popping out. Even analysis popping out saying the 30/15, 15/15 is probably not the perfect. Ischemic preconditioning is proven to have some potential advantages, that I feel have been just a little bit extra theorized previously, that are actually beginning to come out in among the analysis.
So I feel there’s some neat new stuff or possibly we’re simply, I don’t know, we’re simply maturing with it. Is that a great way to say it? We’re beginning to determine… Any time you get a shiny new toy, I feel we overuse it after which we type of discover out the place it really works greatest for us. And it would work just a little bit totally different for you, however I don’t know. Len, I imply, you do a ton of our decrease extremity and our post-ops and stuff like that. I don’t know. Why don’t we begin with you? And simply how are you utilizing BFR these days, simply within the clinic?
Lenny Macrina:
Proper. I take advantage of BFR. I see a bunch of ACL sufferers and that’s type of my main, nicely truly ACL and UCL. I see loads of ACLs and I take advantage of it early on. I have a tendency to attend two weeks after the surgical procedure, let the injuries heal, let the knee settle down. Some folks use it sooner than that. I simply don’t, simply because that’s me. I feel there is likely to be some papers that say to attend two weeks, so I simply type of wait. Speak to Dan Lorenz, who you and Dan have a BFR course, that’ll be within the present notes. Simply kidding.
Mike Reinold:
I imply, why not?
Lenny Macrina:
Proper. And so I type of use the two-week window, type of do stim early on, after which shift to BFR or biofeedback as nicely. And so BFR for 2 weeks whereas they’re doing the leg raises, whereas they’re doing a little fundamental weight-bearing kind stuff. In my head, BFR is used if someone can’t elevate heavy weights. It replaces that potential so if they’ll do a two-pound ankle weight whereas they’re doing stuff, I take advantage of BFR. As soon as they’ll get out within the fitness center, say 4 to 6 weeks out of surgical procedure, BFR continues to be used, however type of used much less, and now they’re attempting to elevate heavier weights, kettlebells, issues of that nature.
After which from there on, they principally get it in the direction of the top of a session for me. I would like the burden coaching to be the first supply of the strengthening, after which on the finish, I could lock in some knee extensions. I talked to Scott Morrison out in, I feel Oregon, talking of Oregon, who used it quite a bit in supine with a flexed knee and dealing knee extension that manner, as a substitute of only a conventional seated 90/90 knee extension.
That’s how I end loads of my applications, only a large burn to the quad, isolate the quad as a lot as potential in an elongated place. And I do this for the period. In any other case, BFR is quite a bit at first after which solely on the finish of a session, in any other case, they’re simply lifting heavy, heavy weights. Possibly I’ll put them on in the event that they’re going to do bike sprints or one thing like that to essentially freak them out and actually get that extremely coaching to the quad and general to the decrease physique as a result of there’s a systemic impact. It’s not simply going to the quad. There’s a systemic impact that goes on when you’ve gotten the cuffs on, so I’m attempting to capitalize on that once they’re doing sure stuff.
However in any other case, it’s type of utilized as I progress in ACL. It’s rather less, however I nonetheless use it a bunch. And such as you stated at first, it’s evolving. How I’ve used it a 12 months or two in the past is totally different than how I take advantage of it now, and it’ll proceed to evolve in my head, so I’ll have updates as I shift my ideas.
Mike Reinold:
We’ll do one other episode in six months…
Lenny Macrina:
Proper, precisely, nearly.
Mike Reinold:
Which we should always. I imply, I feel that’s what you need to do. However I imply, I feel you’re proper. What I actually like about how Lenny’s talked about shifting proper right here is I feel after we first began fascinated with BFR, we’re like, “Oh, we’ll put it on throughout the entire rehab session and do a bunch of stuff and we’ll do it on a bunch of workouts.” And I feel what we’re discovering, and I feel that is one large tip with what we’re doing totally different right here, is that this doesn’t exchange load. In case you have the flexibility to attempt to load someone, load them. That is an adjunct once they can’t load, and I feel it’s a great way of doing it although. And that doesn’t imply… So Lenny’s speaking about three, 4 weeks after an ACL, he does each.
Since you nonetheless need to attempt to load with out the BFR, however then nonetheless just remember to’re utilizing the BFR. Once more, you get the consequences of BFR, you get to work them at a fatigue state in the direction of the top and I feel that’s just a little little bit of the profit. I feel that’s actually neat.
Dan, that’s how Lenny’s advanced just a little bit together with his post-ops. You have got lots of people that aren’t essentially simply post-op, proper? You have got folks which are simply an harm or in ache or one thing like that. Folks getting again to their sports activities. I do know there are folks that may deadlift with full load proper now that can say, “Ought to I BFR?” And also you’re like, “Properly, we’d need to lower the load to do this.” So it’s attention-grabbing. So how have you ever advanced your why and the way you’re utilizing BFR in that setting?
Dan Pope:
Yeah, I feel identical to Lenny stated, we’re largely attempting to load people in the event that they’re in a position to tolerate it. You’ll find some research that blow my thoughts the place they may do BFR coaching versus common loading and one rep max take a look at, like their squat afterward, and have a really comparable enchancment in energy, which is type of loopy, which doesn’t make any sense to me. I’d anticipate that heavier loading goes to be higher for constructing energy. I’d additionally anticipate it’s higher for energy. So if you happen to’re searching for energy and energy, then I feel you most likely need to perform a little bit extra of the heavier loading.
What I discover quite a bit, and we’re bodily therapists, so I at all times say we’re harm magnets. We see people which are having a tough time tolerating their actions due to accidents. And also you see loads of athletes, let’s say you’ve gotten a powerlifter and so they like heavy deadlifting such as you stated, and so they simply type of run this yo-yo impact of like, all proper, their again was hurting. They get just a little bit higher, they begin loading up once more, they’re having some success for just a little bit, and so they harm themselves once more and so they have to return to rehab. They de-condition, they ramp again up once more. They’re making some progress and so they get harm once more and so they simply trip with this.
And we additionally know that quantity is a giant consider constructing muscle mass and energy, two of that are actually necessary for powerlifters. So one of many issues I’ll use BFR for is that. It looks as if the athlete’s not tolerating the coaching program nicely, that’s my thought. It’s most likely an excessive amount of of one thing. So one of many issues that we are able to proceed to do is we are able to add some further quantity within the type of BFR coaching when the hundreds are quite a bit lighter. And it is a private opinion, however I feel loads of powerlifters and folks within the fitness center on the whole, though this isn’t parsed out in research and analysis, however I feel they get into sizzling water as a result of they do too heavy weights, an excessive amount of, too incessantly. I feel it’s simply the heavy load that finally ends up hurting folks. Unpopular opinion, I’m positive, however I see this time and time once more. It looks as if when people go just a little too heavy for too lengthy, that’s once they get into bother.
So I’ll complement folks’s program with some BFR. The opposite place I see it quite a bit is older people who’ve arthritis the place when you’ve got a youthful particular person with low again ache, my expectation is usually you’re going to get again to feeling fairly good and we’re going to have the ability to load you heavy. If I’ve somebody that has dangerous knee arthritis and it’s been hurting for the previous 20 years and each physician tells them, “Hey, you want a knee alternative,” I’m not anticipating this individual to get again to the purpose the place they’ll again squat 500 kilos. It’s most likely not going to occur.
So I’ll use BFR as a most important remedy possibility with the intention to assist to construct their squat or to assist to reinforce their energy, no matter joint wants it. The quad is a giant one for knee arthritis. These people have a tendency not to have the ability to tolerate a complete lot of knee intensive workouts. I’ll possibly do the vast majority of their knee intensive train with BFR and possibly some type of squat modification. In order that’s type of how I’ll use it in these people. However largely I agree with Lenny. It’s the identical thought, simply to a unique inhabitants, proper?
Mike Reinold:
Yeah, and I’ll add a few factors on restoration that I feel is turning into just a little bit extra in style now too with restoration. So there’s some analysis popping out on ischemic preconditioning and utilizing it in that style with out train. And simply having it type of settled, it should truly assist folks with their restoration.
I’ll say we began utilizing that extra in our wholesome professional athletes and so they really feel nice and so they like it. Now that’s the Journal of Anecdotal Medication. I don’t know that, however once more, it’s one thing that I’m enthusiastic about, that we are able to put it on our legs and do it as a refresh after a recreation. And I feel that that’s a neat evolving development. I need to see extra analysis on that as a result of it’s beginning to come out and also you’re beginning to see one thing. I simply learn one thing and despatched it to Dan Lorenz and stated, “Oh, that is nice,” on ischemic preconditioning, as a result of I do know we’ve been hoping that this was going to supply increasingly more analysis through the years and it’s getting there. So I do like that for restoration. However Jonah, what do you assume?
Jonah Mondloch:
Much like Dan’s first level, I feel that typically whenever you’re working with, say, non-strength athletes, so baseball gamers, basketball gamers, particularly older ones in school or skilled athletes, the place they’ve been working onerous within the fitness center for five, 10 years, and so they is likely to be individuals who fairly frankly don’t benefit from the fitness center in any respect. In a typical coaching session, they probably have some pace energy kind work. They’ve some heavy lifting that’s meant extra for the neural variations. Then they’ve some accent work on the finish that’s meant extra for the muscular variations. I feel that may be a good time to throw some BFR on the place they’re able to… Say they’re doing a little step-ups or RFE cut up squats for increased reps and so they’re able to doing it with 80 kilos, however they simply don’t actually need to need to go decide up these heavy weights once more.
I feel it might be a good time to throw on some BFR cuffs, allow them to get a very good pump, have a unique feeling of working onerous, as a result of it’s simply not at all times enjoyable for a non-strength primarily based athlete to need to go decide up the heavy weights and grind within the fitness center. So I feel it will probably simply be an awesome choice to throw in for one thing like that.
Mike Reinold:
I like that. I feel that’s a very good perspective too. You’ve witnessed that within the fitness center with loads of our shoppers, even our grownup shoppers. That’s a reasonably neat manner of doing it. However once more, I’ll simply reiterate that Jonah’s not saying do your complete exercise with blood circulation, proper? It’s an adjunct with that. So nice stuff, Jonah. I like that.
I’ll add simply because I’ve spoken about this, and I don’t assume all people agrees with me right here, however I’ll add this: I’m nonetheless not utilizing it in our baseball gamers. I nonetheless advocate that you simply don’t use it in your baseball gamers. We see manner too many neurological points and TOS kind points that I don’t need to compress the brachial plexus or the brachium up there, and I nonetheless don’t see the necessity of it. I imply, I see baseball gamers after a recreation desirous to do BFR, and so they’re those that possibly they’ll’t fairly really feel their fingertips.
They’re strolling guys, two guys an inning, and have horrible command, after which they need to get better with BFR after. And through it, they’re like, “Oh yeah, no, that is nice. I really feel it in my hand. My complete hand’s tingling.” And also you’re like, “That’s not good. That’s simply not what we want.”
Plus the opposite undeniable fact that I feel is actually necessary with me on that is… Why are we utilizing BFR in our overhead athletes? It’s for energy features, proper? I can actually say, I preserve saying this again and again, I do not need bother getting their forearm robust, do you? Proper? I don’t assume you do both. So don’t simply do BFR since you assume you’re imagined to do it. You employ BFR as a result of you’ve gotten bother getting energy after an ACL or one thing like that, or they’re unable to tolerate load.
So I proceed to see not solely not a purpose in baseball gamers, however I truly see contraindications. Now that being stated, Mike Scaduto, Mike, you’ve achieved some actually nice stuff on integrating BFR in our post-ops, like our Tommy Johns in our baseball gamers. Why don’t you converse on that just a little bit right here as a result of I feel it’s been a very welcome boost to what we’re doing in our rehab protocols for our overhead athletes after surgical procedure.
Mike Scaduto:
Yeah, positive. I don’t need to converse for you, Mike, however simply to make clear, I feel you meant you don’t like to make use of BFR within the higher extremity for baseball gamers.
Mike Reinold:
Sure. Thanks for that. I received excited, sure. So we use BFR within the decrease extremity on a regular basis in baseball gamers, however we don’t apply it to the arm in our baseball gamers. Thanks, Mike.
Mike Scaduto:
Yeah, for positive. So for shoulder and for elbow surgical procedures, once they’re in that type of acute post-op part with a UCL, they’re most likely in a brace wherever from 4 to 6 weeks on their arm. Clearly, we are able to load the contralateral and non-surgical arm, however there are some limitations as to how a lot weight they’ll maintain in the event that they’re having Tommy John surgical procedure. They’re most likely a highschool or school professional-level athlete. So considered one of their main targets after surgical procedure is, when can they get again within the fitness center and begin coaching? So we’ve began implementing BFR round that two week post-op mark for his or her decrease physique, as a option to at the very least preserve some muscle mass or hypertrophy. So once they get again into the fitness center, we’re not additionally attempting to essentially construct up their decrease physique energy or hypertrophy from scratch. We will attempt to preserve a few of that whereas there are some limitations.
I feel psychologically it additionally provides them the sensation that they’re working actually onerous and so they get pleasure from that a part of the Tommy John rehab. I feel early on with UCL rehab, it’s actually type of boring for the shopper. We’re doing loads of elbow vary of movement, isometrics for his or her forearm and for his or her shoulder. If we are able to throw some decrease physique train the place they really feel like they’re getting a very good exercise in and dealing in the direction of their purpose of getting again into the fitness center, I feel it’s psychologically useful for them. So we’ll positively use it. We’ll simply do fundamental workouts, cut up squats, step-ups, lateral lunges, ensuring that we’re being secure about them as a fall danger, not falling onto their surgical arm, nevertheless it appears to be an excellent software for all these causes.
Mike Reinold:
Mike, what do you love to do for the set rep schemes for someone like two, three weeks out? That was 4 decrease extremity workouts I feel that you simply type of stated. What do you do for set rep schemes? Do you do 30/30/30 or 30/15/15/15, or do you simply do it as a complement to what they’re doing?
Mike Scaduto:
Yeah, I’ll simply do it as a complement. So I feel for a extra compound motion, like a cut up squat, I’m most likely not going to do 30/15/15/15. I feel that is likely to be fairly brutal for them. So it’ll most likely begin within the two to a few units of 10 to 12 reps for these workouts, after which we’ll add some weight on their non-surgical arm if they’ll maintain a dumbbell and preserve that very same set and rep scheme. I’ll depart it at that.
Mike Reinold:
I imply, I like that although as a result of the overall rep quantity and all these workouts are nonetheless fairly excessive, however once more, you’re getting motion variability. You’re not like we’re simply going to do mini squats for 90 reps. I don’t assume that serves loads of the aim of why you’re doing it. So I feel it’s superior. Clearly the systemic results and the decrease physique results on that, I feel is nice. However I received to confess, I feel it’s the response of the athletes in that part on how a lot they’ve loved it, that type of received me essentially the most enthusiastic about it, like seeing Mike begin to implement it in these athletes, it was that they beloved it. And I feel to his level, it’s just a little little bit of psychological that like, “Okay, I’m not only a slug laying on a desk doing vary of movement. I’m truly beginning to get figuring out once more.”
After which once they transitioned into the fitness center proper round that point, their consolation degree’s higher. They simply really feel higher in regards to the motion. It’s a win-win-win. So I do assume that’s a very neat manner we’ve been evolving our BFR champion there too, is you’ve gotten an higher extremity individual, let’s put it on the legs and simply do a decrease physique circuit on the finish, for thus many causes.
So superior. Nice query, Christine. I hope that helps you as you’re getting began with that stuff. I imply, we’re going to proceed to evolve our ideas as we be taught extra, and hopefully, you’ll too. However if you happen to loved that, head to mikereinold.com, click on on that podcast hyperlink, and fill out our type. You possibly can ask us questions that we are going to reply on a future episode, and please charge, subscribe, Apple Podcasts, Spotify, and we’ll see you on the following episode. Thanks.
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