Where Does Blood Flow Restriction Fit in the Toolbox of Athletic Development? A Narrative Review of the Proposed Mechanisms and Potential Applications

Abstract

Blood flow-restricted exercise is currently used as a low-intensity time-efficient approach to reap many of the benefits of typical high-intensity training. Evidence continues to lend support to the notion that even highly trained individuals, such as athletes, still benefit from this mode of training. Both resistance and endurance exercise may be combined with blood flow restriction to provide a spectrum of adaptations in skeletal muscle, spanning from myofibrillar to mitochondrial adjustments. Such diverse adaptations would benefit both muscular strength and endurance qualities concurrently, which are demanded in athletic performance, most notably in team sports. Moreover, recent work indicates that when traditional high-load resistance training is supplemented with low-load, blood flow-restricted exercise, either in the same session or as a separate training block in a periodised programme, a synergistic and complementary effect on training adaptations may occur. Transient reductions in mechanical loading of tissues afforded by low-load, blood flow-restricted exercise may also serve a purpose during de-loading, tapering or rehabilitation of musculoskeletal injury. This narrative review aims to expand on the current scientific and practical understanding of how blood flow restriction methods may be applied by coaches and practitioners to enhance current athletic development models.

Cerebral cortex activation and functional connectivity during low-load resistance training with blood flow restriction: An fNIRS study

“…While BFR has been combined with various types of exercise, research indicates that the most substantial muscular gains come with resistance training (RT) under 20%-40% of the 1 repetition maximum (1RM) or maximum voluntary contraction (MVC) [ 5 ]. With the increasing popularity of BFR in the training domain, many researchers have started to investigate its potential mechanisms, such as metabolic stress, cellular swelling, hormone regulation, and other mechanisms at the cellular and molecular levels [ 6 – 8 ]. Surprisingly, even though neural regulation has significantly contributed to muscle hypertrophy and strength gain [ 9 – 12 ], studies concerning BFR training in this area remain limited.…”

Acute Hemodynamic, Metabolic, and Hormonal Responses to a Boxing Exergame with and without Blood Flow Restriction in Non-Athlete Young Individuals

“…Research has indicated that a combination of aerobic exercise with BFR results in improved acute and chronic neuromuscular and metabolic responses to exercise and more significantly increases hemodynamic outcomes compared with exercise alone [ 7 ]. This modality permits the attainment of physiological adaptations traditionally associated with high-intensity training regimes, albeit at markedly lower exercise intensities [ 8 ]. Specifically, BFR induces a spectrum of physiological effects, including augmented muscle protein synthesis, facilitated by an elevated anabolic hormonal environment; enhanced muscle hypertrophy and strength gains through metabolic stress and muscle fiber recruitment patterns that mimic those observed in high-load resistance training; and improvements in vascular function due to increased shear stress [ 9 ].…”

“…Furthermore, BFR has been shown to elevate lactate concentration and promote systemic hypoxia, which are critical factors in stimulating aerobic and anaerobic metabolism, thereby improving endurance and muscular efficiency [ 10 ]. In essence, BFR offers a mechanism by which training intensity can be intensified without the corresponding increase in load, thereby holding significant promise for advancing sports performance by amplifying the physiological impacts of training sessions [ 8 , 10 ]. Bridging the gap between these innovative training methods and their physiological impacts, the convergence of technology and physical exercise opens a new chapter in understanding and optimizing the human body’s response to exercise.…”