5/6/16

BENEFITS AND PROGRAMMING

FOR BLOOD FLOW
RESTRICTION TRAINING
Presenter: Dr. Mario G. Novo DPT, PT
The Lifters clinic
Liftersclinic.com
Twitter: @drnovodpt
Instagram: drnovodpt
FaceBook: lifters clinic

Muscle hypertrophy Mechanical Stress

Physiological triggers for growth Movement types
Mechanical stress: Concentric: Shortening of muscle =ssue
Applied tension to the muscle resul=ng in muscle Leads to muscle ber growth in parallel
damage leading to a subsequent inammatory Eccentric: Elonga=on of muscle =ssue from a contracted
response and healing posi=on
Metabolic stress: Lead to muscle ber growth both in parallel and in series
Accumula=on of fast twitch muscle ber byproducts
such as lactate (lac=c acid), and Hydrogen ions, Response
resul=ng in a cascade of cellular signaling that lead to Localized inammatory cascade and cell damage lead to
the ac=va=on of protein building or muscle growth leakage of growth factors : Growth Hormone ac=va=ng
pathways. specialized Satellite cells and IGF-1 which leads to repair
and protein building pathways

MetaBolic stress Muscle Fiiber types

High intensity training (HIT)
Ac=va=on of high threshold motor units (muscle ber
type II) which u=lize an anaerobic energy pathway.
This pathway uses the Cori cycle (Lac=c Acid cycle)
where lactate is produced as a byproduct.
Response: Localized accumula=on of metabolites
lead to an increase in more muscle ac=va=on and
more lactate produc=on. Leads to increased
cellular swelling and a subsequent protein
building response.

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Hypertrophy trigger BFR vs HIT

ACSM guidelines: Moderate to High Intensity Elbow Flexors Strength --- CSA Brachialis
(Intensi=es greater than 65% 1 RM)
Across 8 to 10 upper and lower body exercises
Strength
Targeted frequency: 2-3 =mes per week
Hypertrophy: 70-75% 1 RM, 3-4 sets, 8-12 HIT
BFR+LIRE 30%
Repe==on Range, 30-60 second rest
Muscle CSA LIRE 30%
Strength: 80-90% 1 RM, 3-4 sets, 6-8 Repe==on
Range, 90 200 second rest
0 5 10 15 20 25
% Avg changed --- % CSA

What is BFR training How does Bfr work

Blood ow restric=on: By enhancing and prolonging the exposure
Applica=on of =mes to normal muscle byproduct or waste
restric=ng venous blood (lac=c acid, and hydrogen ions (H+)), there is
ow away from a
working =ssue to
subsequent increase in protein synthesis, high
enhance the metabolic threshold motor unit recruitment, Vo2Max,
demands and rate of Bone density, and =ssue regenera=on all while
increased muscle demonstra=ng no increase in mechanical
hypertrophy and damage.
strength.

Blood Flow Restriction

Practical Vs Pneumatic
BFR
High intensity (HIT) (BFR) +low Low intensity
Prac%cal BFR Pneuma%c BFR intensity
Performed by the Medical provider who is Training range 65 90% %1 RM

20 35% 1 RM 20 35% 1 RM

applica=on of wrapping a cer=ed to apply a Muscle Damage Present Not signicant Not signicant
proximal arm or leg to a set specialized FDA (Del) (Crea=ne Kinase)

compression level to further approved pneuma=c pump Lactate produc=on

(mmol)
Similar Similar Not present

enhance muscle growth and unit, for the same goals. Neuromuscular Type II ac=va=on near Type II ac=va=on at sub No addi=onal recruitment
(Type II recruitment) maximal eort max eort
strength to the working
Growth Hormone 100 fold increase 1.7 X greater than HIT No change from baseline
limb.
IGF-1 Increase Signicant Increase No change from baseline

MTOR1C Increase Signicant Increase No change from baseline

Myosta=n Down regula=on Down regula=on No change from baseline

Time to adapta=on 12 weeks 2 weeks

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Body Building Strength training

Applica=on programming: Applica=on programming:
Twice a day AM, PM Throughout programming
AM Strength session
Mechanical damage higher % 1RM - 60 to 90 second rest Best applied at end of training session with an isolated
Tradi=onal big ligs executed through eccentric isometrics, explosive open chain or closed chain movement
force reps, forced nega=ves, and intra set stretching
PM Pump session
Reasons for applica=on:
Metabolic damage lower % 1RM - 20 to 30 second rest Op=mize muscle hypertrophy not seen with low volume
Isola=on training executed with pre set posing, peak contrac=on higher % 1 RM programs (5/3/1)
along a shortened/mid range/stretched posi=on
Applied with isolated ligs for bringing up under developed
areas to emphasize increasing =ssue injury resilience
Single day training Poten=al for increased =ssue recovery secondary to
Start session with strength (mechanical damage) increased muscle protein synthesis without addi=onal
End session with pump work (metabolic damage) muscle damage

CrossFit CrossFit
Applica=on programming:
Reasons for applica=on:
WOD/MetCon/MobilityWOD/ :
Op=mize muscle hypertrophy not seen heavy aerobic
Best applied at end of training session (addi=onal 5 min) work
Lower extremity: Direct Hamstring/Glute/Hip external rotator cu
Applied with isolated ligs for bringing up under
Closed kine=c chain: Decit Bridges, Hip thrusters
developed areas to emphasize increasing =ssue injury
Isolated open chain: Standing knee exion, Seated knee
extension, Standing hip Abduc=on/Extension/Flexion/
resilience
Adduc=on Poten=al for increased =ssue recovery secondary to
Upper extremity: Direct Shoulder Rotator cu/Deltoid/ Elbow increased muscle protein synthesis without addi=onal
Flexor/Elbow Extension muscle damage
Closed Kine=c chain: Push ups varia=ons low level, Shrugs o
Floor, Inverted TRX rows
Isolated Open chain: Crossover Symmetry shoulder program

Practical Vs Pneumatic Application and Safety

Prac%cal BFR Pneuma%c BFR Prac%cal BFR Pneuma%c BFR
Performed by the Medical provider who is 5 inch knee wrap required Acquire BFR Safety and
applica=on of wrapping a cer=ed to apply a Find distal pulse training cer=ca=on
Upper extremity: Radial Pulse
proximal arm or leg to a set specialized FDA (Del) Lower extremity: Posterior (Owensrecoveryscience.com)
compression level to further approved pneuma=c pump Tibial Pulse Purchase of rent FDA
enhance muscle growth and unit, for the same goals. Lower extremity: Measure a approved DELFI BFR
hands width distance from
strength to the working inner thigh pneuma=c unit
limb. Upper extremity: Measure a Unit is designed for medical
hands width distance from
arm pit purposes with specic
Apply even tension criteria to meet healthy
throughout wrap and secure qualica=ons
Compression Scale 1-10
Train within a 7-8/10

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EBook BFR Training manual

Training Manual
Applica=on
Training protocols for
Body building
Strength training
CrossFit
Endurance
Running and Cycling
Included Videos and Pictures
Nutri=on on maximizing muscle growth and op=mizing
body composi=on
Supplement guide for op=mizing max muscle growth