Build Strength and Muscle Fast with Occlusion Training
A protocol called occlusion training, also known as blood-flow restriction (BFR) training, is one of the most interesting and effective trends in strength and conditioning. In studies, it has been shown to result in skeletal muscle hypertrophy, increased strength, and increased endurance. So how can we fit folks use it safely and effectively?
Brock Armstrong
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Build Strength and Muscle Fast with Occlusion Training
Occlusion training is simply a way of restricting blood flow in the veins of a working muscle in hopes to kick-start some larger gains in muscle size and strength. For example, you can wrap an elastic band around the top of your leg before doing your squat workout. It sounds crazy, and a little bit scary, but there’s definitely something to it.
An article in the Military Times reported that one form of occlusion training, called Kaatsu, is “a revolutionary new training system” from Japan that is blowing fitness researchers’ minds. Does that sound too good to be true? A little, right? Well, let’s take a closer look.
What is Occlusion or BFR Training?
During this workout, a specific type of tourniquet (similar to what a phlebotomist uses on your arm when you are giving blood) slows down the movement of the blood that is flowing back to your heart. This allows the limbs that are doing the workout to become engorged with blood.
This specific type of veinous occlusion significantly increases the concentration lactate in your blood, at lower workout intensity or weight. This, in essence, simulates the feeling of a much harder workout in the muscles while also tricking the brain into thinking the body is performing a very difficult workout. As a result, your pituitary gland (a tiny organ found at the base of the brain) releases more growth hormones (reportedly up to 170 percent more) along with hormones that are directly related to muscle hypertrophy (muscle growth) including IGF-1, MTORC1, and myostatin.
When lighter loads are combined with occlusion, you get bigger, faster—and without having to lift as heavy of a weight.
To achieve this veinous occlusion, you could, for example, tie elastic bands or exercise tubing or even an old bicycle tube around your upper arms before you do a set of dumbbell curls. Or before a set of squats or machine leg extensions, you can tie the elastic bands around your upper thighs. Then you do your workout as usual (with lighter weights than usual) and reap the benefits of your over-stimulated pituitary gland.
Occlusion training can and has been used by athletes, patients in postoperative rehabilitation, cardiac rehabilitation patients, the elderly, and even astronauts to combat atrophy.
How Does Occlusion Training Work?
By restricting the blood flow in and out of the working muscles you achieve what is called Cell Swelling, which is directly linked to muscle gain. That swelling, combined with a buildup of metabolites (or Metabolic Stress), has been shown to activate more muscle fibers—even at lower than usual intensities.
The three ways that BFR training is thought to work are:
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The muscle cells become so full of fluid that they must grow (or burst)
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The low oxygen level in a muscle during the accumulation of blood forces your body to recruit the larger fast-twitch fibers, which can stimulate more muscle growth
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When oxygen is low, lactate rapidly accumulates, and many studies show that lactate (also known as lactic acid) can increase protein synthesis
A 2016 Sports Medicine systematic review found that occlusion training increased muscle size and strength in the shoulders, chest, and arms better than conventional training. In fact, the review concluded, “Current evidence suggests that the addition of BFR to dynamic exercise training is effective for augmenting changes in both muscle strength and size.”
In our body, muscles are made of two types of fibers: Type 2 & Type 1. Type 2 fibers are generally known as the fibers that grow easily. The trouble is that Type 2 fibers only really get involved in your resistance training workout when you go to all the way to failure or when you use very heavy weights. This is generally pegged at about 80 percent of your 1RM or 1 rep max (your 1-rep max is the most weight that you can lift once and only once).
So, when lighter loads (below 80 percent of your 1RM) are combined with occlusion, the Type 2 fibers are recruited much easier and earlier, allowing you to get bigger, faster and without having to lift as heavy of a weight.
How Tight Is Tight Enough?
The tourniquets should be good and snug, but not so snug that you start to feel pins and needle. If any of your extremities start to go white or blue, you are restricting arterial flow—and that is definitely too tight!
There is no benefit to be gained from lifting too heavy with the occlusion bands on.
Research done on healthy people with resistance-training experience found that a perceived level of seven out of 10 (10 being the tightest you can possibly make it) will deliver the optimum (and safest) amount of blood flow restriction.
Another word of caution: before you begin your workout, make sure you decide which area of the body that you are going to train and stick with that. You do not want to have blood flow restriction in both your upper and lower body at the same time. You can wrap either the upper arms (just below the shoulders or delts) or around the upper thighs (just below the crease of the hips) but not both.
Make sure that you wrap around a narrow area of your limb, such as the narrowest part of the upper arm just below the deltoid. You want the blood to be able to enter the muscle (via arterial flow) but the blood should be partially prevented from leaving the working muscle because the venous flow is restricted.
How heavy Is heavy enough?
All the research I have found indicates that there is no benefit to be gained from lifting too heavy with the occlusion bands on. In fact, using a weight that is merely 20 to 40 percent of your 1RM is enough. But beware—even though this sounds easy, you will be suffering by the end.
I would suggest starting with four sets of 15 reps with 30 seconds rest between each to maximize muscle growth. You can do this workout two times per week safely with a maximum of three times per week with 48 to 72 hours of recovery between each.
Occlusion Training Workouts
Keep it basic using exercises like the squat, bench press, leg press, leg extension, leg curl, and biceps curl. Start with a very light weight and increase over time.
Jeremy Loenneke, Ph.D., who is one of the world’s top BFR researchers and a competitive bodybuilder, says “If you can’t get near 30 reps on the first set or 15 on the subsequent ones, the wraps are either too tight or the weight is too heavy.“ This is a good measuring stick to keep in mind. I would suggest adjusting the weight first and if you still can’t hit those reps, try loosening the tourniquets.
Step-by-step, this is what you should be doing:
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Wrap the strap around the top of the muscle that you want to work on
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Make sure it is tight without causing numbness or turning your extremities blue
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Begin your set with a lighter than normal weight
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If possible, do not loosen the bands between sets. You want to keep the blood trapped in the muscle to maximize the benefits
A paper called The Use of Occlusion Training to Produce Muscle Hypertrophy suggests that low-intensity occlusion training done at loads as low as 10-30% of maximal work capacity for 3 to 5 sets to volitional fatigue with 30-second to 1-minute rest between sets is effective. They add that the pressure only needs to be high enough to block venous return (~50-100 mm Hg).
Is Occlusion Training Safe?
BFR has been shown to be safe (when done as directed). But if you have any type of vascular disorder (like deep-vein thrombosis, varicose veins, high blood pressure, or cardiac disease), don’t fool around with BFR. And, it likely goes without saying but if you are in pain or feel numbness during your sets, stop immediately.
By expanding our repertoire of workouts, modes of exercise, and the sports we are comfortable playing, we really do set ourselves up for a lifetime of healthy and happy movement.
Of course, as usual, if you have any doubts or worries, check with a medical professional.
Alternatives to BFR?
If after all this you are still feeling reluctant to try tying tourniquets around your limbs, you can get a similar benefit from simply include some pulsing movements in your exercise sets. To do this, simply choose 2 exercises for the 3 big muscle groups (e.g. squats and leg curls for your legs, chest presses and push-ups for your chest, pull-downs and rows for your back). Then proceed as follows:
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Do 3 sets of 10 for each exercise
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At the end of each set do a 10-second hold in the most difficult part of the movement (e.g. the bottom of a squat) followed by a 10-second pulse in which you slightly bounce up and down through a very small range of motion
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Feel the burn!
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Rest 1-2 minutes, then go to the next exercise for the same body part
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Repeat until you finish off one body part, then move to the next
Despite all the buzz around blood flow restriction training over the last few years, many people are still reluctant to try it. While I don’t advocate doing any one workout too often or for too long (no matter what that workout is) I do believe by expanding our repertoire of workouts, modes of exercise, and the sports we are comfortable playing, we really do set ourselves up for a lifetime of healthy and happy movement.
For more blood flow info, occlusion tips, and to join the muscle building conversation, head over to Facebook.com/GetFitGuy, twitter.com/getfitguy or BrockArmstrong.com.
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About the Author
Brock Armstrong was the host of the Get-Fit Guy podcast between 2017 and 2021. He is a certified AFLCA Group Fitness Leader with a designation in Portable Equipment, NCCP and CAC Triathlon Coach, and a TnT certified run coach. He is also on the board of advisors for the Primal Health Coach Institute and a guest faculty member of the Human Potential Institute.