Blood Flow Restriction: A Powerful Tool for Rehab

What is Blood Flow Restriction (BFR)? It sounds scary, but it’s actually a powerful way of tricking muscles into working harder with less weight. Professional athletes, Olympians, body builders and CrossFitters all use it in their training, and scientists are studying its many applications – it’s even been studied in space to test whether it can mitigate the muscle and bone density loss suffered by astronauts. Talk about your space-age technology!

BFR can also be used in a rehabilitation context, to allow patients to develop and strengthen muscles without putting strain on joint injuries or surgical sites.

So how does it work? Why does it work?

By restricting – but not completely cutting off – the blood flow to the affected limb, BFR reduces the flow of oxygen to the area. Our slow-twitch Type I muscle fibers require oxygen to work and cannot function fully while subjected to BFR. This forces the Type II fast-twitch muscles to pick up the slack, which usually only happens when we work at or near our maximum weight capacity or workout intensity.

This leads to an increase in muscle protein synthesis, and a decrease in muscle damage. For athletes and body builders, this means less pain and quicker gains from training. For rehab patients, it means you can build or maintain muscle tone while recovering from procedures such as an ACL repair or knee replacement.

Athletes use a variety of inexact methods to restrict blood flow to their limbs in training, with or without the guidance of a trainer. Some of these methods can be inefficient or even dangerous if done improperly (causing nerve damage if too narrow of a band is used for restriction, for instance). Because of the potential dangers of using untested equipment, the FDA only approves one device for use in a rehab setting: the Delphi Personal Tourniquet System from Owens Recovery Science. Approved use of this device requires training and certification from ORS to ensure that it is used properly and safely.

NJOSMI has been offering BFR services for over a year with great success. We are the only facility in New Jersey using this technology, and are pioneers of its use on the East Coast.

“BFR has been a gamechanger in restoring early joint motion and muscular strength following surgery or after injury,”says NJOSMI Physical Therapist Lawrence Kim, PT, DPT, OCS. “It has sped up my ability to get everybody from the at home grandmother to the elite athlete back to their life.”

If you’re interested in learning more about BFR and whether it may be right for you, contact North Jersey Orthopedic and Sports Medicine Institute at 855-777-8362, or by emailing

Dr. Michael Russonella is a Board Certified Orthopedic Surgeon and specializes in Sports Medicine. He completed his Sports Medicine Fellowship at the American Sports Medicine Institute in Birmingham, Alabama. Dr. Russonella utilizes the latest in both non-surgical and surgical treatments to treat athletes of all ages and is an expert in the utilization of arthroscopic surgical techniques.

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