Effective strength training usually involves high loads; reaching momentary muscle failure elicits adaptive responses that result in increased strength in the exercised muscles. Athletes and others search for methods to produce an anabolic effect more efficiently, quickly, and safely.
The B Strong Training System promises such an outcome through a safe and natural manipulation of the circulatory system. We’ve been testing the system for almost eleven months during the physical therapy and strengthening following a catastrophic injury.
B Strong Blood Flow Restriction (BFR) training impedes blood flow in working muscles to elicit a cascade of physiological and nervous system responses which trigger adaptation without the requirement of high mechanical load. The goal of BFR training also differs from classic strength training; a systemic, whole-body anabolic effect instead of impacts isolated to the targeted muscle groups.
How BFR training works
When muscles work at their limit, biochemical disruptions cause the familiar burn and momentary muscle failure. Traditional strength training manipulates the load that produces failure at the desired number of repetitions. This relatively high mechanical load and the associated muscle failure elicit hormonal and other responses but also causes microdamage. Although repairing this damage leads to muscle growth, it is sometimes undesirable and requires a long recovery period.
BFR training uses inflatable bands around the upper arms and upper thigh to reduce venous flow from the limbs, impeding the delivery of oxygen and removal of waste products from the working muscles. This situation creates an environment that causes momentary muscle failure at a much lower mechanical load, resulting in an anabolic response with less tissue damage.
The physiological responses ushered by BFR training work at a systemic level; the anabolic hormonal effects can be beneficial to all tissues in the body, not just the exercised muscles. This global view is ideologically different from classic strength training. Although responses to normal strength training can have a bodywide effect, the adaptations to repairing damaged muscle are mostly isolated.
But I see BFR bands on Amazon for less than $30!
The MSRP for the B Strong Training System is $430 and a quick perusal of Amazon will yield “BFR bands” for less than $30; what gives?
There is a critically important distinction between the blood flow restriction mechanism of the B Strong system and the blood flow occlusion that the cheaper knock-offs employ. The B Strong Training System bands have an elastic convoluted inner surface that produces the blood flow restriction through air pressure. Even under maximum inflated pressure, these convolutions and elasticity of the system still allow some blood flow. The flow of blood is restricted, NOT occluded.
Video showing the above is found here.
Total blood flow occlusion, as can be imagined, could be damaging and dangerous to some, and these cheaper bands have no consistently repeatable or measurable way to control the amount of blood flow restriction. The B Strong Training System includes an app that guides proper use.
The B Strong Training System in Use
I received the B Strong Training System early in a long recovery process. An ACL reconstruction procedure and two subsequent staph infections inside my knee joint (and five surgeries over five months) resulted in a left leg that was non-functional and not much bigger than my arms. I started using BFR for therapeutic reasons and now, 11 months post-surgery, I am starting to use it for training purposes. My orthopedic surgeon and physical therapy team provided guidance and I’m an American College of Sportsmedicine certified personal trainer.
BFR causes the uncomfortable muscle burn at drastically lower loads and quicker rate. Early in my recovery process, my leg could only handle a small fraction of my body weight; using the B Strong bands at a low inflation pressure during this period elicited the muscle burn at this relatively tiny load very quickly without injuring my still fragile knee joint and related tissues. This effect of BFR is a great advantage for the injured and more fragile populations, like the elderly.
As my function and strength improved, I continued to employ BFR training. The inflation pressure needed to produce the muscle burn increased along with the load my leg could tolerate. I was able to do more exercises with loads at bodyweight and beyond.
Now that I am starting to return to some normal activity, the purpose of BFR training has evolved from being a therapeutic tool to an adjunct to normal strength training. Early in my recovery process, the maximum recommended 20-minute BFR session was the entirety of my physical therapy exercise set because that is all my leg could handle. As my condition improved, this 20-minute session was only a part of my therapy session, and now it is only a segment of the strength training program.
The biggest change of thinking for me was the global effect theory; instead of performing an exercise to strengthen my affected leg, I was performing motions to elicit the burn in my arms and legs for the responses that would benefit my entire body. The exercises chosen during BFR training almost became a non-factor; any motions that produced the muscle burn were deemed appropriate. I still chose movements at a low load that improves joint range of motion to foster gains in mobility along with the systemic anabolic effects.
The two biggest concerns I have about BFR training stem from the reduced mechanical load. Connective tissues (ligament, tendon, bone) respond to increased mechanical loads. BFR training may not be as effective for these tissues compared to traditional strength training.
The other concern is that load, joint range of motion, contraction speed, and other variables are best trained to mimic the motions of the chosen sport. BFR training reduces the load, which also affects the other factors of sport-specific motion, removing much of the specificity of training. But BFR philosophy stresses the overall bodily effects.
I feel that the B Strong Training System is an excellent way to maintain and build strength in the injured and certain populations, like the elderly. It is also an excellent adjunct to traditional strength training; it provides additional anabolic signals that can aid the entire body without further tissue damage or the related recovery cost. And although I have no lab results of my own to show the correlation between the BFR training and my improved strength, research studies show the efficacy and safety: https://bstrong.training/research/