How does blood flow restriction training really work?

Blood flow restriction training, or BFR training, is an exercise modality that uses a manipulation of the body’s circulatory system in combination with lightweight exercise to achieve training results similar to high intensity strength training (traditional heavy weight lifting).

Key advantages of the system are:

  • Light weights = less risk of muscle strain or joint injury
  • Light loads = less soreness and quicker recovery
  • Portability means strength training can be done anywhere.
  • Sports-specific motions can be practiced, resulting in functional strength gains.


  1. Light weights + BFR produces profound muscle fatigue.
  2. Nervous system communicates feelings to brain (muscle burn).
  3. Pituitary releases growth hormone.
  4. Anabolic hormones circulate in blood stream.
  5. The anabolic hormone release facilitates repair and increased strength in all exercised tissues.

This is an extremely simplified explanation of the complex theory of the mechanism behind BFR.

For example, the graph below shows the Anabolic Hormonal Release as documented by a robust increase in circulating growth hormone levels (GH) 30 minutes after a BFR session, where the same exercise without BFR produces no increase in GH levels.

H. Takano, T. Morita, H. Iida, K Asada, M Kato, K. Uno, K. Hirose, A. Matsumoto, K. Takenaka, Y. Hirata, F. Eto, R. Nagai, Y. Sato, T. Nakajima.
Eur J Appl Physiol (2005) 95: 65–73


Occlusion of blood flow in and out of a limb is the root cause of all major complications associated with any blood flow restriction training system. The (B)STRONG BFR training system is constructed in such a way that it is incapable of occluding blood flow in a limb. The video below demonstrates this important safety feature.

(B)STRONG Belts and App Are Designed To Avoid Total Occlusion

This sequence of images and videos demonstrates that the (B)STRONG BeltsTM maintain some arterial inflow when safety rules, cautions, and app guidelines are followed. On the other hand, blood pressure cuffs and surgical tourniquets, which have sometimes been used for BFR training, occlude at pressures just higher than the person’s systolic blood pressure. Avoiding occlusion of arterial inflow to a limb mitigates against the root cause of serious complications.


  • Existing untreated deep vein thrombosis (DVT’s)
  • Any on-going medical emergency
  • Belt placement on a limb with lymphedema
  • If unsure, seek advice of your medical practitioner


We do not recommend a pregnant woman start (B)STRONG TrainingTM sessions during her pregnancy. Seek the advice of your doctor if you have other concerns about (B)STRONG Training during or after pregnancy.

The field of blood flow restriction training continues to evolve, and our mission is to keep you informed of the latest developments.

Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow.

Takano H1, Morita T, Iida H, Asada K, Kato M, Uno K, Hirose K, Matsumoto A, Takenaka K, Hirata Y, Eto F, Nagai R, Sato Y, Nakajima T.

Eur J Appl Physiol. 2005 Sep;95(1):65-73. Epub 2005 Jun 15.


We investigated the hemodynamic and hormonal responses to a short-term low-intensity resistance exercise (STLIRE) with the reduction of muscle blood flow.

Eleven untrained men performed bilateral leg extension exercise under the reduction of muscle blood flow of the proximal end of both legs pressure-applied by a specially designed belt (a banding pressure of 1.3 times higher than resting systolic blood pressure, 160-180 mmHg). The intensity of STLIRE was 20% of one repetition maximum. The subjects performed 30 repetitions, and after a 20-seconds rest, they performed three sets again until exhaustion. The superficial femoral arterial blood flow and hemodynamic parameters were measured by using the ultrasound and impedance cardiography. Serum concentrations of growth hormone (GH), vascular endothelial growth factor (VEGF), noradrenaline (NE), insulin-like growth factor (IGF)-1, ghrelin, and lactate were also measured.

Under the conditions, the arterial flow was reduced to about 30% of the control. STLIRE with BFR significantly increased GH (0.11+/-0.03 to 8.6+/-1.1 ng/ml, P < 0.01), IGF-1 (210+/-40 to 236+/-56 ng/ml, P < 0.01), and VEGF (41+/-13 to 103+/-38 pg/ml, P < 0.05). The increase in GH was related to neither NE nor lactate, but the increase in VEGF was related to that in lactate (r = 0.57, P < 0.05). Ghrelin did not change during the exercise. The maximal heart rate (HR) and blood pressure (BP) in STLIRE with BFR were higher than that without BFR. Stroke volume (SV) was lower due to the decrease of the venous return by BFR, but, total peripheral resistance (TPR) did not change significantly. These results suggest that STLIRE with BFR significantly stimulates the exercise-induced GH, IGF, and VEGF responses with the reduction of cardiac preload during exercise, which may become a unique method for rehabilitation in patients with cardiovascular diseases.

For more info on products mentioned in this article or for info on current product specials, please contact your personal ELIVATE Account Manager.

If you don’t know who your Account Manager is, please call 800.537.5512 to find out.

Recommended Products from ELIVATE