A few U.S. Olympic athletes have been spotted exercising with bands wrapped around their arms or legs causing many to wonder if this is a new trend. The New York Times reported that swimmer Michael Andrew and marathoner Galen Rupp use these “tourniquet-like bands” during training. While this might seem odd to a casual observer, these straps are likely used for what’s known as blood flow restriction training. This training relies on slowing the blood flow to a muscle by using a strap or cuff while a person lifts 15 to 30% of their normal lifting weight.
“It’s almost like a personal tourniquet system. So you have a cuff that’s applied to your arm or leg that significantly reduces blood flow,” Marc Sherry, a physical therapist and manager of the UW Health Sports Rehabilitation Department in Madison, Wisconsin, told TODAY. “The basic premise is that it’s inflated to a pressure that prevents the blood from coming out of your arm but doesn’t prevent the blood from going into your arm.”
The reason? That extra pressure allows the muscle to develop like it would from lifting heavier weights but using lower weights.
“The research has shown that exercising with this tourniquet on gives you comparable gains in strength that you would see with normal heavy lifting,” Evan Luse, a physical therapist at the Jameson Crane Sports Medicine Institute at the Ohio State University, told TODAY. “One of the advantages is that you do not need to use heavy weights. Typically you use anywhere between 15 to 30% of your one repetition max and we see similar gains.”
For weight training, people lift about 65% of their maximum repetition weight. So if a person’s max is 100 pounds, they’d lift 65 pounds. Blood flow restriction training allows people to build muscle without putting extra strain on their muscles and joints from heavier lifts.
“It’s a very, very low-intensity exercise,” Dr. James Bradley, a clinical professor of orthopedic surgery at the University of Pittsburgh School of Medicine and head team orthopedic surgeon of the Pittsburgh Steelers, told TODAY. “You’re protecting your joints and you’re protecting (surgical) repairs.”
Most people who have exercised and lifted weights have experienced muscle soreness, which occurs because the act of lifting damages the muscles.
“You don’t get nearly as much actual muscle tissue breakdown so you can do it more often,” Luse said. “One of the things that we’re seeing in the Olympics — especially as this technology becomes more widespread in sports — is that this is used when you get closer to competition to supplement. You’re doing something that’ll give you continued strength gains without making you feel really sore or actually damaging your muscle tissues.”
Dr. David Geier said that it might be particularly useful for athletes in endurance events, such as swimming or long-distance running.
“I imagine it did make them stronger and it wouldn’t just be for powerlifting type sports. Swimming, track and field a lot of sports that require muscle power, muscle endurance and muscle strength absolutely would benefit from it,” the sports medicine specialist in Charleston, South Carolina told TODAY. “There may be some benefits to making those muscles be able to work for longer periods of time, which for an athlete might be very beneficial.”
Blood flow restriction training works because it sparks an increase in certain substances essential in developing muscle mass.
“The metabolite that builds up is called lactic acid or lactate. When that accumulates in the muscles that triggers these hypertrophic changes that makes the muscle increase the size and strength,” Bradley said. “It increases your growth hormone and your insulin-like growth factor, which are really important for muscle growth."
Bradley said he often uses it with patients and football players who have undergone surgery. It helps them maintain muscle mass as they recover.
“I use it routinely on all my athletes after surgery for ACLs (anterior cruciate ligaments), some for rotator cuffs, any kind of cartilage work in the legs,” he said. “It prevents them from losing their muscle mass and it doesn’t hurt them … Sometimes patients will lose up to 40% of their strength in their leg just because they’ve had surgery.”
How to practice blood flow restriction training:
While it might seem that just tying an exercise band around a muscle and lifting would do, the experts stress that there are specially designed cuffs for it that base the restriction on a person’s blood pressure. They recommend working with a physical therapist or trainer who knows how to use the devices. The device Luse uses, for example, continuously monitors blood pressure to make sure it isn’t too restrictive to cause cell damage. Some people do report discomfort when using it. People can experience:
- White or purple looking limbs when the band is on.
- Cold feeling.
These side effects are normally short-term. Bradley notes that people with certain conditions shouldn’t use this training, including people with:
- Sickle cell disease.
- Deep vein thrombosis.
- Artery problems.
- Nerve problems.
- High blood pressure.
“I think in the next decade we’ll see it applied to a lot more populations, including people who might be bedridden or who can’t exercise or people who potentially are in more hospital-based settings,” Luse said. “It will prevent muscle wasting and muscle atrophy to allow them to leave the hospital faster and stay well. For the applications of it, we’re just hitting the tip of the iceberg.”