Case Study

One of my favourite topics is the area of Blood Flow Restriction training (BFR). BFR, known as other names such as occlusion, KAATSU, ischaemic, or hypoxic training involves the reduction of oxygenated blood flowing to the muscle while preventing deoxygenated blood returning out of the muscle. In short, this creates a by-product accumulation effect and induces an oxygen-low muscle state, therefore forcing the body to stimulate anaerobic adaptations, favourable for muscle growth. Using low loads between 20-30% of an individual’s 1 repetition max lift, hypertrophy (muscle growth) has been demonstrated. However, even lower loads have demonstrated favourable outcomes for muscle growth.

This has enabled BFR to be highly beneficial in the following three areas: Pre and post-surgery, after a recent injury where load needs to be reduced, and increasing muscle mass. In the case study below, increasing muscle mass was the favoured outcome and the rationale behind decisions are explored.

Case Study:

In this video, the client is performing single leg calf raises off a step. During his initial assessment 2 weeks earlier, a discrepancy was noted between the right and left gastrocnemius (calf) size as well the client reported a history of achilles issues on the smaller affected side. As middle distance running is his domain, single leg force production and efficiency plays a major part in performance. The rationale behind the selection of BFR on the lower limb was due to the large training volume, upcoming races, and reducing injury risk. The use of BFR was favourable due to the short time period we had to make changes and low loads which would not severely impact on training performance.

We chose a high rep range protocol; 4 x 15 reps each leg, 45 seconds rest between sets. Cuff pressures sat at approximately 45% of arterial occlusion (105mmHG) and were not deflated between sets. The whole intervention period lasted 4 weeks and were performed at the end of each session. Using both types of calf raises enabled gastrocnemius and soleus activation respectively:

3a) BFR Single Leg Calf Raises (Off Step)

3b) BFR Single Leg Seated Calf Raises (20kg resting on knee)

Overall, there was a noticeable difference in calf size after 4 weeks and so far no reported calf niggles. Later in September, I plan to go into further detail on the whole topic so stay tuned for that! However if you have any burning questions in the meantime, please let me know!

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By Loxlee Blacket

Accredited Exercise Physiologist – START Training

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