A protocol called occlusion training, also known as blood-flow restriction (BFR) training, is one of the most interesting and effective trends in strength and conditioning. In studies, it has been shown to result in skeletal muscle hypertrophy, increased strength, and increased endurance. So how can we fit folks use it safely and effectively?
How Tight Is Tight Enough?
The tourniquets should be good and snug, but not so snug that you start to feel pins and needle. If any of your extremities start to go white or blue, you are restricting arterial flow—and that is definitely too tight!
There is no benefit to be gained from lifting too heavy with the occlusion bands on.
Research done on healthy people with resistance-training experience found that a perceived level of seven out of 10 (10 being the tightest you can possibly make it) will deliver the optimum (and safest) amount of blood flow restriction.
Another word of caution: before you begin your workout, make sure you decide which area of the body that you are going to train and stick with that. You do not want to have blood flow restriction in both your upper and lower body at the same time. You can wrap either the upper arms (just below the shoulders or delts) or around the upper thighs (just below the crease of the hips) but not both.
Make sure that you wrap around a narrow area of your limb, such as the narrowest part of the upper arm just below the deltoid. You want the blood to be able to enter the muscle (via arterial flow) but the blood should be partially prevented from leaving the working muscle because the venous flow is restricted.
How heavy Is heavy enough?
All the research I have found indicates that there is no benefit to be gained from lifting too heavy with the occlusion bands on. In fact, using a weight that is merely 20 to 40 percent of your 1RM is enough. But beware—even though this sounds easy, you will be suffering by the end.
I would suggest starting with four sets of 15 reps with 30 seconds rest between each to maximize muscle growth. You can do this workout two times per week safely with a maximum of three times per week with 48 to 72 hours of recovery between each.
Occlusion Training Workouts
Keep it basic using exercises like the squat, bench press, leg press, leg extension, leg curl, and biceps curl. Start with a very light weight and increase over time.
Jeremy Loenneke, Ph.D., who is one of the world’s top BFR researchers and a competitive bodybuilder, says “If you can’t get near 30 reps on the first set or 15 on the subsequent ones, the wraps are either too tight or the weight is too heavy.“ This is a good measuring stick to keep in mind. I would suggest adjusting the weight first and if you still can’t hit those reps, try loosening the tourniquets.
Step-by-step, this is what you should be doing:
Wrap the strap around the top of the muscle that you want to work on
Make sure it is tight without causing numbness or turning your extremities blue
Begin your set with a lighter than normal weight
If possible, do not loosen the bands between sets. You want to keep the blood trapped in the muscle to maximize the benefits
A paper called The Use of Occlusion Training to Produce Muscle Hypertrophy suggests that low-intensity occlusion training done at loads as low as 10-30% of maximal work capacity for 3 to 5 sets to volitional fatigue with 30-second to 1-minute rest between sets is effective. They add that the pressure only needs to be high enough to block venous return (~50-100 mm Hg).