Every now and then, something comes along worthy of being called “the next best thing since sliced bread.” As a physical therapist and strength and conditioning specialist, I don’t throw that term around lightly. But when it comes to helping seniors improve their strength and stay physically strong (and thus, healthier), blood flow restriction training is certainly worthy of that title.
Blood flow restriction training has been studied extensively in seniors and is safe and effective for increasing muscular strength and size when used appropriately. It can provide numerous physical benefits without taxing joints or requiring high levels of physical exertion.
If you want to learn all of the specifics about blood flow restriction training for senior populations, be sure to keep on reading, as this article will provide all the details you need to have a solid understanding of this training intervention.
TABLE OF CONTENTS (QUICK LINKS):
Click (or tap) on the following article headlines to jump to that particular section of the article.
- What is blood flow restriction training?
- Why would seniors want to use blood flow restriction?
- How does blood flow restriction training work?
- What is science finding with seniors who use this intervention?
- Is blood flow restriction training safe to use with seniors?
- Which seniors can benefit from blood flow restriction training the most?
- What are the most optimal protocols for seniors?
- Final thoughts
Related article: Proven by Science: Best Blood Flow Restriction Exercises for Seniors
Disclaimer: While I am a physical therapist, I am not YOUR physical therapist. As a result, I cannot tell you whether or not any treatments mentioned on this website or in this article may or may not be appropriate for you, including blood flow restriction training. By following any information within this post, you are doing so at your own risk. You are advised to seek appropriate medical advice for any pain you may be experiencing.
If you’re looking for a professional, high-quality blood flow restriction training system that has been designed by a team of medical professionals, my recommendation is the Bstrong System (link goes to their website). This is the system I use for myself and my patients. You can use the code “JIMWITTSTROM” to receive 10% off of any purchase through their store. Please note: this is an affiliate link that provides me with a commission at no extra cost to you. I use these commissions to offset the cost of running this website.
What is blood flow restriction training?
I’ve written other articles covering absolutely extensive amounts of blood flow restriction training, both for healthy populations and for those looking to recover from injury or who are limited in functional ability. If you’d like to learn a plethora of the specifics about this information, be sure to check out my other posts:
If you’re in a hurry and don’t have time to read those articles, here’s the quick rundown as to what blood flow restriction training is:
Blood flow restriction (BFR) training is a form of strength and endurance training in which an individual wears restrictive bands around their legs or upper arms, limiting the extent of blood flow moving into and out of those extremities while exercising. It tends to produce muscle fatigue much more quickly and with much less effort than traditional exercise methods that don’t involve BFR training.
What makes this training approach so unique is that individuals performing BFR training only have to lift 20-30% of their muscles’ maximal abilities when exercising or weight training to get significant strength training responses for muscular size and strength. Traditional strength training requires around 70% of an individual’s maximal strength abilities to elicit those same responses from the muscles!
If this sounds too good to be true, it isn’t. There is plenty of science to back all of this up (which I’ll get to in a separate section later on within this article). Of course, this doesn’t mean that there isn’t consistent effort required on the part of the exercising individual.
But with consistent effort, the individual using BFR training can see favorable responses to muscle size, strength, and endurance without working at resistance loads or training intensities beyond what their muscles, tendons, and joints can tolerate.
Why would seniors want to use blood flow restriction?
There are numerous reasons why seniors may want to consider incorporating BFR training into part of their physical activities or lifestyle. While I’ll discuss two primary reasons below, keep in mind that there are, in fact, many more. It’s also worth keeping in mind that these benefits can apply to largely all populations and not just seniors.
Reason 1: Decreasing joint pain
For most individuals, as we age, we experience greater amounts of joint pain (such as osteoarthritis in the knees). Joint pain of this nature can often be made worse if we perform rather heavy lifting or high-intensity exercises, which can irritate arthritic joints. The problem is that when it comes to traditional resistance training, to keep our legs, arms, and thus overall body strong, we need to perform resistance exercises with around 70% of our muscles’ maximal abilities to stimulate them to stay strong, grow in size and become stronger.1,2
Many seniors who wish to perform appropriately challenging exercises to remain strong are limited by their joint pain long before they can perform exercises with the approximate 70% of maximal muscle ability required for these strength gains. The result of this situation is that it becomes challenging to keep our muscles strong and healthy when we are limited by joint pain. If muscles can’t be stimulated appropriately, they don’t become stronger. And if they’re not stimulated regularly, they become smaller and weaker (a process known as muscle atrophy).
Reason 2: Exercise recovery
As we age, it often becomes more challenging to physically recover from demanding exercise or training sessions. The body must be physically stressed to stay strong and/or become stronger. However, our body’s capacity to recover from high-intensity or challenging workouts diminishes as we age. This means that even in the absence of joint pain or other painful conditions, higher intensity exercise sessions take much longer to recover from. This, in turn, directly limits how frequently these types of exercise sessions can be performed.
Of course, one could choose to exercise at much lower intensities to exercise more frequently, but if they always workout with too little physical intensity, they won’t stress the physical capacity of their body enough to adapt to those physical challenges.3–5
This is where BFR training is oftentimes great for seniors; by being able to make the muscles and body positively adapt to low-intensity workouts as if they had, in fact, been high-intensity workouts, seniors can train much more frequently since not as much physical recovery is required from the body for each exercise session.
This increase in stimulus-based training frequency equates to more time performing enjoyable physical activity, less chance for exercise-induced injury, less time spent with sore muscles, and less downtime between exercise sessions to recover fully. All of these are very potent factors that can help the body stay strong or become even stronger.
How does blood flow restriction training work (for seniors and everyone else)?
While science still doesn’t fully understand all of the exact mechanisms behind how BFR training elicits its favorable improvements in muscle size, muscle strength, and endurance, hundreds of studies have determined many physiologic (body operating) responses that are known to contribute to the overall process.
While the exact scientific and physiologic details can get extremely complex and filled with tons of clinical jargon, I’m more than happy to break it down in a very simple, straightforward manner:
When we exercise, it’s our muscles that allow us to complete our physical movements. The more we move and/or the harder we make those muscles work, the more oxygen and nutrients these muscles require to keep going (think of these as fuel). The oxygen and nutrients are brought to the muscles by fresh blood, which is in our arteries (a type of blood vessel that carries blood to the muscles).
As the muscles use up this oxygen and these nutrients (i.e., the “fuel”), they produce a lot of metabolic waste. Think of this as your car requiring gasoline to run but then emitting exhaust after the gasoline is broken down to power the engine. This waste is normally transported out of the working muscles and back into the bloodstream, where it is later dealt with by other parts of the body.
And the harder we make our muscles work, the greater the amount of junk produced by the working muscles. Under normal circumstances, the body can clear this junk out rather quickly from the muscles and limbs.
But…everything changes once we exercise with blood flow restriction bands around our working extremities.
With less “fresh” blood moving into the working muscles and more “old” blood (filled with metabolic junk) staying within the extremities, a relatively large amount of this metabolic junk builds up and stays put. During exercise, this makes ongoing exercise rather tiring on the muscles, which further creates the build-up of junk. Then, once the bands are removed after exercise, this large influx of metabolic “junk” back to the center of the body essentially “tricks” the brain into thinking that much more physically demanding and intense exercise has taken place than actually has.
This trickery of the brain occurs since the brain and body are bombarded with a large influx of this junk, signifying to the brain that tons of heavy, challenging exercise must have taken place (which isn’t the case). And since the brain is in charge of mounting an appropriate response to help the body adapt to the “intense workout” it thinks it just underwent, it tells the body to produce and provide the chemicals required to increase muscle size and strength.
The result is that the body creates a favorably disproportionate response in regards to how much muscle strengthening and endurance takes place, allowing the individual to become stronger without having to use traditionally heavy or intense resistance training protocols that are otherwise needed to create the same response.6–8
In short, the muscles can become stronger and experience more endurance with less intense work performed by the individual.
What is science finding with seniors who use this intervention?
When it comes to using BFR training on senior populations, there have been a decent number of studies that have looked at its benefits for both males and females. Since senior populations are a demographic who can benefit greatly from the ability to become stronger without the ability to perform high levels of physical exertion, science has been quite interested in how this population responds to this training intervention.
When studying BFR’s ability to produce strength gains in seniors, both male and female populations seem to reap the rewards.
Is blood flow restriction training safe to use with seniors?
Like everything else in life, it’s good to know whether or not something is relatively safe to perform. While blood flow restriction has its contraindications (that is, reasons not to use it), so does pretty much everything else in life. While this article does not constitute professional medical advice, I will dive into the safety of BFR training and for whom it’s not likely to be a safe or appropriate intervention.
Reminder: Please read the medical disclaimer at the top of this article if you have not already done so.
It’s also worth mentioning that the main reason why I use the BStrong Blood Flow Restriction Training System on myself and all of my patients is due to it having been designed by a team of medical doctors, with the cuffs being shown to be incapable of fully occluding blood flow no matter how much the cuffs are inflated, making them incredibly safe. This leads to great peace of mind for myself and all my patients when using this system.
If you’d like to save 10% on any purchases with this system, simply click on this link to go to their website and then use the coupon code “JIMWITTSTROM” at checkout.
Anything can, of course, become unsafe when used inappropriately or negligently. However, when utilizing appropriate parameters on appropriate populations, blood flow restriction has been found to be very safe, including for seniors.
When blood flow restriction is not appropriate
The following list covers some (but not necessarily all) absolute or relative contraindications for seniors wishing to consider implementing blood flow restriction training. It’s important to know that blood flow restriction isn’t appropriate for any seniors who:
- Have decreased or absent sensation in their extremities
- Have altered cognition or mental status
- Have a history of blood clots or impaired circulation ( such as peripheral artery disease)
- Have varicose veins or a history of DVT’s (deep venous thrombosis)
- Have open sores or wounds over the area of restriction
- Have a history of hypertension
- Have a history of lymphedema within the extremities
In otherwise healthy populations, studies have shown that when performed properly, blood flow restriction training does not increase the risk for blood clotting or cause an increased risk of blood-flow-related issues.9–13
Which seniors can benefit from blood flow restriction training the most?
Those who are otherwise healthy or can perform their BFR training under medical supervision may be ideal candidates for this therapy. In particular, there are two categories of seniors who can benefit the most:
Seniors who are currently active and wish to stay active.
With any human being, the more intense or demanding a physical exercise session or activity is, the longer it takes for our body to recover appropriately. Unfortunately, as we age, our ability to recover from regimented exercise or perform activities that challenge our physical fitness slowly declines.
Ultimately, this means that seniors who wish to stay active are often limited by how quickly their bodies can recover before partaking in their next activity session. If they wish to exercise more frequently, they must sacrifice their exercise intensity. If exercise intensity drops too low, it becomes very challenging to stimulate the body enough to become stronger and increase its capacity for endurance.
Thankfully, since BFR training allows individuals to exercise at much lower intensities while still experiencing full exercise benefits, there’s much less physical and physiologic recovery required by the body.14–17
This equates to seniors’ ability to exercise with much greater frequency throughout the week due to less “downtime” required for the body to recover from the previous exercise session, all while retaining all the benefits of higher intensity exercise. Greater exercise frequency with simultaneously less taxation on the body greatly expedites the strengthening and endurance-building process.
Seniors who are currently healthy but limited by joint pain due to osteoarthritis
Unfortunately, osteoarthritis is a condition that becomes more common in humans throughout the aging process and more severe (and thus, more painful). This, in turn, can greatly limit exercise tolerance and capacity. When an individual becomes unable to exercise or stay physically active to their desired extent due to joint pain, it can be challenging to exercise with enough physical intensity (and frequently enough) to encourage the muscles and bones to stay strong and healthy.
The research is already quite clear that blood flow restriction training has statistically significant benefits for helping seniors maintain or improve muscular strength, muscle mass, and endurance while allowing them to exercise beneath the threshold or onset of joint pain in arthritic knees.18–20
What are the most optimal protocols for seniors?
I’ve written a detailed post covering the academic literature that has determined the most optimal protocols for seniors. To read that article (and thus, learn tons of great things), click on this link: Proven by Science: Best Blood Flow Restriction Exercises for Seniors
Final thoughts:
Blood flow restriction training for seniors really is an exciting topic. As a physical therapist and strength and conditioning specialist, science shows us that this training intervention truly opens up new avenues for keeping seniors stronger, filled with more endurance, and staying physically healthier.
By being able to train at lighter resistance loads and train with greater frequency, all while not creating pain within unhealthy joints or weaker tissues, seniors have an exciting and scientifically proven way to ensure they can help adequately challenge their bodies to stay physically strong.
Greater physical strength and endurance is a strong predictor in overall health and quality of life. And when it comes to physical strength, there are zero negative consequences to being a stronger, healthier individual with a higher overall quality of life.
Move well. Live bold.
– Jim
References:
10. Nakajima T, Kurano M, Iida H, et al. Use and safety of KAATSU training:Results of a national survey. Int J KAATSU Train Res. 2006;2(1):5-13. doi:10.3806/ijktr.2.5
Hi! I’m Jim Wittstrom, PT, DPT, CSCS, Pn1.
I am a physical therapist who is passionate about all things pertaining to strength & conditioning, human movement, injury prevention and rehabilitation. I created StrengthResurgence.com in order to help others become stronger and healthier. I also love helping aspiring students and therapists fulfill their dreams of becoming successful in school and within their clinical PT practice. Thanks for checking out my site!