Should I use blood flow restriction bands with resistance training? Here's what to know

Recently, I wrote a column about using the pre-exhaustion method during resistance training and was surprised by the high response. The advantage is being able to tax the muscle sufficiently to convince it to make changes and grow bigger and stronger, but without heavy weights that can overstress the joints. This is especially important for older folks with aging and/or arthritic joints and those coming back from injury or surgery.

Considering the high interest, I decided to take things a step further and introduce the “combo” method I have used when a joint (typically a wrist or elbow) is strained and I want to keep training.

The goal of the “combo” method is to increase the effectiveness of the pre-exhaustion method by combining it with blood flow restriction bands. This combination allows even less resistance (lighter weights) to be used during training, while still reaping the benefits of challenging the muscles and forcing them to adapt. In particular, the “combo” method is very successful when it comes to “pumping up” the muscles (as Arnold Schwarzenegger used to say).

At times I have commented on older folks (Note: I’m 77) in the gym merely going through the motions with very light weights. This may be due to unfamiliarity with how to train effectively (within your limitations), or it may be due to tender and fragile joints that cannot tolerate lifting a heavier weight. If the latter is the reason, the “combo” method is the answer to helping workouts be much more effective.

Here's what to know:

What is the pre-exhaustion approach to resistance training?

Let me briefly review the pre-exhaustion approach. First, pre-exhaust the muscle with less resistance than you normally would use. Employ a lighter weight that the muscle can handle easily and exhaust (fatigue) the muscle by performing high repetitions (20 to 30 reps). Rest very briefly, take several deep breaths, then do the exercise again with a heavier weight, but one that is still less than you normally would use with healthy joints. Because the muscle is “pre-exhausted” that amount of weight will feel as heavy as a heavier weight to the fatigued muscle, challenging it similarly as you would with a heavier weight, while reducing the stress on joints.

Next, to appreciate the use and advantages of blood flow restriction bands, you must first understand the basic physiologic response that occurs during traditional resistance training.

How does resistance training work?

Typically, when engaging in resistance training, you would use at least 60% of the maximum weight you can lift, performing eight to 10 repetitions per set for each exercise. When you exercise in this way, you are essentially assaulting your muscles, and possibly creating some degree of muscle damage that must be repaired. During the repair process, the intention is that the body will overcompensate, making the muscle bigger and stronger.

After you assault the muscle, rebuilding starts immediately by “feeding” the muscle with resources (oxygen and nutrients). The post-exercise feeding process is somewhat complicated, but in a nutshell here’s how it works.

When you contract a muscle vigorously with at least 60% of max resistance, the muscle bulges, and presses against the artery that feeds the muscle. This occludes (shuts off) blood flow into the muscle. Even though blood flow is occluded, and no oxygen can be delivered, the muscle keeps contracting. The metabolic rate increases greatly in the working muscle, and it “screams” for oxygen. But none is delivered because the bulging (exercising) muscle occludes the artery.

Even though no blood can get to the working muscles, the body still tries to promote increased blood flow. Nitric oxide is released from the interior of the artery, causing dilation (an expanded diameter). Small vessels branching off the major artery, plus the gatekeepers that allow blood to flow into capillaries (the smallest vessels) also dilate. In other words, all vessels that feed the muscle are wide open, but no blood is getting through during strong contractions.

At the point of muscle failure, the contractions stop, and the artery is no longer occluded. Blood can now surge through the wide-open channels, gorging the muscle, “pumping it up.” The technical term is “reactive hyperemia” — a delayed and substantially increased blood flow into the exercised muscle, “feeding” it and promoting growth.

Blood flow restriction bands create the same “pumping up” effect but in a much different way.

Should I use blood flow restriction bands with resistance training?

Blood flow restriction bands wrap around the muscle but are not tight like a tourniquet. Instead, the bands are adjusted to modesty compress the upper arms by approximately 70%. The modest pressure occludes veins that drain the muscle but it does not occlude the artery that feeds it. This allows arterial blood to "enter" the muscle while contracting with light weights (as you would use with pre-exhaustion), and then "traps" the blood in the working muscle causing blood to accumulate.

In other words, the bands also “pump up” the muscle, but differently and more dramatically. The difference between the traditional approach versus blood flow restriction bands is that with the traditional approach of “assaulting” the muscle, it is necessary to use heavier weights.

In contrast, blood flow restriction bands allow using light weights, especially when combined with pre-exhaustion. This approach places resistance training well within the reach of almost anyone who has avoided it for fear of damaging fragile joint tissue.

If you decide to try the bands, wrap them just below the shoulder muscles and just above the biceps. Keep the bands in place for about 15 minutes before releasing pressure, then you can reapply, alternating back and forth. Velcro makes the bands easy to put on and take off. The bands are labeled and calibrated numerically (the length is numbered) so that you can gauge a modest compression of approximately 70%. The bands are inexpensive and you can purchase them at any sporting goods store, or online.

Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at [email protected].

This article originally appeared on Louisville Courier Journal: Do blood flow restriction bands help resistance training? What to know