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Blood flow restricted exercise in trained athletes

A key objective of an endurance athlete’s training programme is to optimise the underlying physiological determinants of performance. One important consideration is that training adaptations are reduced as training status increases. This means it is harder to improve performance the more training you do.

Blood flow restricted (BFR) exercise is one approach which has the potential to enhance the physiological adaptations associated with training, including increases in capillary supply and mitochondrial function, which can contribute to improving endurance-exercise performance.

The possibilities for BFR exercise to provide “more bang for their buck” for endurance-trained individuals is an exciting prospect that demands further attention. 

Loughborough University academic Dr Richard Ferguson, along with colleagues from Victoria University (Australia), the University of Utah (USA) and the Ineos Grenadiers Cycling Team, has been investigating the potential gains of this technique for elite athletes.

Their recent review paper, published in Experimental Physiology, examines evidence for using blood flow restricted exercise for increasing performance in elite endurance athletes.

The principle of blood flow restriction is that blood flow is reduced to the exercising limbs, most often using an inflatable tourniquet or cuff, which can be used when performing resistance exercise as well as cycling and running exercise. Importantly, the exercise intensity can be kept very low.

What is typically seen when this training method is implemented is that the molecular signals that are associated with adaptation are elevated, even when the exercise is conducted at a very low intensity.

The review concludes that when combined with low-load resistance exercise, low- and moderate-intensity endurance exercise and sprint interval exercise, blood flow restricted exercise can provide an enhanced acute stimulus for forming new blood vessels and increasing cells’ mitochondrial content. 

These augmented acute responses can translate into enhanced capillary supply and mitochondrial function and subsequently into improved endurance-type performance – although this might depend on the nature of the exercise stimulus.

The authors conclude that more research is needed to understand how BFR training interventions could be used by high-performance endurance athletes within their structured training programme.

Find out more

Read the published research:
Ferguson RA, Mitchell EA, Taylor CW, Bishop DJ, Christiansen D. Blood-flow-restricted exercise: Strategies for enhancing muscle adaptation and performance in the endurance-trained athlete. Experimental Physiology. 2021;1–24.

Scientific Triathlon Podcast
Dr Richard Ferguson talks to Scientific Triathlon about blood flow restricted training in a podcast available here:

Page last updated March 2021