Personalized Blood Flow Restriction (BFR) Rehabilitation is a type of Physical Therapy treatment that integrates the use of a personalized tourniquet system to restrict blood flow to an injured limb during active recovery training.

Often, after an injury or surgery, a patient does not have the ability to lift heavy weights/loads thereby slowing down their overall recovery.  Studies find BFR rehabilitation allows the patient to begin strength training using lesser weights/loads that won’t stress their joints or soft tissues, while still being able to gain the muscle strength, hypertrophy and endurance comparable to that of a heavy load lifting program. (Slysz et al 2015)

While initially used in the treatment and recovery of service members who were wounded in Iraq and Afghanistan, it is now being used with the training and rehabilitation of elite athletes and in orthopedic clinical settings. Clinical trials have shown advancement in the rehabilitation of total knee replacements, wrist fractures, tendinopathies, cartilage injuries and chronic weakness after surgery.

This technique is particularly successful in assisting injured and/or post-surgical patients who are struggling with muscle mass loss and weakness. When a limb is injured, it cannot tolerate the heavy lifting necessary to prevent and reverse the loss process. BFR rehabilitation training, however, allows the patient to achieve the same benefits of heavy lifting while using light weights. BFR has also been demonstrated in the research to significantly reduce pain in the early stages of rehabilitation. (Giles 2017)BFR - blood flow restriction therapy

The basic process involves application of a tourniquet to the injured limb, that is then inflated (similar to a blood pressure cuff) to occlude blood flow to a limb, blocking veins but not arteries, while performing light load exercises.

While exercising with the tourniquet, the patient feels as if they are exerting a lot more force to perform what is typically considered an “easy exercise;” although it is anything but easy. During exercise with the tourniquet, the muscle fatigues and swelling occurs as fluid accumulates and lactic acid builds up. This reaction is what helps stimulate protein synthesis, stem cell proliferation and triggers hormonal responses in the body including increased growth hormone.

It is important to let your health care practitioner know your medical history prior to beginning this exercise program and discuss with your physician if you are a candidate for this rehabilitation.

If you are curious is this type of rehabilitation would be good for you, schedule an appointment and speak with your physical therapist. A thorough evaluation and medical review will be necessary before a determination can be made.

For appointments please call (212) 254-7750 or email


1. Sylsz, Joshua et al “Efficacy of blood flow restricted exercise: A systematic review and meta analysis,” The Journal of Science and Medicine in Sport (2015)
2. Giles L, Webster K, McClelland J, Cook J., “Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain. A double blind randomized trial,” Journal of Science and Medicine in Sport 20S (2017 e67-e105)