BLOOD FLOW RESTRICTION : NEW TOOL IN THE TOOLBAG?

Wait a minute…. you’re telling me to restrict blood flow while resistance training?  Doesn’t that lead to blood clots, embolus, etc.?  You’re out of your mind man.”  We hear this conversation far too often when discussing a novel technique used to induce muscle growth.  When considering resistance-training variables, everyone traditionally mentions drop sets, supersets, different periodization models, etc.   Now that you’ve incorporated and tried those techniques, it is time to add a new tool to your repertoire.  Lets examine what BFR is and how you can incorporate it into your training program.

WHAT IS BLOOD FLOW RESTRICTION TRAINING?

Blood flow restriction (BFR) {sometimes called occlusion training}, as the name implies, involves decreasing blood flow to a working muscle, by application of a wrapping device, such as a Kaatsu device, blood pressure cuff, or knee wraps.  This technique is typically used in conjunction with lighter weight (30-50% 1RM) and performed on the legs and arms, although some research suggests that there may be benefits for other body parts as well (Yasuda et al).  Interestingly enough, some research shows that even walking while BFR can increase muscle size!! (Abe et al)  Thus, the real question becomes:  How in the world is this happening?!?

trainingdayschart

WHAT ARE THE METHODS THROUGH WHICH BFR WORKS?

There are several mechanisms through which BFR may work but we will touch on the 3 primary mechanisms:

1)     Increased Muscle Activation/Motor Unit Recruitment

Typically lifting 30-50% of your 1RM trained to non-failure would only target the Type I (slow twitch fibers).  However, with BFR + exercise we see that even 30% of your 1RM can target the larger, Type II fibers that are important for muscle growth and size.  Interestingly enough, Yasuda et al (2010) found greater muscle activation in the chest muscles when wrapping the cuffs at the top of the arm and performing a bench press movement.  This indicates a possible benefit for muscles other than the ones that are purely “restricted.”

2)     Increased Metabolic Stress

Don’t fear.  Acute metabolic stress, such as that seen when training can actually be a good thing.  One of our colleagues Dr. David Gundermann found that the plasma lactate response seen during BFR at 30% 1RM was significantly higher than high volume workouts using 70% 1RM!  Why does this matter?  In fact, research indicates that increased metabolic stress was linearly associated with changes in muscle cross sectional area.  As if that wasn’t enough, Dr. Gundermann did an experiment where he took muscle cells and exposed them to lactate.  Just exposing them to lactate alone drastically increased downstram targets of mTOR which we all know is the master regulator of protein synthesis.

3)     Increased Cell Swelling

Arnold used to say he “trained for the PUMP!”  Maybe he was on to something because there appears to be evidence that intracellular metabolites cause cell swelling which may activate anabolic pathways.

bfrus1 bfrus2

HOW CAN YOU INCORPORATE BFR INTO YOUR PROGRAM?

Stop lifting heavy weights.  Everything you have been doing has been a lie.  Just kidding again.  It’s important to remember that this is a TOOL to use in addition to your regular resistance-training regime.  You can use it as a finisher, but you can also use it if you’re flat out tired, injured, or just want to train on Saturday yet you still feel like you got hit by a truck from a Friday night out.  Some important considerations to consider:

1)     Scheme Typically Used Is: 30-15-15-15 reps with 30 seconds rest:

Keep rest periods short.  Its all about pumping them out and keeping that metabolic stress and cell swelling up.

2)     Its Not about Damage:

One of the kings of BFR, Dr. Jeremy Loenneke, did an interesting study that showed that the concentric portion of the contraction seemed to be more important than the eccentric.  The goal with BFR isn’t to create muscle damage.  Pump out the reps with proper form…proper form aka don’t be the guy at the gym doing the hip thrust – bicep curl combo workout.

3)     Wrap at a moderate, snug pressure:

If you can imagine 10/10 being as tight as humanly possible, our lab has found that at about a 6-7 out of 10 is ideal.

4)     Device:

You can use knee wraps or even plastic tourniquets:

5)     Keep your Wraps On:

It will be painful and it will hurt but keep your wraps on the entire time (30-15-15-15).  Now if you start turning blue/purple, that might be a time to release them and rewrap.

Our lab and as well as others (Leubbers et al) found that doing your supplemental work with BFR can result in significant gains in muscle size.  So as a take away, you can use BFR when you are injured, as a finisher for your workout or as an entire workout itself on a day when you feel pretty crappy, yet still want to get some work in.

REFERENCES
  1. Abe, T., Sakamaki, M., Fujita, S., Ozaki, H., Sugaya, M., Sato, Y., & Nakajima, T. (2010). Effects of Low‐Intensity Walk Training With Restricted Leg Blood Flow on Muscle Strength and Aerobic Capacity in Older Adults. Journal of Geriatric Physical Therapy, 33(1), 34-40.
  2. Fujita, S., Abe, T., Drummond, M. J., Cadenas, J. G., Dreyer, H. C., Sato, Y., &  Rasmussen, B. B. (2007). Blood flow restriction during low-intensity resistance  exercise increases S6K1 phosphorylation and muscle protein synthesis. Journal of  Applied Physiology, 103(3), 903-910.
  3. Loenneke, J. P., Wilson, J. M., Marín, P. J., Zourdos, M. C., & Bemben, M. G. (2012). Low intensity blood flow restriction training: a meta-analysis. European journal  of applied physiology, 112(5), 1849-1859.
  4. Lowery, R. P., Joy, J. M., Loenneke, J. P., Souza, E. O., Machado, M., Dudeck, J. E., &   Wilson, J. M. (2014). Practical blood flow restriction training increases muscle hypertrophy during a periodized resistance training programme. Clinical   physiology and functional imaging, 34(4), 317-321.
  5. Luebbers, P. E., Fry, A. C., Kriley, L. M., & Butler, M. S. (2014). The effects of a 7-week practical blood flow restriction program on well-trained collegiate athletes. The Journal of Strength & Conditioning Research, 28(8), 2270-2280.
  6. Wilson, J. M., Lowery, R. P., Joy, J. M., Loenneke, J. P., & Naimo, M. A. (2013). Practical blood flow restriction training increases acute determinants of    hypertrophy without increasing indices of muscle damage. The Journal of Strength & Conditioning Research, 27(11), 3068-3075.
  7. Yasuda, T., Fujita, S., Ogasawara, R., Sato, Y., & Abe, T. (2010). Effects of low‐ intensity bench press training with restricted arm muscle blood flow on chest muscle hypertrophy: a pilot study. Clinical physiology and functional imaging, 30(5), 338-343.
  8. Yasuda, T., Loenneke, J. P., Thiebaud, R. S., & Abe, T. (2012). Effects of blood flow restricted low-intensity concentric or eccentric training on muscle size and strength. Plos one, 7(12), e52843.
  9. Yasuda, T., Ogasawara, R., Sakamaki, M., Ozaki, H., Sato, Y., & Abe, T. (2011). Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size. European journal of applied physiology, 111(10), 2525-2533.
ABOUT THE AUTHOR

Ryan Lowery has his masters of science in exercise and nutrition science from the University of Tampa.  Having published over 80 manuscripts, abstracts, and book chapters on human performance and sports nutrition, Ryan serves as a research scientist in Dr. Jacob Wilson’s lab.  Ryan has compiled over $1.8 million in grants for his university and serves as a reviewer for some of the top peer reviewed journals. Ryan plans to begin his PhD work this fall at Aukland University.

www.linkedin.com/in/ryanplowery

https://www.researchgate.net/profile/Ryan_Lowery?ev=hdr_xprf

Twitter: @ryanlowery14

 

USING VARIABLE RESISTANCE TO BUST THROUGH PLATEAUS

Variable resistance training, or VRT, has been a fixture in powerlifting for decades. In this context, VRT specifically refers to resistance training with elastic bands or chains attached to a barbell, mostly in the squat, bench press, and deadlift exercises. These are not thera-bands or machines with lumpy cams; we’re talking about real-deal exercises with bands or chains creating load in addition to the traditional plates. It is referred to as VRT because the resistance changes throughout the movement, increasing as the lifter approaches the lockout. VRT can also be called accommodating resistance, as the resistance is accommodating the “strength curve,” meaning the resistance is greater in the range of motion which the lifter is usually stronger.

You might be thinking, “but if I’m already stronger in that range of motion, why the hell am I training it? I don’t get stuck at the top!” There are two components to power generation, force and speed. We all know force is necessary for moving serious weight, but speed, and momentum, is often overlooked. If you get stuck about 3 inches off the chest in the bench press, then that 3 inches can be used to generate momentum to help press through the sticking point. VRT emphasizes maximal power generation through the entire range of motion – you have to work harder at the bottom to get through the top. This can be achieved by working both sides of the power equation, force and speed.

Speed training, or dynamic effort training a la Westside Barbell, uses submaximal loads with the goal of fast bar speed, and it is an underutilized tool for many intermediate level lifters. Everyone knows lifting heavy can make you stronger, but few realize lifting fast can make you stronger too. The first research study I ever conducted compared a traditional 6-week strength and conditioning program to the exact same program with bands added to the squat and bench press exercises once per week on the dynamic effort day. The group with added bands had greater increases in strength than the traditional training group.  More recently, Soria-Gila et al. found that in 10 out of 11 studies researching VRT, the VRT group experienced greater improvements than traditional training.

So how do we use bands or chains? First, load is important. Somewhere around 30% of 1RM from band tension currently seems ideal for speed training with 40-60% 1RM as traditional free weights. When I say 30%, I mean 30% at the top, or at the bands longest length during the lift. At the bottom of the lift, the band or chain ideally is providing very little to no tension. However, you do not want the band to go slack more than 1/2 inch from the bottom of the range of motion. If you do not know the tension of your bands at particular length. You can pull a MacGyver and figure it out by hanging a weight from the band and measuring its length with a tape measure. To fine tune the tension, you can wrap the band around the bar a few times. Second, great gyms will have squat racks and benches with band pegs, but other times you can secure them to a dumbbell or the bottom of the rack. Make sure it’s a heavy dumbbell; if it comes off of the floor, that’s called crazy bells, and that’s fun, but it’s not what we’re doing – get a heavier dumbbell. On the bench press, you can also wrap the band underneath the bench. It’s a bit more precarious and awkward, but it gets the job done. Third, always remember that this is SPEED TRAINING. Move the freaking bar like you mean it. For 2-5 reps, 3-8 sets.

For strength training (i.e. max effort method) with accommodating resistance, add 10-25% 1RM as band/chain tension to 80-95% free weight. 3-5 sets. 1-5 reps. This is the same setup, just a different application. For strength adaptations, both bands and chains are great, but I favor chains or chains with a light band. Conversely, I will always use bands over chains for speed training due to their multiplicative nature. Let me explain. Bands will get harder faster, and chains will get harder at a constant rate. For example, for every inch a band is stretched, it will increase in resistance by 1lb for the first inch, 1.5lbs for the second inch, 2.5lbs for the third inch, 4lbs for the fourth inch, etc. but chains will always add 2lbs per inch it is raised from the floor. Don’t quote me on the exact numbers, but you get the point. I also like bands because you can use them against gravity as well as with gravity.

What I’m talking about is called reverse bands. Not only does this get your ego yoked, but it’s a great tool for getting mentally and physically comfortable under near-max loads as well as work on power development out of the hole in a manner more akin to heavy lifting. It similarly accommodates a strength curve, but instead of adding variable resistance in the concentric, it variably removes load as you descend. For reverse bands, it should be obvious from the name, but you attach the bands to the top of the rack instead of the bottom. Then you toss another plate on the bar and legally change your name to Billy Badass. Use bands this way if you fail in the hole, off the chest, or off the ground. This means you suck at changing direction in the squat/bench or at initiating the pull in the deadlift and can help fix it with the reverse band exercise. That being said, if you have bad technique, then reverse bands will not help you much – fix your technique! The reverse band exercise is also great for improving bar speed with heavy loads, and leading up to a 1RM test or meet for building comfort with heavy, supramaximal weight.

Now we know VRT can help you get stronger and more powerful, but what about bigger? I’ll change the exercise here to meet a bodybuilding application and discuss the leg press. We all had a friend or classmate growing up that thought it was awesome to half-rep a few hundred pounds on the leg press. If you didn’t have one, you might need to check your range of motion next time you leg press. Anyway, the point is that the top half of a leg press is easy-peasy. As a result, we don’t really need to keep pressing very hard once we get out of the bottom to complete the lift, and in fact it is discouraged to press so hard that the sled flies off of our feet. What can we do? I think you know. We can accommodate the strength curve. Using bands, we can increase the load selectively at the easy range of motion to make it harder at the top and get a better contraction in the quads.

In short, bands make you faster, stronger, and bigger, and you should really start using them in your training.

 REFERENCES
ABOUT THE AUTHOR

Jordan Joy is currently a Research Coordinator at the MusclePharm Sports Science Institute. He is a CISSN certified sports nutritionist and CSCS certified strength coach. Jordan has his MS in Applied Nutrition with Northeastern University and is pursuing his PhD in Human Performance.

STRONG IS THE NEW SEXY: INTRO TO STRENGTH TRAINING FOR WOMEN

Women need to lift.  It’s as simple as that.  Not only to look better and be stronger, but also because it’s good for us.  It’s good for your bones, increasing bone mineral density and protecting against osteopenia and osteoporosis.  It increases lean mass, which in turn increases your resting metabolic rate, or the number of calories you burn on a given day just laying around doing nothing.  It’s good for your self-esteem, and can improve both body image and overall perceptions of well-being.

So what is a girl to do who is looking to start a weight training regimen but has no idea where to start?  Well, for one, get off the treadmill and into the weight room!  Check out what the guys in the gym are doing, at least the ones who look like they have a clue.  Chances are, if it works for the guys, it will work for us too.  But don’t worry, you aren’t going to get huge if you lift like a man – guaranteed.  That’s just not possible.  We don’t have the testosterone levels and never will.  You will get stronger though, and particularly if you squat regularly, you’ll end up with a firm, rounded posterior that will be the envy of all those cardio queens.  If you want to be stronger than ever, have more defined muscles, and an athletic physique, then look no further.  This 4-week intro to strength training program will put you on the right track, because let’s face it ladies, strong is the new sexy!

Below is an example of how you might train each week.  You don’t have to do MWF, but you should lift on non-consecutive days since you’ll be hitting all of the major muscle groups each time you lift.  48-72 hours between lifting sessions is sufficient, but don’t be alarmed if you are still experiencing some muscle soreness from the previous workout, especially if you are a beginner.  When in doubt, consult a certified personal trainer or strength and conditioning specialist to advise you on form and technique. Or just ask one of the gym rats, they’ve been wanting to talk to you anyway.

Start with a light warm up set before moving into your work sets.  That is, use the empty bar or a light weight you can easily lift for 10-15 repetitions just to get the movement down and prepare your muscles to do work.  Mondays will involve sets of 10-12 repetitions of each exercise (for one arm row, that’s 10-12 per arm) with a weight that just allows you to finish the prescribed number of reps, but not more than that.  This will take some trial and error initially, but you’ll figure it out pretty quickly and build from there.  Rest 60 s between exercises/sets.  Core work will always be a higher number of repetitions (15-20 per set) for any given workout, as you want to develop local muscular endurance in this region that will improve core stability and help with the rest of your lifts.

Wednesdays are sets of 8 repetitions with 1-2 minutes rest between exercises/sets, using a moderately heavy weight that just allows you to complete 8 reps but no more than that.  Fridays will be your heaviest weight lifting days, don’t be afraid!  You’ll only be doing 6 repetitions, but it should be challenging, i.e. don’t use the same weight you used Monday.  You get to rest for 2-3 minutes, which is plenty of time to recover even though the weight is heavy.  Be certain to focus on proper lifting technique and breathing.

Use the 2 x 2 rule for increasing weight on a particular exercise (don’t know the 2 x 2 rule?  Check it out on MPSSI’s website: http://mpssi.com/using-the-2-for-2-rule-to-determine-weight-load-increases/ ) so that you continue to build strength each week.  As long as you’re making progress (increasing the amount of weight lifted on a given exercise) you may choose to repeat this 4-week cycle using 3-4 sets once you’ve finished the initial one.  Want to mix things up?  Try switching between dumbbell, barbell, and cable variations of exercises.  The key is to stick with it!

ABOUT THE AUTHOR

Roxanne Vogel, EP-C, CSCS, CISSN is a certified strength and conditioning coach (NSCA), exercise physiologist (ACSM), and sports nutritionist (ISSN) who currently works as a research assistant at MusclePharm Sports Science Institute.  A former cardio queen, she has long since seen the error of her ways and adopted a heavy resistance training regimen that has allowed her to climb some of the world’s highest mountains.

REFERENCES

Ahmed, C., Hilton, W., & Pituch, K. (2002). Relations of strength training to body image among a sample of female university students. The Journal of Strength & Conditioning Research16(4), 645-648.

Cunningham, J. J. (1982). Body composition and resting metabolic rate: the myth of feminine metabolism. The American journal of clinical nutrition36(4), 721-726.

Kelley, G. A., Kelley, K. S., & Tran, Z. V. (2001). Resistance training and bone mineral density in women: a meta-analysis of controlled trials. American journal of physical medicine & rehabilitation80(1), 65-77.

Kraemer, W. J., Ratamess, N. A., & French, D. N. (2002). Resistance training for health and performance. Current sports medicine reports1(3), 165-171.

Linnamo, V., Pakarinen, A., Komi, P. V., Kraemer, W. J., & Häkkinen, K. (2005). Acute hormonal responses to submaximal and maximal heavy resistance and explosive exercises in men and women. The Journal of Strength & Conditioning Research19(3), 566-571.

Pollock, M. L., Franklin, B. A., Balady, G. J., Chaitman, B. L., Fleg, J. L., Fletcher, B., … & Bazzarre, T. (2000). Resistance exercise in individuals with and without cardiovascular disease benefits, rationale, safety, and prescription an advisory from the committee on exercise, rehabilitation, and prevention, council on clinical cardiology, American Heart Association. Circulation101(7), 828-833.

CONCURRENT TRAINING 101

Concurrent training is inclusion of both resistance and endurance training within the same training program. For example, if you lift weights on Monday and run a few miles on Tuesday, then repeat this pattern throughout the week or in the same day, you are training concurrently. This can be advantageous for reducing body fat compared to resistance or endurance training alone, as strength training typically does not yield decrements in body fat, and endurance training reduces lean body mass, strength, and power in trained individuals. However, concurrent training does not produce as great of an increase in muscle mass or strength as resistance training alone, nor does it produce as great of a loss of body fat as endurance training alone.

Progress may be halted by the large volume of work necessary to perform both modalities simultaneously by pushing the athlete into an overreached or overtrained status. However, those accustomed to higher workloads should be able to handle high volume. Therefore, it is more likely that stalled progress is due to competing adaptations. Wherein, resistance training adaptations (i.e. increased muscle mass, strength, power, and maintained oxygen consumption) compete with endurance training adaptations (i.e. reduced muscle mass, strength, power, and increased oxygen consumption). Much of this difference can be attributed to muscle size. It is advantageous for strength and power athletes to have large muscles, as larger muscles have higher force output, yet they also increase the diffusion distance for oxygen, making it more difficult for the mitochondria to receive oxygen to produce ATP (energy). Thus, it is beneficial for endurance athletes to have smaller muscles to oxygenate, and the longer duration you perform steady state cardio, the more muscle and strength you lose! Reduced muscle also reduces basal metabolic rate, making long term fat loss more difficult. At this point, you might be wondering, “what the hell do I do then? Concurrent training is bogus!”

For primarily anaerobic athletes such as football players, or those who just want to be huge and ripped, it is not worthwhile to perform much steady state cardio for the reasons listed above. Instead, cardiovascular activity for these sports should be primarily of very high intensity (90-100+ %) and short duration (10-30 sec) with fairly long rest periods (2-4 min). This type of cardio (also known as HIIT, or high intensity interval training) will impede resistance training adaptations less than steady state cardio. Of course, these athletes should weight train often, 3-7 days/week depending on training status.

For anaerobic and aerobic athletes such as basketball or soccer players who are active for a long duration, but also intermittently sprint, limited steady state cardio can be helpful. Although keep in mind that it will blunt increases in power from resistance training – don’t overdo it; once per week is sufficient for most individuals. The cardio train doesn’t stop there. Perform HIIT 2-5 days/week in addition to the steady state cardio depending on your sport and training status… then run through people like a train (this requires 3-5 days/week of resistance training).

For purely aerobic athletes such as marathoners, concurrent training is highly preferred! Rejoice! However, long duration steady state cardio should still only be performed once or twice per week with a focus on technique. HIIT, and other forms of higher intensity training such as fartlek and pace training, alone is very capable of increasing endurance, not only via increased oxygen consumption, but increased lactate threshold and/or lactate clearance. The maximal lactate steady state (MLSS) is arguably more important than maximal oxygen consumption for endurance athletes. MLSS can also be positively influenced by resistance training. Moreover, resistance training increases muscular tone. Increased muscular tone, when running, reduces energy lost to “rebounding” off the pavement, for example. In lax muscles, energy is required to absorb the force of contact with each step, yet tense muscles will absorb the force without expending as much energy. Weight training will also not blunt endurance adaptations if performed at a high intensity with low volume (i.e. without inducing muscle growth).

In summary, concurrent training reduces increases in strength, power, and muscle associated with resistance training. On the flip side, it enhances strength, power, muscle, and basal metabolic rate for endurance training alone. HIIT is recommended to reap the benefits of concurrent training without the drawbacks associated with steady state cardio.

ABOUT THE AUTHOR

Jordan Joy is currently a Research Coordinator at the MusclePharm Sports Science Institute. He is a CISSN certified sports nutritionist and CSCS certified strength coach. He has his MS in Applied Nutrition with Northeastern University.

REFERENCES

Alabini, C. P., Psarakis, C. H., Moukas, M., Assiliou, M. P., & Behrakis, P. K. (2003). Early phase changes by concurrent endurance and strength training. The Journal of Strength & Conditioning Research, 17(2), 393-401.

Dolezal, B. A., & Potteiger, J. A. (1998). Concurrent resistance and endurance training influence basal metabolic rate in nondieting individuals. Journal of applied physiology, 85(2), 695-700.

Hickson, R. C. (1980). Interference of strength development by simultaneously training for strength and endurance. European journal of applied physiology and occupational physiology, 45(2-3), 255-263.

Lowery, R. P., Joy, J. M., Brown, L. E., de Souza, E. O., Wistocki, D. R., Davis, G. S., … & Wilson, J. M. (2014). Effects of static stretching on 1-mile uphill run performance. The Journal of Strength & Conditioning Research, 28(1), 161-167.

Wilson, J. M., Marin, P. J., Rhea, M. R., Wilson, S. M., Loenneke, J. P., & Anderson, J. C. (2012). Concurrent training: a meta-analysis examining interference of aerobic and resistance exercises. The Journal of Strength & Conditioning Research, 26(8), 2293-2307.