Blood Flow Restriction coming to Ortho RI!



About one year ago, I was scheduled to evaluate and treat a high level athlete who had suffered a complex meniscus injury that required surgical intervention. Together, we worked on resistance, endurance, and functional training prior to the surgery. After the surgery, the athlete was limited in how aggressive we could be with training without further injuring the tissue. Around that time, I had also come across a technique known as Blood Flow Restriction (BFR). Upon further investigation, I felt like that might be a great approach for my patient, however application of the technique requires formal and hands-on training and the timing did not work out for that individual. While we missed out on that opportunity, I am now very excited to share that other practitioners and I are now able to apply the BFR technique and better assist our patients.


Accordingly, I’m very excited to announce that Ortho RI will introduce BFR services across all of our rehabilitation facilities starting next week!


So, what is BFR and how does it work?
Blow Flow Restriction was first discovered by Yoshiaki Sato, a Japanese professor. It took him about a decade to develop an effective rehabilitation protocol. His method is also known as Kaatsu training. The training is based on implementing low load resistance training combined with blood flow restriction (1). The technique requires brief occlusion of venous flow while allowing arterial flow. The application requires compression cuffs that are placed on the proximal part of an upper or lower extremity. The application can differ between resistance training, aerobic exercises, and as passive application. While using these techniques, practitioners must adhere to specific treatment protocols in order to effectively perform all activities. Patient’s who most benefit from this training are typically athletes, post-surgical patients, elderly and load compromised population (2).  During training, there is a cascade of physiological changes such as activation of myogenic cells, release of human growth hormone, hypoxia and cell edema, all of which lead to muscle hypertrophy, or muscle mass increase. This technique must be carefully monitored and caution should be taken to avoid side effects which might include dizziness, numbness, fainting and delayed muscle soreness. There is also a pool of patients who do not quality for BFR treatment including those with lymphedema, open fractures, crush injuries, vascular grafts, impaired circulation, acidosis, cancer, or infections.

I hope that this brief description will help you understand the process behind this new training that is coming to Ortho RI. I would like reiterate once more that all of your physical therapy clinics will offer BFR training starting Monday, October 3, 2022!


1.Journal of Strength and Conditioning Research: October 2013 - Volume 27 - Issue 10 - p 2914-2926
doi: 10.1519/JSC.0b013e3182874721
2. Front. Physiol., 15 May 2019 Sec. Exercise Physiology