Progressive Strength Training & Blood Flow Restriction

What is Progressive Strength Training?

Individualized progressive strengthening is a method of strength training utilized by physical therapists to gradually increase a patient’s muscle strength based on their observed muscle weaknesses and their specific injury. Blood Flow Restriction is sometimes utilized as an additional technique to improve the results of Progressive Strength Training.

Progressive Strength Training in Eliot

When a person gets injured, they may suffer from muscle weakness, either because of the injury or as a cause of the injury. During your initial evaluation, your therapist will evaluate the strength of the muscles surrounding your injury and take measurements to assess how well your muscles are functioning to support activity. These measurements will be used to establish your muscular strength and will be used as a comparison for further testing to observe how well you progress during your physical therapy treatment.

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Progressive strengthening is used by our physical therapists to help build muscle strength by gradually increasing the amount of resistance or weight used during exercise.

The basic physiology of strengthening muscles requires increasing load to fatigue the muscles
which then responds by getting stronger.

We begin each patient’s strengthening program with small amounts of weight. As their strength increases, we progress the exercises and the weights used during those exercises to gradually build muscle strength.

We tailor progressive strengthening programs specific to each patient to help them maximize their strengthening and to address their individual injuries and weaknesses.

Improved muscle strength
Maintaining flexibility, mobility, and balance, which can help maintain independence in ageing
Weight management
Greater stamina – as you grow stronger, you won’t get tired as easily
Prevention or control of chronic diseases such as diabetes, coronary artery disease, arthritis, back pain, depression and obesity
Pain management
Improved posture
Increased bone density and strength and reduced risk of osteoporosis
Improved sense of wellbeing – resistance training may boost self-confidence, improve body image and mood

The goal of BFR is to quicken the healing process.

BFR is a technique that reduces the blood flow to an extremity, which causes the muscles to work harder metabolically. Forcing the muscle to become more acidic triggers the brain to release growth & healing hormones, which leads to healing with time and repetition.

We know, Blood Flow RESTRICTION sounds intense, but it is an evidence-backed technique that is safe and our therapists are properly trained to utilize it correctly.

BFR is a way to avoid the muscle micro-tearing that results from traditional strength training & exercise. Emphasizing the chemical reactions within the body to lead healing, can have a system-wide impact. There is an obvious local impact to the muscle effected, but it can also have systemic effects within the body helping tissues heal all over.

Athletes! Athletes of all kinds that are hoping to fast-track or enhance their muscle growth can benefit from the effects of BFR.
Post-Surgical! Those who are in the early stages of recovery post-surgery and have limited movement can benefit, since BFR commonly requires less effort or movement.
Older adults! BFR allows muscles to work ‘harder’ in a shorter amount of time and less effort.
Stubborn elbow, wrist, or hand pain! When there is pain in these areas, the range of motion is typically reduced. BFR allows for a heightened likelihood of strengthening those muscles.
Knee, ankle, or foot pain! Similar to the above mentioned, if movement is restricted or limited, BFR can be a great workaround to alleviate the pain and strenghten the necessary muscles.

Want to read a bit more about BFR? Click here to read our blog post!

Current Research:

There is a lot of research that has been published in the past several years that shows the benefit of progressive strengthening on an array of injuries. Our therapists utilize current evidence to help dictate their patient treatments to give our patients the best possible treatment incorporating the latest treatment techniques. Utilizing scientific research is vital to achieving the best possible outcomes for our patients as it allows us to incorporate tried and true methods that have been proven to be beneficial.

Below is a sampling of the current research about progressive strengthening. It has been utilized in a variety of studies with a variety of patient populations, each of which improved because of progressive strengthening exercises during their physical therapy treatment.

These research articles demonstrate the effectiveness of progressive strengthening to increase strength and improve patient outcomes for the following injuries:

ACL reconstruction, recurring low back pain, children with Cerebral Palsy, Coronary Artery Disease, Stroke, and knee pain due to osteoarthritis.

1.	Progressive strength training restores quadriceps and hamstring muscle strength within 7 months after ACL reconstruction in amateur male soccer players. Welling W, Benjaminse A, Lemmink K, Dingenen B, Gokeler A. Phys Ther Sport. 2019 Nov;40:10-18. doi: 10.1016/j.ptsp.2019.08.004. Epub 2019 Aug 9. PMID: 31425918
2.	Effectiveness of a Group-Based Progressive Strength Training in Primary Care to Improve the Recurrence of Low Back Pain Exacerbations and Function: A Randomised Trial. Calatayud J, Guzmán-González B, Andersen LL, Cruz-Montecinos C, Morell MT, Roldán R, Ezzatvar Y, Casaña J. Int J Environ Res Public Health. 2020 Nov 11;17(22):8326. doi: 10.3390/ijerph17228326. PMID: 33187076 Free PMC article. Clinical Trial.
3.	The Effects of Functional Progressive Strength and Power Training in Children With Unilateral Cerebral Palsy. Kaya Kara O, Livanelioglu A, Yardımcı BN, Soylu AR. Pediatr Phys Ther. 2019 Jul;31(3):286-295. doi: 10.1097/PEP.0000000000000628. PMID: 31220015 Clinical Trial.
4.	The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials. Hollings M, Mavros Y, Freeston J, Fiatarone Singh M. Eur J Prev Cardiol. 2017 Aug;24(12):1242-1259. doi: 10.1177/2047487317713329. Epub 2017 Jun 5. PMID: 28578612 Review.
5.	Progressive resistance training increases strength after stroke but this may not carry over to activity: a systematic review. Dorsch S, Ada L, Alloggia D. J Physiother. 2018 Apr;64(2):84-90. doi: 10.1016/j.jphys.2018.02.012. Epub 2018 Mar 27. PMID: 29602748
6.	Effect of High-Intensity Strength Training on Knee Pain and Knee Joint Compressive Forces Among Adults With Knee Osteoarthritis: The START Randomized Clinical Trial. Messier SP, Mihalko SL, Beavers DP, Nicklas BJ, DeVita P, Carr JJ, Hunter DJ, Lyles M, Guermazi A, Bennell KL, Loeser RF. JAMA. 2021 Feb 16;325(7):646-657. doi: 10.1001/jama.2021.0411. PMID: 33591346 Free PMC article. Clinical Trial.