179 - Blood flow restriction-benefits, uses, & the relationship between muscle size and strength

[@PeterAttiaMD]

In this episode, we discuss: 00:00:00 - intro 00:00:10 - Jeremy’s interest in exercise and weightlifting and his scientific training 00:05:24 - The microstructure and physiology of muscle 00:10:42 - Definitions of fast-twitch and slow-twitch muscle fibers 00:20:18 - Comparison of strength vs. hypertrophy 00:28:00 - Blood flow restriction training and the origins of the Kaatsu system 00:45:28 - The details and metrics related to exercise under blood flow restriction 00:54:25 - Considerations when training with blood flow restriction: loading, pace, rest, and risks 01:06:53 - Blood flow restriction studies and the relationship between muscle size and muscle strength 01:21:00 - Evidence that increasing muscular strength is not dependent on increasing the size of the muscle 01:32:35 - Practical applications of blood flow restriction training for athletes and average people 01:40:50 - Situations in which blood flow restriction training is most advantageous 01:46:02 - The mechanisms by which blood flow restriction training can produce so much hypertrophy at such low loads 01:54:26 - Applications of “passive” blood flow restriction training 01:59:15 - What experiments would Jeremy do if he had unlimited resources?

[@simonmojarad4806]

This is one of the most amazing in-depth video about BFR. We all appreciate your work!!

[@simonrupprecht5617]

By far the most in depth discussion around BFR I have heard so far - excellent. Conversation flow is a bit bumpy, but I attribute this to the precise questions that need more time to think before the response. Would've liked to see a little more lighthearted mood of the two of you though. Meanwhile the scientific discussion was just great. As a follow-up Jordan Shallow D.C. would be an awesome guest, since hearing him speak in scientific precision and depth around exercise and adaptation seems like second nature.

[@daleoldham8245]

I stuck around until the end to get the referenced providers of such devices. Did I miss it or did he forget to address it?

[@richarddodson560]

So, for a person concerned about longevity, and wanting to follow Attia’s “old age olympics”, should one focus more on strength (minus hypertrophy), endurance, or a combination of both?

[@mcylk]

If you liked this podcast, go to Dr. Mercola’s August 15, 2021 podcast, where Mercola interviews Jim Stray-Gunderson, MD, about BFR. Much more practical application information and less trying to sound academic.

[@kentnoller5658]

Thank you Jeremy and Peter for this open and detailed discussion. Well done. I would love to see exploration and a good research study conducted on a training and treatment sequence using exposure to red light, then near infrared, just prior to BFR and exercise. Just one more method to optimize the positive metabolic cascade. Anecdotally, I personally found these modalities helpful for a speedy full recovery from a left leg lateral malleolus fracture and severe knee and ankle sprain. I also used the Normatec compression system at a low level after a positive x-ray at 2 weeks post injury. Had lots of good PT starting one day post injury. Back skiing again.

[@teabone112]

Nice interview. It would have been nice to hear Jeremy's thoughts on strategies for using BFR to enhance endurance performance.

[@alansulikowski2331]

Excellent talk. Very thought provoking. Thank you. Peter, after having heard the talk, prepared your questions and read scientific papers, it would be great to add your Two cents and or conclusions to this format or to an AMA Q&A. For me, reducing the work out time and improving the gains may mean more efficiency and better outcomes. Thanks again

[@grambebe]

I’m 79 and used to be a swimmer but have not worked out in years . I know I have to get stronger for longevity and this sounds like a great way to reduce the time required. I run a business where I travel a lot and don’t have time for regular workouts. Could you comment about how much benefit BFR would be for a senior who is not in shape? My feeling is that I could spend less time and get more benefits. I’d love your opinion.

[@felipearbustopotd]

Maybe Steven Munatoes, co-founder of Kaatsu Global could be interviewed on BFR? I do this type of muscle stimulation after a 2 year absence due to an injury and a further 8 months of rehabilitation. Getting results like never before. Example Pull up. 5 seconds up. 5 seconds hold at the top Then 20 seconds, if not longer when lowering for completion. I then hold for another 5 seconds I then dismount. Thank you for uploading and sharing. ❤

[@jron20r51]

I got into BFR a few years ago from when I saw an ex NFL player talk about it. He gave the credit to Sato, I looked at everything about it and it was Sato in Japan who came up with it. In America it is guys like Layne Norton hates to give credit to anyone else. Even Jeremy here tries to sideline Sato's discovery. Kattsu is way to expensive for me, and like Peter I own the cheap cuffs and they work great.

[@bluloo]

Fantastic interview. One of the most intelligent and thoughtful on the subject. Kudos

[@eja2512]

Jeremy mentions Andy Galpin. I recall him on joe Rogan podcast maybe 4 years ago. I feel he would also provide an interesting discussion on this topic.

[@michaelderenne9838]

What bfr bands do you recommend? Ive been thinking about buying the SAGA bfr bands.

[@johnfisher8510]

If you engage all motor units to failure (or even a little short of failure) what's the benefit of doing additional sets?

[@piercep2091]

Very interesting topic, thanks for sharing

[@fernandoguk]

Interesting video. Even that the 2 things that I remember the most are the set of heavy Deadlifts , this week I just decided to stop on my heaviest set after 2 repetitions, and not risking to look like an angry cat, but instead of doing leg presses, I went for my straps and "finished" the set, so I did another set with 3 reps, I had done heavy squats before. And second the conversation about Scotch and Single Malt, It reminded me of my days of having Whisky after dinner on the weekends, I might retake that. Thanks for the video.

[@samashford1968]

I can't help thinking of Ryan Hall and his transformation in the past few years. He went from a world class elite Marathon record holder to pumping iron and adding a lot of mass. And this, after tremendous overtraining fatigue. Any thoughts?

[@Thedudeabides803]

Very cool discussion and I loved the one with Lance.

[@F.Portellano]

Any book recommendation on bfr training? thx!

[@salehaallal4364]

I was always the fastest on the soccer field, but always was the tall lanky kid. My explosion in the first 2 meters was always slightly above average, but after the first few meters I was always the fastest .. what kind of type 2 do I have? I feel like most tall dudes I know are just ki d of awkward and slow, and looking at me objectively no one would think I look like I can sprint really well… did I adapt to soccer which has an explosive component to it? But why did I adapt better than then shorter explosive dudes with huge quads and hammies? I think there is also a skelletal aspect to this, my leg length, the way my muscles and reins are attached might also be favorable for efficient running which is making me be pretty fast, despite having a morphotype that would be more suited to cardio type athletics? Because I’m actually pretty good at running 10 ks ( I can run under 40 minutes )

[@HelenDriscoll]

Ah, you are having a problem because you're using a hard band vs a bladder (inflated) cuff. I've been using BRT for a year, and bought the cheap bands first too. Invested in a bladder cuff system within a few months, because restricting arterial flow began to make me really nervous. Utterly different experience. (I'm 69 yrs old and have been working out consistently for 35 yrs, multi- techniques and gear) You should be concerned about nerve damage with the cheap bands. The bands I use are slightly uncomfortable before workout, but in a good way. After approx 20 minutes, I take them off. I really tune in to how it feels for safety.

[@viorelgalan7913]

What kind of bands you got, what brand ect?

[@HelenDriscoll]

@@viorelgalan7913 We bought the B-Strong system. The pump nozzle can be a bit fussy, but it's been a good system so far.

[@dahVEEDBBone]

@@HelenDriscoll Mine are from Edge Mobility but a piece of paper in the package mentions B Strong so I guess it's the same system, branded differently. At work (PT clinic) we have the single cuff from Owens Recovery Science.

[@edwardaligonzalez123]

I use bands for bfr and notice a huge increase in size n pump in biceps, any studies of if any of that size is kept as gains or all temporary? Thanks knowledge is power

[@HM11793]

Hello is there a way I could contact both of you for further information on this? I have some questions concerning how bfr would work with different blood flow environments?

[@HelenDriscoll]

Interesting. I wonder if T2DM sarcopenia is a mix of nerve damage and metabolic damage.

[@howardmiller5411]

Bikram (hot 26-2) yoga utilizes blood flow restriction and release in its floor poses. The benefits of this are discussed in the instructor’s dialogue.

[@CoachHeyward]

How’s bikram these days? Did the FBI manage to extradite him from Mexico?

[@toekneeevans]

Does Peter have Elvis pants on? 👀

[@swimraces]

or old school ABA warmups.

[@PerryScanlon]

Is the only benefit size? I doubt it would be best for strength, endurance, and economy.

[@Markhypnosis1]

It's great for endurance too. I follow a cycling coach who uses them for bike training. It's because it puts the muscles into a hypoxic state with lower intensity, forcing the muscles to use oxygen more efficiently. Amongst other things.

[@PerryScanlon]

@@Markhypnosis1 compared to high reps?

[@Markhypnosis1]

@@PerryScanlon Compared to high reps with no blood flow restriction? Firstly you'd have to use a heavier weight to get the same amount of high reps as you would if blood is restricted. The main point of bfr is that you can use much lighter weights, thus eliminating the muscle damage that needs to be healed before any adaptations take place. Which means that with the very light weights with bfr, the body can go straight into the adaptation phase. It hugely reduces the risk of overtraining, so you can add more volume. Another thing that happens, is that due to the restricted blood flow and build up of waste byproducts, growth hormone and other hormones are released systemically (whole body). The restricted blood flow also causes more blood vessels to form within the muscles to allow for greater efficiency of oxygen uptake due to the lack of oxygen within the muscles.

[@PerryScanlon]

@@Markhypnosis1 interesting theory. I'd be curious if a study has compared the two. Sometimes athletes are ahead of the research and sometimes not.

[@knight9464]

I'm truly increasingly concerned about Peter, he sounds depressed. This is depressing... We care for genius talent like Peter

[@williamerdman4888]

How do you get depressing out of this?

[@elvay6847]

How do you get genius talent out of this?

[@knight9464]

@@williamerdman4888 I don't expect everybody to understand

[@williamerdman4888]

@@knight9464 You've explained yourself exceptionally well.

[@knight9464]

@@williamerdman4888 glad that now you see what I see. I care for Peter, hence my comment.

[@vincentrevers3004]

What exactly is the point??? Yes you can use lower weight, but you can do that without restriction if you are rehabbing. If restriction doesn't actually change the outcome why do it?????

[@googlesmostwantedfrog147]

It releases a flood of hormones, 15 minutes after you take them off it turns off the slow twitch fibers and turn on the fast twitch fibers

[@askingwhy123]

I'm interested because I tend to get medial epicondylitis; my elbow tendonitis is load dependent. If I can train biceps with 30% of my one rep max with a reasonable volume, I'm much less likely to aggravate my elbows.

[@Rafaela.F.S]

Legendas em português por favor

[@oldschoolhomeschool8071]

Quem tem tempo?

[@knight9464]

So basically guys zip it and put in the smart work at the gym...

[@kimdavis7812]

This is MUCH more interesting than L. Armstrong…. Thank you 👍