Should Rock Climbers Do Blood Flow Restriction Training? (Reviewing BFR Evidence)

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// TIMESTAMPS //
00:00 Intro skit
01:21 Quick clarification
01:28 Context for this video
02:35 Why the hype?
04:06 The research
05:06 Does BFR work for rehab?
07:02 Does BFR work for healthy athletes?
09:06 BFR for healthy athletes pt. 2
10:50 Does BFR cause tendon injuries?
12:00 Conclusions from the research
15:15 My personal conclusions as a PT
15:56 How to try BFR for yourself
// SHOW NOTES //
Episode 106
Should Climbers do Blood Flow Restriction Training? | BFR Research Review
Have we gone too far with our skits yet? Or not even close?! Comment below to let us know ;)
This week's video: Should Climbers do Blood Flow Restriction Training? | BFR Research Review
We focus on the intriguing rehab and training tool, Blood Flow Restriction (BFR).
How do you train or prevent strength loss when you’re injured? How do you gain strength while also being able to put in quality sessions on your project?
The answers to those questions often depend on who you ask. But there’s one technique that some say is the solution to all three, even though it might not sound very enticing, and that is: blood flow restriction (BFR).
BFR training has actually been around for quite a while, with research going back to the 90s as a potential rehab and training tool. And I’ve seen it discussed in climbing circles somewhat recently, probably for good reason: some advocates claim it’s superior to traditional resistance training.
But is that actually true? To find out, we’re going to have to assess the following:
Is the research good?
Is BFR effective for rehab?
Is BFR effective for strength and hypertrophy training?
Are there any safety concerns?
Is it worthwhile for climbers?
As always, we’ll look to science for answers.
To see the entire video, click the link in our profile and then click on the KZbin Link!
#climbingtraining #trainclimbsendrepeat #physicaltherapy
Show Notes:
First, let’s understand why BFR has been getting more hype.
And that’s just the start! Sound too good to be true? Let’s find out.
Ran out of room!! For the rest, please check out the show notes:
www.hoopersbeta.com/library/s...
// DISCLAIMER //
As always, exercises and rehab programs are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting a new training or recovery program.
// IMAGE ATTRIBUTIONS //
Research hierarchy: Options for basing Dietary Reference Intakes (DRIs) on chronic disease endpoints: report from a joint US-/Canadian-sponsored working group - Scientific Figure on ResearchGate. Available from: www.researchgate.net/figure/H... [accessed 18 May, 2022]
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Written and Produced by Jason Hooper and Emile Modesitt
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[@HoopersBeta]

If you like this kind of content, give it a thumbs up??? :D All research citations, analyses, tables, and more are in the Show Notes! bit.ly/38ODAPA

[@BeGravity4]

Really high level videos. These are well produced and thoughtful and nuanced - a rare combo on KZbin.

[@HoopersBeta]

Thank you for the kind comment! The combination of Emile and I working on these I think gives it that combo :)

[@Noshuas]

Ya'll are quickly becoming one of my favorite climbing channels. I love the effort that goes into each video. Keep 'em coming.

[@HoopersBeta]

Thanks so much!!

[@shtthsths]

Awesome content, amazing review. Will be trialling this myself based on your review!

[@jerryzhang8098]

Always love your condensed explanations for those long papers, your videos are beneficial for me to train smart and hard at the same time🥺. Appreciate all of your work!

[@HoopersBeta]

Thank you, glad to hear it :)

[@NestorMandela]

I love this channel. It has, by far, the best scientific based physio knowledge for climbers e.g. your pulley video quickly become a reference on the subject. I wonder if you've done something about collateral ligament sprains in the fingers. I had one in my left index 4 months ago and still not yet full recovered. Apparently is a common injury in climbing but I couldn't find any good rehab program for it (apart from buddy tapping and work with a rubber band). Keep the good work and flawless humor!

[@HoopersBeta]

Thank you for the support and kind words! No we haven't done one specifically on that yet, sorry!

[@sebjan180]

Great with the condensed summaries of the papers! For the conclusion that the effects on tendon stiffness were the same between LL-BFR and HL, do you know how statistically strong that conclusion was? I can't access the paper (sci-hub seems to be no longer working sadly) but in the abstract it mentioned only that the stiffness increased significantly in both groups, and that there were no significant differences between groups. Since this doesn't mean that there couldn't be smaller differences that they simply didn't have sample size to cover, so I'm curious if they also tested for that? Also, from your expertise, would you say their measures of tendon adaptation are sufficient to predict injury risk (apart from the fact you mentioned about not being the most relevant tendon for climbing) or are there other metrics that ideally would be also be important? If the tendon adaptations are robust, could this mean that this might be a good way to get finger strength adaptations with less impact on climbing? For instance doing hangboard sessions with BFR?

[@vegardstmoe917]

Thanks for the great indepth content :)

[@moehassani]

I don't know if anyone gave a translation for the Persian article, but the summary of findings says: "it appears that BFR helps with an increase in VEGF and GH, and subsequently an increase in blood vessel density/development."

[@HoopersBeta]

Oh awesome, thank you for sharing! I wish I could read the entire article, though, to see about their methods and etc.

[@samdunkksu2b129]

The “slow runners” bit got me

[@sauntgrodsmachine104]

I really like BFR as a traveler who has lived out of a backpack for a couple years at a time. Even if I can't climb I can buy a cheap bag of rice, find a bucket, and go at it for 15 minutes while watching Hooper's Beta. When I have been doing it regularly I pretty much don't get pumped on climbs even though I am a boulderer and have no right to have as good of endurance as I sometimes seem to have. Hard yes for me but I would love more data.

[@Phaneau]

I heard about BFR a while ago on the podcast "Peter Attia Drive" and I have wondered since how it would apply to climbing training. Thanks for answering my questions, great video!

[@HoopersBeta]

Great podcast!

[@NWRinehart]

Apologies if you noted it somewhere and I just didn't see, but do you have a link to the BFR cuffs you used? Loved the video!

[@HoopersBeta]

These are the ones we have: saga.fitness/products/the-bfr-cuffs?gclid=CjwKCAjw4ayUBhA4EiwATWyBrkR6zHFvm1XUsrsS81QfXjstcd2SqyDaKW-dWBHvTzCRQfjDPXZtgBoCaLAQAvD_BwE 🙂

[@jakeartibello]

Interesting perspective, another high quality video. I have been supplementing my regular strength training with BFR (with saga bands) for about the last 3-4 months or so. While I cannot say that they have been the main impetus in strength gains recently seen, they have most definitely made me more comfortable while maintaining a huge pump. Hopefully this will transfer into my climbing when I transition back to sport climbing in the fall.

[@HoopersBeta]

Let us know what you find! Always curious what people’s unique experiences are

[@jakeartibello]

@@HoopersBeta Will do!

[@zacharylaschober]

Will note, with BFR cuffs what I have found is either working strength capacity on second days on or anaerobic capacity heading into performance season is probably the best application. If you spend long periods in deeply pumped states, this can be counter productive for the mitochondria (both from amount of and efficiency of each). Thus, using over a course of many months for developing a deep pump may not be as beneficial for climbers.

[@jakeartibello]

@@zacharylaschober please define "long periods". I have only utilized BFR training as a second session or rehab so perhaps strength capacity is a better descriptor. Do you have some sources I could take a look at?

[@ericmcelyea5089]

Great Video! This reminds me of EMS Training. But way cheaper.

[@insti751]

Hi, thanks for all the infos you gather and explain clearly. You show the occlusion of the arm immediately below the shoulder, in the upper part of the biceps. Is the occlusion on the forearm, say near the elbow an option for forearm specific training? I take a look at the BFR saga, and the options, with different sizes, are for arms (not forearms) and legs...

[@HoopersBeta]

Thanks for the comment and question! Standard protocol is to apply it as proximal to the target limb as you can, even if you are working a more distal muscle group. Translation: you would keep it in the same area I demonstrate regardless of whether you are working the bicep or the forearms.

[@donkyuhbuhts540]

Soooooo, I'm not sure this makes me confident enough to try for rehabbing my injuries. Gotta discuss with my PT.

[@A2intact]

video production is top tier

[@HoopersBeta]

Thanks! -Emile

[@leoandre2171]

someone in my gym told me he was training power endurance with this method so he could climb easier routes not as traumatic for pulleys as hard ones. Sounds interresting

[@abelabel3664]

Nice video. As someone who is dealing with an ulnar nerve entrapment in the elbow region, the thought of having something pressing my arm is not quite comfortable... Any comment on that?

[@HoopersBeta]

This may be a classic "it depends" scenario. It may depend on the exercise you choose which may place your body / nerve in a more compressed position, or it may be totally fine. I have neural tension in all 3 nerves and BFR doesn't cause me any nerve issues, as long as I don't up the compression more than ~60% and 40-50% is the recommended. You may have to try it out for yourself and avoid high elbow flexion positions and see how it feels.

[@abelabel3664]

@@HoopersBeta Thanks a lot for the answer :)

[@Huh_this_name_is_taken]

Nice video (as always), I was wondering if there is any research on increased capillarization induced by BFR for fighting the pump. That would be relevant to climbing and for me a huge plus in BFR training. Thanks :)

[@HoopersBeta]

There is some research about endurance training with BFR but for simplicity we didn't go far down that rabbit hole yet.

[@zhalzel]

Yea I'm interested in this question too! seems like potentially awesome for training forearm aerobic capacity

[@SpartaSpartan117]

Haven't watched the video yet truth be told but the endurance training aspect is what I originally heard interest in

[@zacharylaschober]

Likely not the capillarization from using BFR because you’re greatly inhibiting the aerobic system and the body instead has to tap the glycolytic system, increasing the ability for the mitochondria to produce atp in an increasingly acidic environment. Perhaps could be done at low pressure and frequently removing the cuffs, but would just do harder boulders with a set rest cycle between for targeting power and similar at the same time

[@Huh_this_name_is_taken]

@@zacharylaschober my thoughts were that the inhibition of aerobic metabolism would be a stimulus for the body to try to counteract this by increasing blood supply (capillarization), so yes, I would gel real acidic but it doesn't have to be a bad thing IMHO

[@jonkrause6714]

Good video. First introduced to this concept when I was in high school attending a wrestling camp (‘85) at Lehigh University. One of the coaches learned about BFR when he was competing in Japan and observing a Japanese wrestler restricting blood flow to his calves? It helped him have phenomenal stamina. Maybe this would be similar in athletes that train at high altitudes for less oxygen? Worth a try. Thanks.

[@HoopersBeta]

Thanks for the anecdote :). Makes me think: we should do a video about training at altitude! -Emile

[@jonkrause6714]

@@HoopersBeta ah yeah, that’d be cool. I know when I climb in Black Mountain or Tramway (8,500’ (2,591 m)) elevation, I’m gassed quick-especially with asthma.

[@brutalctg7654]

your videos are so interesting but they always make me so sleepy haha. its not your fault its more just my bad sleep schedule but every time i finish one of your videos im just sitting there confused as to what i just learned but i dont regret it haha. what i do pick up is useful and the videos are entertaining. also all the graphs and visuals are nice :)

[@HoopersBeta]

Hahaha it’s definitely a lot of information in one sitting! Thanks for the support :)

[@lucalem8640]

I don't understand you said it was good for maintaining strength/ gain strength during rehab but the protocol is 30 reps wich is far from strength training. Is it related to BFR method or did I misunderstood? And thanks for the vid I just strained my pulley I'll definitely try this later on my rehab

[@HoopersBeta]

Yes :) it's related to the physiological changes caused due to BFR

[@jeremakela9273]

Do you think this could promote your body to get better blood flow to your hands as while you are climbing your hands are often above your head and getting less blood into them making you fatigue faster.

[@Limbaugh_]

The two different articles saying it could be good or bad for tendons makes me pretty nervous to try it for my tendinitis

[@michajabonski1138]

This video has all quality research except for one thing - how can you call BFR training low cost? Price of cuffs with gauge start at around 150 USD, which is quite a lot for some miscellaneous training gadget. Maybe simple 15 USD cuffs could be fine too, but I'm skeptical considering lack of information regard their effectiveness.

[@kasrak.a8264]

Hi! If you wanna find out what the persian article is saying, I'd be happy to help!

[@sebastientardivel8179]

The question is: why do people need cuffs for BFR in rock climbing? Just do a crazy repeaters set like 15s hang/5s rest with no stop until you get pumped. It will take 3 or 4 minutes. The pump is a blood flow restriction, an ischemy, no? Then when you get really pumped, do light hangs... the results can be the same, can't they?

[@gekquad116]

Crazy that the doctor Mitch Hedberg saw was in this episode.

[@HoopersBeta]

He gets around!

[@mardev2967]

I would be interested to see how bfr would impact pump. Maybe you could use it on boulders or a board to train for endurance if you don't have access to routes

[@zacharylaschober]

I find BFR to be more effective for development of pump and therefore anaerobic capacity than almost any given sport route. I usually do this on designed problems for about 30 on and 60 off or for long sets of belays around 10min in a rope gym. With gyms being shorter than most outdoor routes by huge margins, I often get powered out well before pump sets in, having to a link a few hard routes together and greatly increase my volume of climbing. With the cuffs, I can drop the grade slightly and continue to accumulate pump throughout a few sets.

[@ryanw3058]

I feel like y'all really missed out on including a bat-hang somewhere in that opening skit.

[@HoopersBeta]

Huge missed opportunity!

[@ryanw3058]

@@HoopersBeta it was thoroughly enjoyed never-the-less

[@LilDeb]

I’ve used BFR to help after knee surgery. My vastus medialis is almost the size it used to be pre-injury. I hadn’t seen growth with PT until we started the BFR training. This may not work for everyone and it did not grow and become stronger overnight.

[@HoopersBeta]

Currently, a high percent of the research related to BFR is related to post-op knee surgery. It seems to be quite positive overall as well, so I'm glad you also had a positive response!

[@illegitimate0]

I would be surprised to see BFR be considered "safe" when a non-medical professional could easily occlude themselves too much. I don't know if the cuffs themselves have the ability to release themselves or provide feedback on occlusion %, but it seems obviously risky for the layman.

[@HoopersBeta]

Certain cuffs are designed to be safer. For example, ones such as the SAGA cuffs will actually measure your occlusion % for you and then provide the recommended occlusion % to operate at. Exceeding that would be creating unnecessary risk. I've also read other cuffs such as the Bstrong cuffs are also designed to not allow for full / dangerous occlusion levels. But you're correct there are many other cheaper alternatives that could be quite easy to occlude too much blood flow and cause issue, which is why I haven't recommended those in the past.

[@Productionbrikfilm]

how do you find those papers and know they are from a thrustworthy source?

[@HoopersBeta]

There are various places you can find these articles (links/names in the show notes), like pubmed or just do a Google search. To determine if it’s trustworthy you ideally have to read the whole thing to make sure it meets certain standards (as discussed in the video) and then if you really have time on your hands, look for any conflicts of interest.

[@Productionbrikfilm]

@@HoopersBeta ok thks. Have you also heard of google scholar? Im a bit sceptical about restricting blood however... Intuition tells me its dangerous. I mean blood is suposed to fuel your body... I especialy loved your video about proper pain protocol.(pain science) And "why your finger injurie doesnt heal" (It helped me a lot after lockdown) I hope you might explore the subject more.(even tho you covered it very well) Maybe for other parts of the body than fingers like shoulders

[@petroffma]

Look for articles from refereed (peer reviewed) journals, with authors who are professional researchers. Generally search through pubmed, Google scholar, or similar. Avoid generic Google and other search engines.

[@algorerhythm2751]

I wonder how much of BFR "positive" results is attributable to the research gap presented. Obviously everyone wants to get published, so run a low duration study and attribute the psychosomatic performance effects to the rubber band? Seems like a lot of this. I do love BFR, I use it often and always for hangboarding, but it seems plagued by its pop-culture/gym-bro perception to get real evidence.

[@jeremiahjahn]

How much of a difference do you feel it's made in your HB training? Where else and how do you use it?

[@09paradox]

The 2015 review isn't an actual review or can't be with only 12 paper

[@HoopersBeta]

I’m not aware of any lower limit for systematic reviews. Technically you could do a systematic review on 1 paper. -Emile

[@13x]

Bench press was one of the targets? How were they restricting blood to the pecs??

[@HoopersBeta]

That’s the interesting part - they weren’t. Some studies look at the effects of BFR on muscles that can’t be occluded (it’s like “indirect” BFR). This is discussed somewhat later in the video :)

[@nbka8rs]

Algogogo

[@adrianlandreth9918]

[@WILL_CLAY]

Is it just me, or does this make anyone else feel super queasy???

[@rawrpirate]

makes me feel sick to my stomach too. just thinking about the thumping and pressure in the veins/arteries with one of these things on.

[@SpartaSpartan117]

Yes