Blood Flow Restriction (BFR) is used interchangeably with KAATSU Training. BFR uses the same principle of constricting an arm or a leg to limit the arterial and completely block venous blood flow. BFR has the advantage of using lighter loads to get the same health benefits as doing high-intensity exercises or lifting heavy barbells.

BFR is used in sports, rehabilitation, the elderly, and clinical medicine. Many studies have shown that it is safe and low risk.

However, any discussion with a health professional who is not familiar with BFR will surely get many warnings and concerns that it can lead to complications like unwanted blood clot formation in the legs and hypertension.

This article will talk about the studies that examined the risk of doing BFR.

How risky is KAATSU  or BFR?

In the study, Use and safety of KAATSU training: Results of a national survey. the complication rate in healthy people and those with various medical conditions are:

• Blood Clot Formation – Deep Venous Thrombosis – 0.055%
• Deterioration of ischemic heart disease 0.016%
• Pulmonary Embolism – 0.008%
• Rhabdomyolysis  – the destruction of muscle fibers that can lead to kidney failure if untreated – 0.008%
• Other mild side effects;
  • subcutaneous bleeding 13.1%,
  • numbness 1.297%,
  • lightheadedness 0.277%,
  • cold feeling 0.127%

What about hypertension?

Applying a constricting band around an extremity can increase the work of the heart. However, since the venous return is decreased,  the overall effect on the blood pressure is neutral.

Who should not do Blood Flow Restriction or KAATSU Training?

Don’t do on the following situations

1. Women treated for breast cancer with radical mastectomy with axillary lymph node dissection. Lymphedema, an irreversible swelling of the arm, may ensue.
2. Hemodialysis patients with a dialysis shunt in the arm.
3. Infections of the extremities
4. Presence of  open wounds or blisters of the extremity – leads to the weeping of fluids
5. Sickle cell anemia – the presence of hypoxia or low oxygen may lead to sickling of the red blood cells causing a sickle cell crisis
6. Severe uncontrolled hypertension – Systolic >180 mm Hg
7. Pregnancy by itself is a risk factor for the development of DVT and PE.
8. History of deep venous thrombosis
9. History of severe aortic stenosis and hypertrophic obstructive cardiomyopathy – the pooling of blood in the extremities may decrease the cardiac output
10. Cancer patients are prone to a blood clot formation
11. Heart Failure patients who are unable to carry on any physical activity without discomfort – Class IV

Be careful with the following

• Those who take blood thinners like warfarin and dabigatran. Application of high pressures may develop a large hematoma that can cause compartment syndrome.
• Patients with ischemic heart diseases

Take away message

Blood Flow Restriction training is safe for sports, healthy people, and various kinds of medical conditions.

Further readings:

1. The Story of KAATSU. The Incredible Technique for Muscle Toning and Hypertrophy
2. The Science of KAATSU Training
3. Precautions in KAATSU or Blood Flow Restriction Training
4. Sarcopenia: The Scourge of Aging
5. The Deadliest Diseases Associated with Metabolic Syndrome
6. Atrial Fibrillation and Metabolic Syndrome
7. How Effective are Drugs that Increase HDL?
8. Inflammation: Dolor, Tumor, Rubor, and Calor
9. Health Advice from “The Art of War”
10. Effect of Short Term Exercise on Mortality

References:

1. Yasuda, Tomohiro & Meguro, Miwa & Sato, Yoshiaki & Nakajima, Toshiaki. (2017). Use and safety of KAATSU training: Results of a national survey in 2016. International Journal of KAATSU Training Research. 13. 1-9. 10.3806/ijktr.13.1.
2. WILLIAM R. VANWYE, ALYSSA M. WEATHERHOLT, ALAN E. MIKESKY. Blood Flow Restriction Training: Implementation into Clinical Practice. Int J Exerc Sci. 2017; 10(5): 649–654. Published online 2017 Sep 1.

Image Credit: Deep Vein Thrombosis By James Heilman, MD – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=9444797

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