Evidence based medical wellness for active people from a doc who walks the walk

Voodoo flossing: Blood flow restriction and low intensity exercise


In July I got a little happy and, let’s be honest, beat the crap out of my new knee.  I went hiking three days in a row, then played back to back tennis matches, one of which lasted 3 hours.  I have paid for this for two months now, having been forced to with draw from league tennis play and other fun activities.   Worse, I had to go whimpering back to my PT and orthopedic surgeon, neither of which said “I told you so” to my  face. After a fun MRI (really, you believe this?), two steroid injections in my knee and bursa, family scorn and exasperation, I dragged my sorry self back to PT today.

My PT is a great time, as he is always searching for new inventions to make it hurt heal faster.  Today’s torture was using “voodoo floss.”  In this fifty shades of black PT torture, a tight band was wrapped around my thigh enough to cut of  blood flow.  Then I did body weight squats  and lunges, kettle bell swing with a low weight and step downs.  To make it even more exciting my PT wrapped a second band higher up on my thigh.  I literally begged to have the bands removed at the end. I also, in my oh so nice way, asked him about the science behind this latest torture healing technique.

Well, of course, he knew the literature, and indeed there are some great benefits to this technique.  Turns out, this actually has a name beyond “voodoo flossing.” It is called Blood Flow Restriction (BFR) and Low Intensity Resistance Exercise  (LIRE).  (Please don’t ask me about all the abbreviations.  It’s a science-y thing designed to make geeks look smarter.) Anyway, doing leg and arm exercise at low intensity (perfect for those of us recovering for self imposed bursitis and inflammation) with blood flow restriction increases muscle size (hypertrophy for the geeks in the crowd.)  So it was a great way to get some strength gains with out over stressing my knee.

The literature I reviewed was mixed if this technique could be used on those with coronary artery disease (some studies showed benefit, some not), so I don’t think I can recommend it for those folks.  I also wouldn’t use it in someone with DVT.  The literature did show benefit in muscle hypertrophy in the elderly with out cardiovascular disease.  (Elderly being those greater than 71 years, which makes me laugh.  A lot of 70 and 80 year olds are out their kicking young butt!)

PS: click the links if you want to read the articles for some good bed time reading.

I look forward to using this torture technique as it as sound evidence behind it.

Picture of thigh with floss wrapped around it

Thigh wrapped floss to cause blood flow restriction

Author: PookieMD

I am a board certified internal medicine physician. I love medicine and seek to bring evidence based medicine to the fitness and wellness world.

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