Ep. #237: Research Review: Dr. Mike Zourdos on Blood Flow Restriction Training

Mike Zourdos: [00:00:00] It’s pretty clear that blood flow restriction training does increase strength and it does increase hypertrophy. It’s also clear that blood flow restriction training at 20 to 30 percent of 1RM doesn’t increase strength as much as training at a higher load without blood flow restriction training.

Mike Matthews: Hey, this is Mike from Muscle for Life and Legion Athletics. And as you probably know, I work pretty hard to understand and promote high quality. Quality diet, nutrition, and exercise science. And that’s why I have spent and continue to spend quite a bit of my time researching and then writing articles, writing books, recording podcasts, recording videos, and so forth.

And that’s why I reference quite a bit of scientific literature in all of my work. Now, something I don’t do though is produce a Research review where individual studies are broken [00:01:00] down and analyzed because one, my plate is already overflowing with projects as it is. And two, I honestly don’t think that I could do it better than the researchers who are out there.

creating research reviews and whose work and research reviews I myself read regularly, like James Krieger, Eric Helms, Greg Knuckles, Mike Zordos, Alan Aragon, and Brett Contreras. And so I had an idea, why not get those guys to come on my podcast to discuss various studies that they have analyzed in their reviews and share with us what they’ve learned, and how we can use these key takeaways, how we can use the information in those studies to better optimize our diets, exercise routines, supplement regimens, and our overall lifestyle.

I reached out to them and they thought it was a great idea, and so a monthly series was born. Basically, once a month, I’m going to have [00:02:00] one of these guys on the show and they’re going to break down a study that they have analyzed in their respective research reviews and they’re going to explain to us why these studies were conducted, how they were conducted, what the results were, what their interpretations of the results were, and how we can use the information to improve our diets, our training, supplementation, or in some cases just the overall quality of our lives.

And in this podcast, we’re going to talk about blood flow restriction training, something that has been making waves as of late because it sounds new, it sounds scientific, and some people are saying it may even sound revolutionary. It may change the game. It also sounds hokey, right? It sounds like it was contrived.

by marketers to sell their latest round of PDFs, pills, and powders. And if you’ve been skeptical about it that’s good. You should be. Because the more time you spend educating [00:03:00] yourself in the ways of muscle building, the more you become certain of one thing. And that is, if something sounds too good to be true, whether it be a training methodology, a supplement, a diet, If it sounds too easy, too effective, too innovative, it almost always is.

And so the question is that the case with blood flow restriction training? Is it too good to be true? And in this episode, Dr. Mike Zordos is going to break it all down. He’s going to explain what BFR, as it’s generally called, is, how it’s supposed to help you build muscle faster, what it’s actually best suited for, how to do it safely, and more.

And in case you are not familiar with Dr. Zordos, he is an assistant professor of exercise science at Florida Atlantic University. He is a published scientist himself. He is a competitive power lifter as well as the head power lifting coach at Florida State University. And I should add, a very cool, [00:04:00] down to earth, fun to talk with kind of guy.

And Mike produces a fantastic monthly research review along with Dr. Eric Helms and Greg Knuckles called MASS, M A S, which I highly recommend that you check out if you like to dive into the science of not just building muscle, but improving your body composition. So that includes building muscle, but it also includes losing fat and getting strong.

So again, the name of the review is MASS. And that is short for Monthly Applications in Strength Sports, so it’s MASS, and you can learn more about it at strongerbyscience. com slash mass. And this interview actually is based on one of the studies that was analyzed in that review. So again, if you like this discussion, and if you like this type of content, definitely Check out mass.

I read it every month and find it very helpful. Very enlightening. [00:05:00] Very educational. This is where I would normally plug a sponsor to pay the bills, but I’m not big on promoting stuff that I don’t personally use and believe in. So instead I’m just going to quickly tell you about something of mine, specifically by flexible dieting cookbook, the shredded chef.

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I love them myself because they let me make the time that I spend doing stuff like commuting, prepping food, walking my dog and so forth. Into more valuable and productive activities. So if you want to take Audible up on this offer and get my book for free, then simply go to www.bitlybitly.com/free. Ts.

See, and that will take you to audible and then you just click the sign up today and save button, create your account and voila, you get to listen to the shredded chef for free. All righty. That is enough shameless plugging for now, at least let’s get to the show. Hey, Mike, it’s great to have you back on.

Thank you again for taking the [00:07:00] time. 

Mike Zourdos: Of course, man. Always good to be here. 

Mike Matthews: Cool. So this time around, we’re going to be talking blood flow restriction, which I’ll just let you explain to everybody what it is, but it’s something that is getting a bit of hype these days, unconventional and makes you look weird.

So I, I personally actually haven’t seen anyone doing it, but in person, but I’ve seen plenty of people on the Instagrams. So therefore I’ve been asked by a lot of people, is it legit? Is it. It’s a necessary. It looks like it’s dangerous. Are you going to, are you going to hurt yourself?

That’s why I wanted to get you on to talk about a study on blood flow restriction. And this was in the second issue of mass, your research review for everybody listening to know this is where the research is. This is where it was reviewed and this is what Mike is going to be covering. So yeah, I think that’s it for the intro.

I’m just going to again, let you do your thing. 

Mike Zourdos: But yeah, it’s definitely on the instagrams, as you said, and, I would say maybe a lot of things that you see on the instagrams aren’t legit, but this one is legit, which is 

Mike Matthews: surprising because at first you look at it, you’d be like, there’s no way this is fucking worth it.

This is [00:08:00] stupid. 

Mike Zourdos: It’s funny, man. I remember when I Blood flow restriction training, which actually used to be referred to as occlusion training, and we’ll talk about why it’s not really called that anymore. But when I first talked about what was then occlusion training in 2008, 2009 10 years ago, so you can figure out my age if you’re that interested.

When I first started doing this and doing it in gyms, the way that you utilize this and we’ll talk about this more is you will actually restrict moderately the blood flow to a muscle proximal to the working muscle and you would typically do this with knee wraps. So if you have knee wraps or an ace bandage or something like that, that you’d wear in the gym, you would take those knee wraps and you would tie them.

Let’s say you’re training your lower body to train it on the upper part of your thigh, right? Proximal to your quadriceps and your hamstrings 

Mike Matthews: And proximal, just meaning close to, right? Okay. 

Mike Zourdos: Proximal mean close to the proximal meaning above. So rather than distal, which would mean below. So if you have your, the upper part of your leg, you have your thigh, you would tie.

If you want to work anything on the lower body, you would tie the knee wrap for blood flow restriction training at the [00:09:00] top of the thigh. So just as if you wanted to exercise your biceps, you would tie the knee wrap. In this case, you might use an ace bandage or something that’s a little bit smaller because the upper body muscles are smaller.

And you would tie that proximal or above your bicep. So just below your shoulder, they’re 

Mike Matthews: restricting blood flow to it. Cause if you go below your, you’re not restricting blood. Exactly. 

Mike Zourdos: Hence the name. And so 

Mike Matthews: I just looked in the dictionary. So proximal situated near to the center of the body or point of attachment.

Hey, let me 

Mike Zourdos: go and see, 

Mike Matthews: to be fair, I’ve actually cleared that word a dictionary before, but it didn’t come back to me properly. 

Mike Zourdos: We got a man, there’s I know that word and some other things because we’re talking about an area that I’m interested in, but you have me on the on the podcast and we want to talk about something that doesn’t have to do with exercise science.

I’m in deep trouble. I only know what I do for a living. But in 2008, 2009, I was doing that and I would go into the gym and do squats with this or do curls with this, whatever it might be. And I would have people come up to me and they would say things like, Hey, man, you’re not using those or what are you doing?

Or are trying to have [00:10:00] a heart attack? And the countless times that somebody came up to me, I’m provoked in the gym and to try to question me on what I was doing. It was pretty crazy back then, 10 years ago, when really nobody knew about it. There were only a few people researching it and it was really new.

And so then I would calmly try to explain what it was. And, Not a whole lot of people were willing to listen. There were a couple of people. I remember I got one person to listen and he actually did it in the gym with me that one day, some random dude. And it was it was pretty fun, but a lot of people weren’t willing to listen back then.

And they thought I was a crazy person or I had no idea what I was doing and I probably didn’t really know what I was doing back then, but I was trying to do a blood flow restriction or occlusion training. But it’s amazing to see how far it’s come over the past 10 years and it’s I don’t know if it’s mainstream yet, but it’s definitely out there much more and it’s talked about a lot more.

So it’s pretty cool. But nonetheless, that’s the basis of how you would apply blood flow restriction. So the study we’re looking at here is actually a systematic review and a systematic review is It’s a review paper that has strict guidelines for how it searches other papers. And then it reviews [00:11:00] all of the other papers that are in that area based upon its guidelines to give an overarching recommendation, if you will.

Is this a good idea? Is this not a good idea? What are the overall findings? So it’s similar to a meta analysis, but it doesn’t run as many in depth statistics as a meta analysis. So we can’t quite call it that. So for a systematic review here, this wanted to look at the efficacy and safety of blood flow restriction.

So for the efficacy, how the results are for hypertrophy and strength. So there are a few things to keep in mind here when looking at this, which is that blood flow restriction is compared in two different ways to other training modalities. Most commonly one, it’s compared to high load training and then also compared to low load training.

And now when we talk about using blood flow restriction training, when you’re using that knee wrap, And you’re, let’s say you’re using that knee wrap on the lower body and then you’re restricting blood flow and then you’re squatting. Typically, you only need to squat with about 20 to 30 percent of 1RM and that applies to all exercises.

So if you were to do a leg extension, 20 to 30 percent of 1RM. And obviously, you’re [00:12:00] most likely not going to know your 1RM leg extension. But the point is, you can take a very light load and utilize blood flow restriction training. So what the systematic review shows, is that it’s pretty clear that blood flow restriction training does increase strength and it does increase hypertrophy.

It’s also clear that blood flow restriction training at 20 30 percent of 1RM doesn’t increase strength as much as training at a higher load without blood flow restriction training. And I think that’s pretty logical because if you can understand the mechanisms by which strength occurs, strength can occur via hypertrophy, meaning as muscle size increases.

That should play some role in the long term and muscle strength, but strength also increases from a neuromuscular perspective or an efficiency perspective. And this is really illustrated that if you think back to the first time you ever bench press, right? In any male’s life, the first time they ever bench press, they probably can remember it.

I know I do. And. I was in eighth grade and I benched 65 pounds and I pretty much thought I was the strongest person in the world. I remember the bar path on the bench if you can [00:13:00] remember back to when you bench press at first It wasn’t a straight bar path It probably one side went up more than the other It you know teetered around a little bit then you finally were able to lock out that lift And then the next time you did it, it was better and better then ultimately not only were you stronger But you had a straighter bar path and the movement was more fluid.

That’s with any skill, right? That’s looking at a skill or a neuromuscular adaptation. At high loads, if you want to increase your 1RM, you’re going to get much better neuromuscular adaptations for other reasons as well that are going to increase the 1RM. Blood flow restriction training. Is it really training for neuromuscular adaptation?

So it’s not going to be as good for strength as high loads. But from a hypertrophy perspective, when compared to low loads and then somewhat when compared to high loads, blood flow restriction training does seem to cause pretty robust hypertrophy that’s similar to the other methods of training. The last thing that this meta analysis pointed out is that blood flow restriction training is definitely safe.

And I think that if you’re going to use kind of an alternative training method, just as it’s the first question I ask. So if somebody, same thing I ask if somebody says, Hey, are you going to take this supplement [00:14:00] or would you recommend this supplement? Even before figuring out if it works or not, I want to say, Hey, is this safe?

And blood flow restriction training is definitely safe. The way to make sure it stays safe though, is if you can think about when you tie that knee wrap on your upper part of your thigh or the upper part of your arm, you have to think about the tightness in which you tie it. If you can think about tightness on a scale of 1 to 10, what you’re shooting for is about a 7.

If 1 is really not tight or no pressure at all and 10 is maximum pressure and it’s tight and you can’t even stand up. With the knee wrap tied around the proximal part of your thigh, that’s too tight. And I think that could lead to certainly could play a much greater role in injury than tying the knee wrap, much looser.

So I think you’re shooting for around a seven, maybe even a six in terms of the tightness scale or the discomfort scale that you would have. So if you can do that, you’ll be fine. 

Mike Matthews: I think maybe it might help if people understand what are you going for? What physiologically are you going for?

Mike Zourdos: Yeah, I think so. So I think this is, it’s hard to state and exactly how each individual person is feeling. But what I would say is that if [00:15:00] you are on a basic sense, if you’re sitting down when you tie that knee wrap and you’re having trouble standing up and you have to waddle over to the squat rack, it’s too tight.

If you’re seeing discoloration in your leg before you even do an exercise, it’s too tight. If you can go ahead and stand up And get over to the rack, no problem. And you feel pretty good. And then after the first or second set, you start to feel like, Hey, there’s some discomfort there, then you’re on the right track.

And that’s what you’re looking for. 

Mike Matthews: Just what you were, you’re accomplishing is you’re occluding the flowing, toward the limbs, but you don’t want to go so tight that the blood can’t get back. 

Mike Zourdos: Yes, exactly. So I think that and just a kind of minor comment on that is I think that you’re not really occluding, rather you’re restricting hence why I would say in 2008 2009.

Oh, because occluding 

Mike Matthews: meaning blocking then? 

Mike Zourdos: Yeah, occluding meaning shutting that off, right? So I think the connotation of all involved with occlusion or the word occlusion, much more strict or, Putative if you will then blood flow restriction and that blood for restriction is just restricting that.

So [00:16:00] I think the way you phrase that physiologically, what are you doing is you’re just restricting that blood flow and a 10 tightness or a nine tightness isn’t really restricting it. It’s occluding it. It’s blocking it, but a six or a seven is a little bit more of a moderate restriction of blood flow. So it’s still going to allow you to perform the exercise appropriately.

So if you’re doing that again, the main conclusions, this is safe, especially if you use it appropriately there. Okay. The increases in strength are going to happen, but not as much as high load training. Then hypertrophy is pretty similar to low load and high load training. Now I would say though that the two limitations of this for hypertrophy are when studies seem to compare blood flow restriction training at 20 to 30 percent or one RM to low load training at 20 to 30 percent of one RM, they typically equate for volume and for load and for stress, meaning that.

They typically also equate for four reps as well. So if you’re doing 20 reps at 20 percent of one around with blood flow restriction training, that’s going to be a lot harder than doing 20 reps at 20 percent [00:17:00] of one around with no blood flow restriction. So if you just do normal squats at 20 percent for 20 reps, that’s easy.

If you do blood flow restriction at 20 percent for 20 reps, that’s going to be a lot harder because you’re going to be a lot weaker when you have this knee wrap tied around your thigh. And you’re restricting blood flow. So it’s not really a fair comparison when you look at that. So I think that if you were to take all of those other sets without blood flow restriction training, let’s say to failure and do more reps, I think it’d be a better comparison.

So while it does match up for hypertrophy in that sense, I don’t think it would match up if there was more stress placed on the low reps in the other group. Also, when you look at blood flow restriction training versus high loads there’s really not that much information out there to say, Hey, blood flow restriction training for hypertrophy is going to be the same as, 70%, 75 percent of one RM training, that’s pretty close to failure, maybe it’s an eight or nine RPE.

So I do think it could be comparable in some sense, but. If you look at the training status, if you were to get really well trained people and you say, Hey, do only blood fluid restriction training versus doing only training, [00:18:00] typical hypertrophy training between 65 and 75 percent or 80 percent of one around, I think it’s highly unlikely that BFR would went out or would even be similar.

That’s not to say, though, That this isn’t a strategy that we can use. So when can we use it? This systematic review did show that there was markedly lower joint stress when using BFR. So I think if you’re in a time of injury, I think BFR would be an excellent thing to use if you can’t really load heavy.

And you say, you know what? I can’t really load 70, 80, 90 percent of one around and really do a lot of reps with that, but when I stayed around 20, 30 percent of one around, I can do this. No problem. And I can train. Certainly training is going to be better than not training. And if that’s not going to lead to more injury and it’s much lower joint stress, and it’s going to keep you in the gym, you’re going to be able to, if not grow muscle, at least sustain and not lose muscle if you’re not able to train for a few months with higher loads.

So I think that’s a really good application to utilize it. To get that in there in times of injury, assuming that the injury is not provoked or not harmed at squatting at that low intensity or benching [00:19:00] at that low intensity doing curls, whatever the exercise might be. 

Mike Matthews: Yeah, that absolutely makes sense.

And just for those people listening who are wondering why does this work? What physiologically makes this legitimate? 

Mike Zourdos: It’s a really good question. I don’t think we have all of the answers to that. Although I do think we know that it’s likely a different mechanism than high load training, high load training is going to be based upon, mechanical tension, which is, really predicated by a volume and the amount that you can load, mechanical loading.

So you calculate volume sets. Times reps times load. If you’re increasing the number of sets you’re doing, you’re increasing the reps you’re doing, or you’re increasing the load. That’s going to increase that individual’s total volume. And to a point, we know there’s a point of diminishing returns for volume, but to a point you should get better hypertrophic adaptation.

With blood flow restriction training, that doesn’t really seem to be the case. There’s good evidence that more volume isn’t really better. So the mechanisms here are probably more along the lines of metabolic stress and cell swelling, and I think those are mechanisms more and [00:20:00] more that we know with high load training don’t seem to be huge drivers of skeletal muscle hypertrophy.

While metabolic stress and cell swelling may play some role in high load training, I do think it’s more of the mechanical tension and I do think it’s training volume. So I think that the mechanisms are more mechanistic here. There could be the pathways that are associated with hypertrophy also leading to a protein synthesis response and anabolic protein expression and things like that.

Those may play some role here with blood flow restriction training, but I think metabolic stress trapping metabolites in skeletal muscle, like we’ve talked about, if you can restrict the blood flow in, that means you’re also restricting the blood flow out. So you’re trapping things inside skeletal muscle, which are stimulating some of those anabolic pathways.

So I think that plays a much greater role with blood flow restriction training than it does high load training. Whereas high load training is more volume blood flow restriction training isn’t necessarily volume. It’s probably more metabolic stress and those mechanistic factors, but a lot of elucidating, a lot of that still remains to be determined.

Even though we talked about, this has been a little bit more [00:21:00] popular for 10 years, 10 years in the scheme of science is still a relatively short timeframe. So we still have to flesh some of that out, but those are the most likely. Mechanisms, at least in my opinion at this point. 

Mike Matthews: Yeah, that makes sense.

So practically speaking, let’s say somebody is dealing with injury now or they’re not, but maybe at some point, hopefully you never do, but if you lift intensely enough for long enough, I guess I wouldn’t say the injuries are inevitable, but some aggravations, there are things you’re going to have to work around that.

That is inevitable, I think for all of us. So let’s say, practically speaking, if somebody is Let’s say before, obviously before an injury, or even just if it’s an aggravation of enough severity that they need to work around it, they’re doing, let’s say a lower body workout is, in mass in, in your whole, in the right up on it, you have okay, cool.

So they were, they used to do, or they were doing a squat, a Romanian deadlift, a leg curl and a standing calf raise. And then something happens to where they can’t do that, but they would like to continue training lower body. How could they use BFR to do that? 

Mike Zourdos: Yeah, [00:22:00] it’s a fantastic question because that’s really where we’re advocating this year.

I’m going to come back to in a moment that this certainly isn’t a standalone training method, meaning it’s not something that you would do always and all the time, but to answer the question directly, like you said, if somebody was squatting and then all of a sudden they have an injury and for whatever reason they can’t axial load, meaning they can’t place the bar on their back, but they want to be able to maintain, as much muscle size as possible.

So then when they get back to squatting, they’re still in a decent position. A hip thrust is a decent alternative. You could use that instead of squatting. If you do leg curls. You could certainly do BFR with late curls when you come back, but if that’s not the case, you can find something else that stresses the hamstring, like for example, if you have an RDL and RDL works on the hamstring, but that also stresses the lower back a little bit, whereas a late curl isn’t going to stress the lower back as much.

So maybe when you come back to training, you can do BFR on the leg curl rather than the RDL, and you’re still going to be able to stress the hamstrings, but you can do so with a really low load until you can work back up to doing something like RDLs. So it’s just a question of if you can still do that [00:23:00] exercise, you can replace, let’s say a squat with a BFR squat.

When you come back from injury, if you can’t do that exercise, find something else that you can do that stresses the same muscle group and use blood flow restriction on that. And with the goal of not necessarily saying, Hey, I’m going to get a ton stronger and a ton bigger, but okay, I’m going to need to do this for about a month until I can get back to my normal training.

I want to be able to attenuate or slow the losses and maintain as much as I possibly can until I get back there. Find an exercise that stresses that same muscle group, utilize BFR with it, and I think it’s pretty safe to say that you’re going to be far better off doing that than just simply not training at all.

It’s, and that’s a difficult thing to do. I think sometimes it’s hard to find the motivation for that. It’s hard to say, I was used to doing this and now I got to go in and I got to lift, I’m doing a leg extension instead of doing the whole stack. I got to put the pin on the second level of the stack and do blood flow restriction.

For 2030 reps at a time, it’s hard to do, but I think that dedication is going to be what makes the difference for a lot of people in the long run, because, everybody can [00:24:00] train for the longterm, but those that are able to be consistent and stick with it. And I think this is one of the things that being consistent is saying, Hey, I’m going to I’m going to adhere to what I need to do.

It’s easy to go into the gym and it’s easy to crush it when you’re injury free and you’re feeling great. It’s hard to come back from something like this. It’s hard to stay focused in doing what you need to do. It’s hard to say, I’m not going to aggravate that injury and go bench press heavy today or deadlift every day.

Rather say, Hey, I’m going to do a, some blood flow restriction on the pec deck today. While that’s not as fun, it is what you need to do sometimes. So I think BFR is a really good tool to be able to do that and say, Alright, my goal this next month is to maintain as much muscle as I can, not necessarily grow new muscle, but maintain as much muscle as I can.

So when I do get back to training normally I’m in a much better position than if I took the month off. 

Mike Matthews: Yep. And I’ve gone through that within a few different instances, I had some biceps tendonitis that was annoying and had to, work with a sports doctor and just really had to work around it and not aggravate it.

I’ve had neck tightness, I’ve never, I haven’t sustained an acute [00:25:00] injury per se, but. That’s probably because I’ve at least, I haven’t tried to push through pain to the point where I’ve sustained an acute injury and also to be fair, I’m not a competitive weightlifter. I’m not tremendously strong.

I have never put up super impressive numbers. I put numbers that are good enough for me, so I’ve had to learn that lesson for people listening. And it was interesting because let’s say in my mid to late twenties, it was what you were saying. It was just always felt good.

Yeah. Nothing really ever even bothered me. I could just go in and, hit everything heavy every week and not really even think about it and recover just fine. And now I’m 33. And I’ve noticed that and it’s just also the nature of repetitive use. So there’s something to be said for that, but I’m a little bit more just cognizant of where the boundaries are and what is, training smart and what is not.

And I can’t necessarily do, I can’t, I just can’t train as intensely, especially on I’ve noticed it on just the big lifts, primarily squat and deadlift a little bit with bench pressing [00:26:00] because of the of the biceps tendonitis that was annoying. Anyways, I’m just saying that people out there it’s, if when you first experience that and having to modify and do things that, are suboptimal, Because you are either working around a problem or you see a problem on the horizon.

You don’t want to have the problem. Yeah. At first mentally, it can be a little bit demotivating, but you just reframe it. And for me, it’s just looking at the long term and looking really what is my goal? Sure. I want to look good. But also I want to feel good. I want to remain injury free ideally, because I want to be doing this for the long haul.

And I want to be healthy. So that was my experience in terms of shifting from just a pure like performance. I just want to lift more weight. I just want to be bigger and stronger too. Yes, I do, I have some qualifications now. 

Mike Zourdos: Yeah, it becomes a secondary goal. I think it’s a really good way to look at it from the perspective of, all right, if I’m going to be getting bigger and stronger, that’s a relatively short timeframe in my life.

If you look at a lifespan where that’s going to be [00:27:00] the case. So while that is a goal and if you have progressive overload and abide by the fundamentals, that’s going to happen, but it doesn’t mean you can’t do that in a little bit smarter way. And the other thing I would say is, if you’re training, as we talked about a little bit ago is, while injuries.

It’s not necessarily, it’s not fair to say that’s inevitable. I think you put that well, a little aches and pains and aggravations here and there are almost always going to come about for almost everybody. So whenever you have those or whenever you can feel those coming on, I think a good way to look at this is to say, okay, I got two sets that are left on my program here today.

Do I want to. Do those and then possibly have to take two or three weeks off from the gym because I’m an aggregate something or do I just want to be smart and forego those and realize that missing two sets and the grand scheme of things is completely irrelevant and then I’m good to go 48 hours from now by being a little smart, I think We’ve almost all been in the situation where we’ve decided, what is I’m not great.

I’m not a hundred percent, but I feel okay. I had to crush these last two sets. And then on that [00:28:00] last rep of that last set, man, you feel something snap and then you just sit down on the bench and just realize, man, I’m out for three weeks. I’m out for four weeks and then you’re just in a bad mood for that next month or so.

And then you’re trying to rehab it and trying to do all the right things. And hopefully you don’t aggravate it again. Whereas if you skip those last two sets and say, I’m going to be smart. You’re good to go. 48 hours later. That aggravation is never to be heard from again. And you haven’t set yourself back.

And just from a quality of life perspective, I think that’s a good idea. I know I’ve been at fault. I’ve been at both sides of that and I’ve been at fault for pushing it when I knew I shouldn’t have sometimes. So I think it’s really easy to do the wrong thing and say, Hey, I’m going to crush it today.

I’m going to do this. And it’s difficult to say, Hey, I’m going to back off. I’m going to miss these last two sets because you know what? It’s just not worth it. And those two sets aren’t that big of a deal. So I think it’s more difficult to make the smart play. Unfortunately, sometimes we do make the wrong play.

And if we do, that’s where I think. Getting back to our conversation. BFR can be a strategy over that next month while you are rehabbing to, get back to full strength without losing too much muscle or too much strength, [00:29:00] but I just keep that in mind. I would ask yourself if you do, if you are in that situation arises would you rather take one day off or two days off, or would you rather take a month off?

And if your answer is, I would rather take a day or two off. Go ahead and forego those final sets. Once you feel something aggravated, you might miss out on that training that day, but you’ll be a lot happier 48 hours later when you can walk around. 

Mike Matthews: Totally agree. So we know we can use it to work around injuries.

You don’t have to be injured to use it, but not to make it like a primary training modality. 

Mike Zourdos: Yeah, it’s just not a stand alone method of training. And I think Mike, this is something we talked about briefly last time I was on, and it’s that to understand the concepts from research and more and more, that’s trying, that’s something I’m trying to get across.

Whereas somebody will look at a research study and say, Hey, this was the protocol they did. I’m going to do this exact thing. This is what I do for training now. Not necessarily. It’s important to understand the concept. If somebody, if the research study shows that, drop sets using drop sets or using rest, pause sets or something like that can add volume and provide some of their muffle adaptations [00:30:00] to regular training.

That’s good information, but that’s not saying you should do that all the time, rather it’s saying it’s one programming strategy. That you can add for a couple sets into your normal training program. Those aren’t standalone methods of training. I think the same thing applies here. If you see that, hypertrophy is similar between blood flow restriction and the other methods that we talked about, I think that’s good.

But we talked about the practical limitations. I think of blood flow restriction training a little bit, and it’s not a standalone training method. So it’s something that you could do in times of injury. It’s something that, let’s say you want to add a little bit of volume. It’s pretty time efficient because you’re only going to take about 30 to 60 seconds rest between sets.

And you’re going to be doing in the neighborhood of 15 to 30 reps with low intensities. So I think that’s a way to accumulate volume. If you say, hey, after my session today, just to switch it up, get a little bit of a different stimulus. I’m going to add, three to four sets of leg curl, blood fluorestriction training to get a little bit more hamstring volume in there.

The other thing is. If you wanted a little bit of stimulus, maybe in a down week or a deload week just to do something else, get a break from, a regular bench press or a regular squat or something [00:31:00] like that, go for it and add that in there. It’s just to drive home the point that if you understand the concept, you can see when it’s appropriate and it’s not a standalone method of training.

And I guess the last thing, just to clarify the only two places where it’s efficacious to apply blood fluorescription training. are on the upper part of the thigh, proximal to the quadriceps, the hamstrings, as we discussed, and proximal to the biceps. Above the biceps, in between the biceps and the shoulder.

Those are the only two places where you should apply blood flow restriction training. When we talk about the bench press, I don’t want anybody going out there and wrapping the knee wrap around their chest and thinking that’s a good idea. It’s it’s the only two places where you should apply blood flow restriction training and that extends to calves.

If you’re gonna, Use BFR on the calves, you would still wrap proximal to the thigh, not proximal to the calf. Or it would still be technically proximal to the calf, but not right above the calf. Yeah, 

Mike Matthews: You wouldn’t wrap around your knee. 

Mike Zourdos: No, that’s not being efficacious to restrict the blood flow to your calf.

So you would still keep that around your thigh. Because I still see some people do that sometimes. And while they’re well intended and that’s, Seems to make sense logically to them. It would still be above your thigh. So not a [00:32:00] standalone method. And those are the only two places where you’d apply BFR.

And I guess, lastly, depending on the knee wrap that you have, if you have a regular knee wrap, the width of it and you use that for your thigh, You could probably slice that knee wrap in half vertically down the middle and you would have a smaller width for your upper body. You don’t need as great of a of a distance there, a great of a width on that knee wrap when you’re applying it.

If you do have a knee wrap of a full knee wrap that’s of a large width and you’re using it for the upper body, the pressure that you can apply it is probably a little bit lower, but you just don’t need as much to cause the blood flow restriction since those muscles are smaller. So I would be cautious if you are using a knee wrap, I would slice it down the middle.

Vertically take a scissors and knee wraps are pretty cheap. You can buy them at sports authority or something that those, the cheap knee wraps, not the really tight ones, but the cheap ones. And you can do that. It costs you a couple of bucks and then you can use that for the upper body rather than using the full width knee wrap that you would use for the lower body.

Mike Matthews: Good tips. And just to reiterate, so it’s really for training the limbs. And if you wanted to, [00:33:00] if you wanted to, I guess it’s a strategy, another useful way to add volume without necessarily adding the muscle damage that would normally come with it. If you want to do that for muscle groups that you can’t use BFR with let’s say your chest or muscles in your back, I personally like rest pause for something like that.

Mike Zourdos: Yeah, real quick though. So while you can’t apply a blood flow restriction wrap or knee wrap directly to the chest, you can still use it for the chest. So there is a good study that came out a few years ago that shows when individuals did low load training on the bench press and then low load training on the bench press with the BFR wrap applied to their arm.

They saw better results with BFR applied to their arm, better hypertrophy in the bench press of the chest than the bench press without BFR group. So what we’re seeing there is we don’t know the exact reason, but it’s possible there that since the BFR wrap is used on the arm, That the chest is having to pick up more of the slack triceps.

That’s interesting. So yeah. So I think that you can still use it there. [00:34:00] I don’t see as nearly as great of an application for that as if you’re directly training the muscle. It’s used on while you wouldn’t apply it. To the chest, of course, directly that muscle group. You could use it above your arm and still see benefits in a chest exercise and so forth.

But in terms of like you pointed out other programming strategies that might work mechanistically similar in terms of saying metabolic stress. I think rest pause as you mentioned is a great one. I think there’s actually two studies in the past year that show some benefits for a rest pause training. So that’s something again, not a standalone strategy, but you can add that in for an exercise or two during your training week.

And I think. That would work from a metabolic stress perspective. Whereas I think hypertrophy overall is more of a mechanical tension, meaning volume with your training normally. 

Mike Matthews: Absolutely. Okay, good. I think that’s pretty much everything in this study. Huh? Is there anything else that you think should be mentioned?

Mike Zourdos: No, I think that’s it in terms of new information. Just the last thing is just making sure that you’re applying the tightness appropriately to about a seven. If it’s your first time, maybe a six or seven on a one out of 10 [00:35:00] scale. So it’s not too tight. If you tie that wrap around your thigh. And you can’t even get up, then it’s way too tight.

So I think it’s better to be cautious than to tie this too tight. So if you 1 out of 10 pressure around a 6 or 7, you should be good to go. 

Mike Matthews: Perfect. Okay. Great. Awesome. That was great, Mike. Thank you. 

Mike Zourdos: Of course. I appreciate the time, man. 

Mike Matthews: Hey there, it is Mike again. I hope you enjoyed this episode and found it interesting and helpful.

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