Owens Recovery Science

PBFR Safety After a Potential Nerve Injury

For clinicians trying to keep up with best evidence-based practices, implementation of a new skill or technique comes with some questions. Does this treatment improve patient outcomes compared to what I’m already doing? How do I integrate this treatment in the safest and most effective way?

In the case of Personalized Blood Flow Restriction Rehabilitation, anyone that has spent time looking into the literature should feel very comfortable with PBFR improving outcomes for strength and hypertrophy compared to a work-matched control. However, for most of us in the rehabilitation world, tourniquet application is pretty foreign outside of the operating room. The idea of using a tourniquet to limit blood flow into a limb while doing exercise can seem a little scary. What is happening to the soft tissue and nervous structures on the receiving end of this pressure? And do we need to be concerned with applying a tourniquet to someone that may have experienced a previous nerve injury?

Dr. McEwen and the experts at Tourniquets.org have taken the time to compile available literature and consult with experts in Neurology and Orthopedics/Arthroscopy regarding the risk for nerves with tourniquet application. “Any risk of nerve injury in BFR rehabilitation, whether or not the patient has a prior nerve injury, is mitigated by the use of a surgical-grade tourniquet instrument in which the lowest and safest tourniquet pressure can be determined based on Limb Occlusion Pressure (LOP), and by the use of personalized tourniquet cuffs which deliver lower pressures and lower pressure gradients to the underlying limb.”