Wide-Rigid vs Narrow-Elastic

The scientific and clinical communities have embarked on a never ending quest to determine the optimal prescription of exercise in healthy and pathological populations. That search carries over into the application of Blood Flow Restriction (BFR). It seems to be well accepted now that BFR can amplify the effects of low intensity exercise.(1–3) While the recent position stand paper provided important guidance for BFR exercise prescription in healthy persons, questions abound as to how best to apply BFR in clinical scenarios.(4) Key topics warranting continued investigation include, but are not limited to risks / contraindications, pressure selection, size and type of cuff, as well as typical exercise parameters of intensity, duration and frequency.

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Vascular Endothelial Growth Factor

Although lesser known and even less frequently considered as an important growth factor for the musculoskeletal system, Vascular Endothelial Growth Factor (VEGF) plays an essential role in muscle adaptations and bone health. Characteristically VEGF is known as a potent angiogenic growth factor and appears to be upregulated during hypoxic conditions. Below, we’ll discuss VEGF’s role in muscle and bone, how that relates to injury, and the potential benefits of upregulating an angiogenic hormone with our BFR prescription in rehab.

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Is There a Pain Modulation Effect with Blood Flow Restriction Exercise?

Blood flow restriction resistance exercise (BFR-RE) has been shown to reduce pain across a training program in a range of clinical conditions (Ferraz et al., 2017; Giles et al., 2017; Hughes et al., 2019). Interestingly, the reduction in pain with low load BFR-RE appears to be greater than high load exercise (HL-RE). It is logical to assume that this may be primarily caused by the lower loads used during BFR-RE, which places less loading induced strain on a pathological joint or limb. However, recent studies suggest there may be an acute reduction in pain with BFR-RE, or “hypoalgesia effect” (Cook and Koltyn, 2000).

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