Blood Flow Restriction (BFR) training is pretty analogous to relationships- everyone wants to get in on the action, but few actually know just what the heck they’re supposed to do once it’ time to shine. As a training technique that shows a lot of promise for physique athletes, for those outside of the research field, a lot of questions float around on how to actually apply BFR to a training program. When should it be used, how to apply the cuffs, what to expect when starting BFR- all valid questions that are often unclear for BFR beginners, until now that is. Below are the ins and outs of BFR training to make the technique as easy and productive as possible to apply to your own routine. After this, you may not be any better at cuffing wifey, but you’ll be a pro at cuffing BFR.
The FYI on BFR
Just as you’ll be adding BFR cuffs as an accessory in your gym bag, the technique itself is a relatively new, but very promising “tool” to add to your training tool belt. In short, performing BFR training supports muscle retention and growth through the restriction of venous blood return out of working muscles during exercise. By allowing deeper, arterial blood to enter muscles unhindered, but greatly reducing more superficial, venous blood return from the muscle, a greater total volume of blood & metabolites are then accumulated within the muscle tissue as the set progresses.
As this blood accumulates, the muscle tissue is forced to expand, and type II muscle fibers are left to perform a greater portion of the work as the aerobic, type I fibers are quickly fatigued due to reduced levels of oxygen within the tissue. These effects lead to muscular hypertrophy through much lower training loads as would otherwise be necessary during exercises not using BFR.  This is turn allows athletes to stimulate hypertrophy through lighter training loads (roughly 20-30% of maximum strength in a given exercise), and continue progressing during situations where training at a normal intensities may be hindered.
When BFR comes up in discussion, I find athletes have a lot of questions about whether or not it’s worth incorporating, but even more common- asking what they should expect or if there are any concerns with using the technique. In terms of concerns related to BFR, the available research suggest that for otherwise healthy individuals, incorporating BFR training doesn’t seem to add any additional health risks in muscle damage, blood pressure or coagulation. 
In terms of what to expect in the actual training sessions with BFR, one of the more key points of emphasis is finding the correct tightness to produce the intended benefits without hindering arterial blood flow into the muscle, or creating undue discomfort that could detract from the exercise. A 2014 interview with Dr. Jeremy Loenneke, a leading researcher in BFR training, provides the following guidelines for athletes beginning BFR Training:
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