Barbell Shrugged - 859 - Blood Flow Restriction with Dr. Michael MacPherson

Episode Date: August 12, 2026

In this episode of Barbell Shrugged, blood flow restriction specialist Dr. Michael MacPherson joins Doug Larson, Coach Travis Mash, and Dr. Mike Lane to break down how BFR training can be used for far more than post-injury rehabilitation. Michael explains how strategically restricting blood flow creates a hypoxic environment that increases type II muscle fiber recruitment, metabolic stress, and cellular swelling—even when training with relatively light loads. The result is a powerful tool for building or maintaining strength and muscle while reducing the mechanical stress placed on joints and connective tissue. They also discuss limb occlusion pressure, why cuff design matters, and why modern BFR protocols don't need to be brutally painful to work. The conversation expands into practical applications for athletes, lifters, and anyone looking to improve performance or recovery. Michael explains how BFR walking, cycling, leg curls, Nordics, plyometrics, and even passive recovery sessions can be incorporated into training, with walking protocols as simple as 10–15 minutes at roughly 30–60% limb occlusion pressure. The team also explores how BFR may help athletes strengthen commonly neglected areas like the hamstrings without adding significant training fatigue, making it especially useful during heavy training blocks, travel, injury rehabilitation, and return-to-play programs. Whether you're trying to add muscle, protect irritated joints, improve conditioning, or address weak links without piling on more heavy loading, this episode provides a practical framework for adding BFR to your training.

Shrug family. Doug Larson here. And this week, I'm Barb Lstrug. We're talking blood flow restriction training with Dr. Michael McPherson from Saga Fitness. In this episode, we break down why BFR can help you build muscle and strength, all while using lighter loads, how athletes can use it to reduce joint stress when coming back from injury, as well as how even to use it during some portion of your cardio and conditioning training. We also talk about the logistics around how to put the cuffs on, how tight they need to be,

who really needs to use them, beginner mistakes, and more. So if you're a person who's heard of blood flow restriction training, and you want another tool for building muscle, accelerating recovery, and improving performance. This episode is for you. Enjoy the show. Welcome to Barbell Strug. I'm Doug Larson here with Coach Travis Mash and Dr. Mike Lane and Michael McPherson from Saga Fitness. You guys do blood flow restriction, which I have actually very little experience with,

so I'm actually excited to do this show. I know Mike Lane and you were talking a lot at NSA, and so we wanted to bring you on the show and kind of dig in to a much greater degree than we have in the past on blood flow restriction training. So welcome to the show. Yeah. for having me. It's a pleasure, guys. Big fan, I must admit. Yeah, right on. Happy to hear it. Give us your background. How'd you get into training, into business, et cetera, and then we can start digging into the details on BFR. Yeah, absolutely. Actually, went to school, went to a small

school and graduated high school. Fortune enough during a football scholarship, went up to Michigan Tech as a civil engineer. Absolutely hated it. Ended up in exercise science, fell in love was strength conditioning, lifting, pursued that career. Was a strength coach there when I graduated, signed on at the University of Toledo for a year, and then I ended up pivoting and earning my master's in teaching, and I ended up as a head strength coach at a high school for over 10 years. Did a lot of group exercise, personal training, taught all the science curriculum, did that for around 10 years, football coach, track coach, you name it.

Trying to help out young kids. Ended up pivoting there, left teaching, and went into the operating room. I was a member of the striker sports medicine team. So I was in ACL reconstructions, rotator cuff repairs, FIA and the hip, you name it, head to toe, ankle, I should say ankle to distal bicep. I was in all those surgeries. And when I was actually in the DMC in Detroit, that's where I'm from around that area, got a call. And it was from a recruiter. And he's like, hey, based on, so at that time, I just learned my doctorate in health science, based on your education, your experience and your coaching background, we think you should, are you interested in BF.

are. And honestly, you know, I'm a C-S-CS. I'd never heard of it before. And I was like, well, like, let me do a little research before I just jump right in. Started reading the literature that night and it was just blown away by what people were doing with this, this form of training. And it was that at that point, ended up joining that company, worked with them a couple of years. And during that process, working with a lot of pro sports teams, realized that education was a huge barrier. Right. People weren't implementing it. Now safety concerns. Is this safe? Are we going to hurt somebody?

How do we use it? When do we use it? All these different things. So at that point, I pivoted again, launched by start of my own education, certifying strain coaches, physical therapists, athletic trainers, all the above. And that's what I ended up partnering with saga fitness as their blood flow restriction specialist. So helping, I'm big believer. I'm drinking the Kool-Aid. A lot of benefits. You've got a pulse. We can find BFR. for you. There's a reason to use it. What are the like the top five reasons

to use blood flow restriction? I've been reading about it and I've used it a little bit but like I'm excited to learn more. So great question. So typically I like to ask like what's your goals? It's going to be, right? So I call it performance let it say. Yeah, performance, right? Strength.

It's going to light hypertrophy faster. Right? We're talking. We should and I see this in older adults, 50s, 60s, lower pressures. But typically if you're exercising three, days a week with BFR for four weeks, you're going to have some form hypertrophy within those limbs. Really quite amazing. So we're doing now, right, hypertrophy and strength is what was big. We're doing more explosive training. So just by BFR walking, well, back up, right? So we do more polymetrics with it, with the idea of we're not adding additional load of the tendon,

but we're creating this muscular environment that increases strength and all of these different, and we'll get into the science behind it. But this physiological response that once you put the cuffs on, everything just operates more efficiently. So with recovery in mind, we can use it passively to enhance our recovery, reduce muscle damage. Guys use it before they lift, after they lift, before games, after games, traveling to loosen up, right? If you're on a plane, you get off the plane, hamstrings, calves, low back, super tight,

put the cuffs on inflate, deflate a couple times, or go for a walk. And you'll actually, you'll feel renewed, a real recent, study just came out. Two weeks of BFR walking in elite athletes. So they walked for 10 minutes twice a day for two weeks. Ended up 12 sessions. They took one day off. 11.1.12 increase in aerobic capacity. 2.5 increase in anaerobic capacity. And they had stronger hamstrings at the end of the study just for two weeks of walking. Where were they wearing the cuffs, you know, during the walk? Always. So it always goes that most proximal portion of your limb. So they were on a lower body BFR, put it on, inflate.

Typically, it's about 60% LOP, and then you're off. It's low, low to moderate pace. And it was really that whole aerobic side. So I had, you know, everyone's got low back pain, 80% of Americans dealing with those issues. I use BFR on a bike, so cycling is where I really was like, this is it. This is what I know I'm going to kind of hang my hat on. I was, ended up hospital.

I had SI joint pain for like three years, right? like leg length discrepancy. I'm like, well, how do my leg get shorter? Right, I'm 30 years old. This is nuts. Take me a half hour to warm up to squat. I was having all these issues. End up in the emergency room.

So I blacked out, fall down some stairs, our basement staircase. Wife calls EMS. They take me to the hospital. Like, what's wrong with you? I'm like, I just in a lot of pain. They put me in an MRI, you know, herniated disc, L4L5, L5S1, radiating pain, numbness down the legs, all that good stuff. started to change the way I trained but added BFR right at this time.

And riding the bike with BFR, it gives me goose one is telling the story. As soon as I got off the bike, I took the cuffs off and I just felt this rush of blood, as crazy as it sounds, through the hamstrings, through the glutes, right into that, like, thick lumbar tissue, and it was just this release.

And ever since then, absolute game, just a game changer for my own performance, exercising, staying fit. And there's been countless, you know, athletic trainers and PTs that I work with that are now implementing BFR on bike as an effect for whether it's hip, pelvic floor, or lower back. Tell me the science there. I mean, yeah, this sounds exciting. So let's dig in more. So BFR on the bike for hips low back.

Yeah. So traditional strain training, right? Like 70% of our one RRRRRM and greater, that's hypertrophy. Right? That's the gold standard for hypershapy. So typically, I guess, and correct me if I'm wrong, you guys know, like the four big things that cause hypertrophy. We're thinking the hypoxic environment recruits more type 2 muscle fibers. The mechanical stress, or we're getting that pump, that cellular swelling mechanism, the hypox.

I'm sorry, the metabolic stress, right, hydrogens, phosphates, lactate, reactive oxygen species. And then with traditional training, we get muscle damage, right? Stimulis hypertrophy. With BFR, we get three of those. So we're going to put the cuff on, put it on our limb, inflate it, and it's going to reduce, it's automatically going to reduce the amount of oxygen entering that limb. Because I put that cuff on, it just changes the way we're slowing the blood down, right? Instead of 100%, we're only allowing 40%, 50% in.

So there's that hypoxic environment. So right then and there, BFR forces the body, right? Because we have less oxygen available, we have to recruit type 2 muscle. fibers. The body has no choice, right? Brain's telling the muscle you have to lift. Muscle's got muscle is going to find a way. So it recruits more type two muscle fibers. So that's where we can get strong with those light loads, right? Where typically we need those heavier loads to recruit those type two fibers. Now, because I have that cuff on, I'm changing the way our venous structure is a much more superficial. So where, right, and our arteries are a little bit deeper, right? Protective thing, right? So if you skin your

knee, you're then bleed out when you're a kid. So those venous structure is a little more superficial. So when we have that cuff on, right away, we're occluding a lot of that venous outflow. So occluding meaning like we're preventing a lot of that blood from escaping the limb. When we do that, that's where we get the metabolic and mechanical stress. So the mechanical stress, that blood's got to go somewhere. Blood's got to go somewhere. So what it does, it starts pushing deeper in those tissues and enters those.

those muscle cells. And I nerd out on biology, former biology teacher, cell membrane starts communicating with the nucleus. Hey, I'm under. Shrug family. Doug Larson here. And this week, on Barb L Shrug, we're talking blood flow restriction training with Dr. Michael McPherson from

Saga Fitness. In this episode, we break down why BFR can help you build muscle and strength, all while using lighter loads, how athletes can use it to reduce joint stress when coming back from injury, as well as how even to use it during some portion of your cardio and conditioning training. We also talk about the logistics around how to do. put the cuffs on how tight they need to be who really needs to use them beginner mistakes and more so if you're a person who's heard of blood flow restriction training and you want another tool for building muscle accelerating recovery and improving performance this episode is for you enjoy the show welcome to barbell shrug

i'm dog larsen here with coach Travis mash and dr mike lane and michael macpherson from saga fitness you guys do blood flow restriction which i have actually very little experience with so i'm actually excited to do this show i know mike lane you were talking a lot at n sca and so we wanted to bring on the show and kind of dig in to a much greater degree than we have in the past on blood flow restriction training. So welcome to the show. Yeah, thank you for having me. It's a pleasure, guys. Big fan, I must admit. Yeah, right on. Happy to hear it. Give us your background. How'd you get into training, into business, et cetera, and then we can start digging into the details on BFR. Yeah, absolutely. Actually, went to school, went to a small school and graduated high school.

fortunate enough during a football scholarship, went up to Michigan Tech as a civil engineer. Absolutely hated it. Ended up in exercise science. Fell in love with strength conditioning, lifting. Pursued that career. Was a strength coach there when I graduated, signed on to the University of Toledo for a year. And then I ended up pivoting and earning my master's in teaching. And I ended up as a head strength coach at a high school for over 10 years.

Did a lot of group exercise, personal training, taught all the science curriculum. Did that for around 10 years. Football coach, track coach, you name. it trying to help out young kids ended up pivoting there left teaching and went into the operating room I was a member of the striker sports medicine team so I was in ACL reconstructions rotator cuff repairs FI in the hip you name it head to toe ankle I should say ankle to distal bicep I was in all those surgeries and when I I was actually in the DMC in Detroit that's where I'm from around that area got a call and it was from a recruiter and he's like hey based on so at that time

I just learned my doctorate in health science. Based on your education, your experience, and your coaching background, we think you should, are you interested in BFR? And honestly, you know, I'm a C-S-CS. I'd never heard of it before. And I was like, well, like, let me do a little research before I just jump right in. Started reading the literature that night. And it was just blown away by what people were doing with this form of training.

And it was that at that point ended up joining that company. worked with them a couple of years. And during that process, working with a lot of pro sports teams, realized that education was a huge barrier, right? People weren't implementing it. Safety concerns. Is this safe? Are we going to hurt somebody?

How do we use it? When do we use it? All these different things. So at that point, I pivoted again, launched my start of my own education, certifying strain coaches, physical therapists, athletic trainers, all the above. And that's what I ended up partnering with saga fitness. as their blood flow restriction specialist.

So helping, I'm big believer, I'm drinking the Kool-Aid. A lot of benefits, you've got a pulse. We can find BFR for you. There's a reason to use it. What are the, like, the top five reasons to use blood flow restriction? I've been reading about it and I've used it a little bit, but like, I'm excited to learn more. So great question. So typically I like to ask me like, what's your goals?

It's going to be, right, so I call it. Performance, let it say. Yeah, performance, right? Strength. it's going to light hypertrophy faster, right? We're talking, and I see this in older adults, 50s, lower pressures, but typically if you're exercising three days a week with BFR for four weeks, you're going to have some form hypertrophy within those limbs.

Really quite amazing. So we're doing now, right, hypertrophy and strength is what was big. We're doing more explosive training. So just by BFR walking, well, back up, right? So we do more polyometrics with it with the idea of we're not adding additional load of the tend. but we're creating this muscular environment that increases strength and all of these different. We'll get into the science behind it. But this physiological response that once you put the cuffs on, everything just operates more efficiently.

So with recovery in mind, we can use it passively to enhance our recovery, reduce muscle damage. Guys use it before they lift, after they lift, before games, after games, traveling to loosen up, right? If you're on a plane, you get off the plane, hamstrings, you know, know hamstrings calves low back super tight put the cuffs on inflate deflate a couple of times or go for a walk and you'll actually you'll feel renewed a real recent study just came out um two weeks of bfr walking an elite athlete so they walked for 10 minutes twice a day for two weeks ended up 12 sessions they took one day off 11 point 11.2 increase in aerobic capacity 2.5 increase in anaerobic capacity and they had stronger hamster at the end of the study just from two weeks of walking.

Where were they wearing the cuffs, you know, during the walk? Always, so it always goes the most proximal portion of your limb. So they were on the lower body BFR, put it on, inflate. Typically it's about 60% LOP, and then you're off. It's low, low to moderate pace. And it was really that whole aerobic side. So I had, you know, everyone's got low back pain, 80% of Americans dealing with those issues. I use BFR on a bike, so cycling is where I really.

he was like, this is it. This is what I know I'm going to kind of hang my hat on. I was ended up hospital. I had SI joint pain for like three years, right? Like leg length discrepancy. I'm like, well, how do my leg get shorter? Right. I'm 30. I'm 30 years old. This is nuts. Take me a half hour to warm up to squat. I was having all these issues. End up in the emergency room. So I blacked out, fall down some stairs, our basement staircase. Wife calls EMS. They take me to the hospital. Like, what's wrong with you? I'm like, I'm just in a lot of pain. They put me in an MRI, herniated disc, L4L5, L5S1, radiating pain, numbness down the legs, all that good stuff. Started to change the way I trained, but added BFR right at this time.

And riding the bike with BFR, for it gives me goose one is telling the story. As soon as I got off the bike, I took the cuffs off and I just felt this rush of blood, as crazy as it sounds, through the hamstrings, through the glutes, right into that, like, thick lumbar tissue. And it was just this release. and ever since then, absolute game, just a game changer for my, my own performance, exercising,

staying fit. And there's been countless, you know, athletic trainers and PTs that I work with that are now implementing BFR on bike as an effect for whether it's hip, pelvic floor, or lower back. Tell me the science there.

Yeah, this sounds exciting. So let's dig in more. So BFR on the bike for hips, low back. Yeah. So traditional strain training, right?

70% of our 1RM and greater, that's hypertrophy, right? That's the gold standard for hypershry. And so typically, I guess, and correct me if I'm wrong, you guys know, like the four big things that cause hypertrophy, we're thinking the hypoxic environment recruits more type 2 muscle fibers, the mechanical stress, or we're getting that pump, that cellular swelling mechanism, the hypox, I'm sorry, the metabolic stress, right, hydrogens, phosphates, lactates,

lactate, reactive oxygen species. And then with traditional training, we get muscle damage, right? Stimulize and perch fee. With BFR, we get three of those. So we're going to put the cuff on, put it on our limb, inflate it, and it's going to reduce, it's automatically going to reduce the amount of oxygen entering that limb. Because I put that cuff on, it just changes the way we're slowing the blood down,

right? Instead of 100%, we're only allowing 40%, 50% in. So there's that hypoxic environment. So right then and there, BFR forces the body, right? Because we have less oxygen available, we have to recruit type 2 muscle fibers. The body has no choice, right? Brain's telling the muscle you have to lift. Muscle's going to find a way, so it recruits more type 2 muscle fibers.

So that's where we can get strong with those light loads, right? Where typically we need those heavier loads to recruit those type 2 fibers. Now, because I have that cuff on, I'm changing the way our venous structure is a much more superficial. So we're, right, and our arteries are a little bit deeper, right? Protective thing, right? So if you skin your knee, you're then bleed out when you're a kid. Sure. So those venous structure is a little more superficial.

So when we have that cuff on, right away, we're occluding a lot of that venous outflow. So occluding meaning like we're preventing a lot of that blood from escaping the limb. When we do that, that's where we get the metabolic and mechanical stress. So the mechanical stress, those, that blood's got to go somewhere. Blood's got to go somewhere. So what it does, it starts pushing deeper in those tissues and enters those muscle cells. And I nerd out on biology, former biology teacher. Cell membrane starts communicating with the nucleus, hey, I'm under stress, strain, duress, signals the nucleus.

We got to go larger, right? We need an incline muscle protein synthesis, testosterone, and growth hormone, insulin growth factor gets spiked. So that's that cellular swelling mechanism. Now, there is another mechanical stress when we take the cup off. We'll talk about that in a minute, though. The other thing is metabolic stress. So as long as that cuffs on and I'm contracting those muscles, right, there's still metabolism there. I like to think of it like a car, right?

It's producing that exhaust. That's my metabolic stress. Well, that exhaust is building up in this limb. And in response to that metabolic stress, the body, right, signal response, increased testosterone, growth hormone, insulin-like growth factor, stimulates the mTOR, pathway, all of those things. A quick break in the action here to let you know that I've just recently chosen to get back into coaching and I specifically am looking to coach Masters Jiu-Jitsu athletes just like myself. I've been doing Jiu-Jitsu for 22 years and strength and conditioning for 30 years.

I'm a black belt, of course, and I live that life. I understand exactly what goes into it. I understand what's like to run a family, do Jiu-Jitsu, try to tie strength and conditioning into it all and all of the ups and downs that come with it from from joint pain to busy schedules to travel and all the things. So if you are a master's jujitsu athlete and you're looking for some support, I'm happy to give it.

You can DM me on Instagram at Douglas E. Larson or you can email me, Doug, at barbell shrug.com. Happy to help. Back to the show. Now when we take that cuff off and you get this rush of blood flow entering the limb, it creates a sheer stress which increases nitric oxide.

Super common. One of the benefits of BFR is a decrease in blood pressure post-sition. It'll drive that down. and now once this cuffs off and that that oxygen-rich blood is rushing in, now we got a systemic effect. Right now everything's circulating throughout the entire body, making positive things happen. That's awesome. I mean, the sheer stress from taking it, that's the first time that I've heard of that.

I'm curious, how does that, like, the sheer stress, is it? I thought sheer stress is when you get, like, you know, like, I guess, tension from the side or, like, you know, but like so how does this work yeah so basically the blood well hopefully i can explain this well the blood on in the middle of the vessel is moving faster than the blood on like touching the endothelial wall of the lining of the blood vessel so as that blood rushes in and it's moving quicker because what they find it's like almost like a vacuum is the way it's been explained to me in my understanding that metabolically right so everything's stuck in here full methamatine my have my cuff on, this metabolite-rich blood, it's really, it's deprived of everything, right?

We've used the oxygen. It's full of metabolites. Even glucose is down, right? A bunch of breakdown of phosphates. When that cuff comes off, it's almost like a vacuum. That blood, this reperfute, the oxygen-rich blood rushes in there, and it pushes all that metabolite-rich blood out. And so as that blood rushes in, it creates the sheer stress along the endothelial, the lining

of those blood vessels. That's the production of nitric oxide. No, I can definitely see that now. It's because it's pushing out. Like, yeah, exactly. Another way to think about it, excuse me, is think about when you've seen a fire hose get charged. When that thing sits empty and then they hit the pressure and you see that thing like, that shering stress is that literally knocking against the walls from the side.

Sure, I totally understand. And so that's why like, we don't want to blow our fire hoses, but when they dynamically have that sudden pressure return, like, So I'm also a professor by Trey and I teach, and it's entertaining where they think your bloodstream is this lazy river. It's like, no, dude, it's essentially just a slamming the pressure, and then it goes real high, but then to low eventually. Like, you're being a cavea, that's kind of a lazy river. But when you're in those arteries and arterials, that's why those stuff shering through pretty hard, depending on obviously the blood pressure behind it, how hard you're working. So obviously, I want to nerd out, but you've done a great job of contextualizing things so far. so I don't want to hop in yet.

Go ahead, Doug, my apologies. I tend to put B.R. on my own brain in the category of hypertrophy, maybe like the minimizing joint stress while still stimulating some type of hypertrophy effect. So if you have your elbows hurting and you want to reduce the weights that you need to lift to maintain muscle mass while you're injured, you can lift lighter weights but still got hypertrophy while minimizing joint stress because you're not lifting as heavy enough weights, things like that. I don't tend to think about explosive power, pliometrics,

or even strength from like a force production standpoint. Like I hear mechanical tension and how does mechanical tension get stimulated by blood flow restriction? Like metabolite build up, muscle damage even, those intuitively make sense. How does the muscle or mechanical tension component get influenced here? So right, we got this. We're including that outflow. So blood's building up within this limb and things start, things start swelling. Blood's got to go somewhere.

So it pushes into the muscle cells. Those muscle cells swell. And there's our form that's either swelling, which is a register, registers as mechanical stress, right? There's our mechanical stress stimulus. There's actually, this is a great, great timing, right? Timings everything. Read a study yesterday that I put on LinkedIn quickly summarized. And they compare 70% of your one RRM to 70% one.

our REM with BFR, 50% of your one rep max with BFR, and 30% of your one rep max with BFR. So we are starting to get into this, this area now because we're seeing more S&C literature. Like originally it was all rehab, rehab, rehab, rehab. So really light loads. And that was 3015, 15, 15, which we've seen that change recently. But we're more in the sports performance around people are you, right, where they're increasing load. They're messing with the pressures and they're doing some different things.

We do a lot. I do a lot with dynamic warmups with BFR and the whole goal, right? Increased type 2 muscle fiber recruitment. And we notice, right, improving mobility, flexibility, changing that traditional static stretching and in BFR with it goes a lot deeper. Yeah, down and hold, some interesting stuff. And I would always, and I say to the classroom, don't believe me, try it. Right.

Tell me I'm wrong. Absolutely. But don't knock it to try because you're going to, it does something. I had a gentleman this morning. He's one of my former athletes. I used to coach, came back from college, and we'll train early mornings together. He had the arm cuffs on at 60% LOP,

and he did 295 for a set of six. Right? It's, yeah. And I was, so mine, I'm not, I'm not at his level. I was 235 for a set of six, but I'll tell you what, compared to last week, my elbows with BFR, even though it was at the end of a lift. It wasn't even at the beginning.

just so much more smoother. When you capture that blood, it seems to lubricate the joints. So when you are lifting heavy, it feels a lot better, to be honest with, right? From an older, you know, been training a little, as you guys have, right? 20-plus years of training, sometimes you go heavy a couple days in a row. You're pretty dinged up or a couple weeks. This does a nice job of really helping out or give you through a download week or through some of those days. I know when I was that muscle driver,

It's a long time ago. It was like for a short spurt. They had a professional weightlifting team, but we used blood flow restrictions. A lot of times if we identified like a weakness to say that an athlete had week camstrings or they had, I don't know, let's say even they had weak quads, you know,

and like you were wanting to target it without necessarily causing a lot of fatigue, you know, because, you know, they still got a snatching cleaners, you know, almost every day. So we would, we would target specific weaknesses with blood flow restriction. And we did seem to get a really,

good result, you know, with almost every body we tried. And it was like, we did that for a solid six months to, like targeting. We actually had a BFR expert that would come in, you know, three times a week to target these muscles that he had identified. It, uh, it really seemed to improve, especially even because we would do obviously test, retest. Um, and it would, we saw some significant games from it. So I have to, in my, those six months, I definitely witnessed, you know, some, I don't know why I haven't been doing it lately, you know, other than just forgot. And it hurts. Yeah, it does.

You're really glossing over the fact that like, if you tell me three sets of 10 with 70% of my max or, you know, three sets of 10 or three sets of failure at 30% of BFR, like, all right, put 70% on. Let's go. Yeah. Yeah. Yeah, that's my first thought. You're talking about the cellular swelling.

I was like, yeah, the cellular swelling means like you feel like your, your biceps are going to pop. Yeah. Or your forearms are going to pop. Forearm or cap training. Either one of those. Plus BFR is just got to be room. That's what I really like using it for those. You guys hit the nail on the head.

Absolutely. Yeah, it's kind of the most practical as well. Yeah. A second ago, you use some terminology that many people probably aren't familiar with. You said 60% of something. Yeah. So limit collusion pressure. Great, great got.

I talk about this stuff all day every day. So if I gloss over some, right, reel me back in. Yeah. Like, how do you get that? get the right pressure how do you just get the the veins to collapse but the arteries are not see not closed off as well etc yeah so this one thing i'm glad uh great question is this alludes to the comfort thing so i've used a ton of a lot of the different bfro devices out there on the market now um so lop is limb occlusion pressure and what that is it's the minimum pressure needed to stop blood

flowing into that limb so that would be arterial inflow and so what we do do. So I've gone to using the Saga BFR Cuffs, which are airbands now. Right. So it's, it is something important with BFR too, because I've had cuffs that, you know, the really thin, like elastic straps super cheap or you can get like built into short. They caused on me. I had significant bruising when I was using those straps. One, you don't know your LOP. And then two, it's like, just pull it tight. Okay, I'm pulling it tight. And then I let go. Like, I'm all purple and yellow. It's like it didn't hurt. But for some people, that's going to, they're going to be like, I'm done. That's it for me.

Try these air bands cuffs. So they're wider. They're around 10 centimeters. So with the cuff that's wider, you can occlude blood flow at a lower pressure. So where I'm occluding blood flow now on my limbs, you know, maybe it's like anywhere like 220 to 240. With those other cuffs, those thin straps, I'd have to use like 500 millimeters of mercury versus 240 to get that, yeah, to get to that same level of occlusion. And some of those cuffs that are air bladder segment like air bladder, elastic air bladder, you can get to some very high millimeters of mercury trying to get to those levels of occlusion because they allow for that venous outflow.

So when you're doing BFR, cuff design is important as well. Like, yeah, I'm a big believer. We want an air bladder that runs a complete length of the cuff, that circumferential pressure, right? That's going to increase comfort. It's going to allow us to train at lower. pressures. And in my mind, I always start like, start people low and leave room to grow up. Because what we're seeing in literature now, BFR is compounding. Things, the more you do it, the better it gets. And with a lot of our PTs where I'm trying to help them out is,

because a lot of literature early on was like 80% LOP, so 80% of that limb occlusion pressure very high, right? Like you're going to take someone who's never trained before and put them at 80% LOP and then have them do 75 reps insane in my mind. And that's where I really, it struck me as a strength coach. I was thinking like, like, when's the last time you ever programmed 75 reps in exercise? I was like, well, I've never done that. So why would I have this person who's injured, right, who's coming off significant atrophy, who hasn't spent much time in the weight room?

Why am I having them do that? So there was a meta-analysis a couple years ago that found that three sets of 15. So they compared three sets of 15. They compared it to the 75 rep protocol, which is 30, 15, 15, 15. Then if you believe this, they also looked at 150 reps. They doubled that. No difference. Yeah, no difference in outcomes.

So that's right away. Like I started banging the drum. Like, we back off. Let's reduce the reps. And let's start them where they're comfortable. Because at the end of the date, right, I'm trying to set the hook. I want to get the bait in the water. I want you to bite.

I want you. And then once you have success with it, it's a done deal. Like I'll start a lot of people on passive BFR or BFR walking. And it's amazing. Again, don't believe me, right? Try it out. You get, they adapt when it's, when the cuff is uniform and the airbladder runs circumfrontal, the adaptation to the pressure.

They get, it's way more friendly. It's not that super intense. You're pulling a strap super tight or you got to keep inflating in order to get to a seven out of ten right like i know data right like i know i know i'm at 50 percent of 50 percent of the blood's coming in of what normally flows so i can use that as a variable in my training right now it's not just sets reps you know rest exercise i use pressure as a variable as well um and that's something too with a lot of these other like the real cheap straps like what i tell someone hey go put around two to 250 pounds on that barbell let's right let's wrap that out for three sets of six like

what? Like no, it's super put on 225, right? Like 82.5% of your one rep max is what we're doing today. Like we get super specific in strength. So trying to bring that same level into BFR. One, just the thing for listeners at home, contextually BFR is really fascinating because it actually started in the tactical community. It was used for people that literally got blown up by like IEDs and otherwise. So it was used as a rehab protocol. That's why the old protocols were super high rep, super low loads because these guys maybe had knees that had literally had to be like fragmentation repairs and you used that to rebuild the quad and the ham so like they were not used on athletes and so hence why what mike's doing is applying it to this population which does not need to do

the old school like again these guys got blown up over in another country type situation for rehab the second which you touched on it because that was wilson was the first one i saw with it that used essentially knee wraps instead of your acclute, like for the folks at home, which don't get me wrong, like, we talked because I liked your product and I was like, oh, that's way better than the ones that I've got at home. You might talk them through if they were going to try to like do this on their own with a set of knee wraps and kind of like what that was. And obviously it's not as good as actually be able to measure it and progress it like you brought up. Yeah, yeah. With the knee wraps, like the biggest thing, if you're not measuring limb inclusion pressure where people got into

trouble in the past is you just wrap it super tight right like you're starting to bring your cause and bruising damage how much is occlusion because what a lot of the studies have found when you when you're exercising and you're at 80 90 100% LOP there is no difference in in strength or hypertrophy outcomes the difference is in pain right like it's going to be way more painful to sit there and try and do you know 15 squats at 100% LOP compared to 80 even compared to 60, but the outcomes, there doesn't seem to be a huge variation in the strength gains over time. So when those ones that just generally wrap, you're guessing. And my thing is, like, when I'm training guys, is my 7 out of 10 on a Monday is not my

7 out of 10 on a Thursday. Monday, I'm ready to go, right? Like, I'm tackling the week. I'm trying to dominate the day. Thursday seems to be where it's like, hey, we got to get to Friday. Let's finish. So when I'm seven out of ten I know I'm not going to have as much in the tank on Thursday

So if I'm due that's where it kind of comes in like a little more Little more little specific Measurement data in that regard That's what's changed just hearing you talk like when we were doing it was just like you know Use a knee wrap it hurts like a mother there was like no There was definitely not Of course you're talking about this is like 13 years ago but like So it's good to hear that it's like you know

you don't have to kill yourself it doesn't have to feel like you're going to have to cut your leg off so no doubt so say say someone's in a training block right now and they're they're doing four sets of eight on front squats and they normally do 275 or whatever it is and they decide they want to try this out they're going to use blood flow restriction for those front squats should they expect to hit the same the same reps that they would otherwise or would they probably fall a rep or too short yeah they're not able to do four sets of eight they got to do four sets of seven or whatever it is and then now they're doing less volume, but there's the benefit of having the restriction.

How does it play out like that? That's a great question. A lot of variability there, depending on the pressure. So if they're using a lower pressure, to be honest, I would think four sets of eight, they're probably going to end up with four sets of six to eight if they're at like a 30 to 40 percent. If they go up higher, right,

you're getting into that 60 to 80 percent range. Now we're capture a little more blood flow. You're probably going to be more so like four sets of, I'd say four to six because that you're going to feel that it's going to build up. Now, what's interesting, that fatigue will build up. You take the cuffs off and it's like there's not there anymore. You might have some sort. It's like we were doing this morning because my big thing is I train with it daily because

I don't ever want to talk to someone that right now I don't want to practice what I preach. I'm going to talk about this. I better be doing it. We did single arm chin ups with some help with bands. when we were included at 60% on the upper body, which is really the highest range of what we typically see in the upper body. It's usually 30 to 60 or 40 to 60, depending on the literature. Very challenging.

Fatigue sets right in, you feel it. As soon as the cuff comes off, that's relaxed. But that's challenging. So I can feel a little bit that soreness, but nothing crazy as you would think doing single arm chin ups or pull-ups. Got it. Here, playing off the example from a second ago, like say you do go from force it to eight to now you're with BFR,

you're doing four sets of six. Should you add a fifth set of six to kind of try to match the reps you would have got otherwise? I don't think so. So what we see, especially with Pliometrics, is we're able to reduce volume because of that, you're not getting the same. So we're not going to get the same muscle damage because BFR should decrease that. But because you're using,

so if you use all the same reps, the sets, weights and you're changing the pressure, we're going to get a much stronger metabolic response, right? There's going to be way more metabolites built up and way more mechanical stress. And granted, with those, very few people are lifting like that. So that's complete speculation. I don't know anyone who's like, we'll do some BFR squatting and we'll get pretty heavy to like three sets of six, but you're feeling it, right? When you get in there, we'll zircher with it with the lower body and it's yeah it's going to you're going to be feeling that when you're done yeah yeah go

ahead I'm sorry right just finishing up this this example here so so say you do your your force at to eight with with bfr and then you're going to finish your workout so you have you have lunges and and glute ham raises and calf raises do you use blue uh bfr for all of the exercises or you generally just pick like your main lift or just if you have a hamstring issue like you're just doing that for your glue ham raises or how do you typically pick and choose when to use it? Yeah, so I'm going to be clear as mud here, so I apologize. Depending on the athlete, what I'm working like me, I'll use it. I really like, and I've gone like completely done a 180 here,

I'll put my squats at the end. And I'll do like very recently in this cycle, I'm doing a lot of my squats and deadlists at the end. And I'll use BFR and I'll just go from the toe up, right? So I'll do foot and ankle to start. I'll do some core work. And it's almost like this activation. Even though I'm squatting at the end, I feel so much better when I squat after using BFR throughout that,

that entire progression is it's like everything's better activated. Everything's warmed up. Everything's ready to go. Depending on the athlete, we'll do a lot of, so if they're a chronic hamstring, I'm going to hammer the hamstrings with BFR. There's no question. We're going to go after it every direction, not just RDLs. I'm a big believer.

We've got a lot of people doing a lot of heavy RDLs with a lot of athletes. And then I'm seeing athletes sprint, right, a thousand reps of leg cycling in their, you know, I'm exaggerating. But they're running all over practice. How many leg curls are you doing? Like, well, we don't. Well, why aren't you do, right? Like you're curling your leg as you're sprinting throughout practice. Why aren't we mimicking that with some of the stuff we do in the weight and we're strengthening those?

So we'll do a lot of leg curls with BFR and tremendous improvement, not just in the hamstrings, but the weight of the low. back fields, the glute, all those things. Finisher's very common. Hey, we just got through our upper body day, put the cuffs on. Let's hit some bicep, tricep. Let's hit some hamstring quad or even calf at the end. I get outside the box with myself because I, you know, I would say I quote unquote, like classically trained, NSCA, CS, CS.

So I'd do all my, for many years, right? It was like clean. I did all my Olympic lifts because I'm USAW. I'd go into squat, deadlift. and then the secondary. So I was like, well, I'm just going to try something different. See how it feels. Just experiment here.

So I'm curious with air bands. I have some, you know, are they not involved anymore? It says, I'm just looking at it. And now it says it's now part of saga. So is it saga is evolved? Are you guys a part of vault? Like I'm so confused. Great question.

So saga is a, sister company of vault. Oh. So they're, yeah, owned by the same guys. Um, where Valled is more right.

And hopefully I don't get in trouble and I'm explaining this properly. Uh, vault, right, it's going to be our data measurements, uh, right? Our force plates,

our force decks, um, our Norfolk board, our dynamo, things along those lines. Sure. Where Saga is we're going to, where vault's going to measure where our improvements are,

saga is going to help you make those improvements. Right. recovery, longevity, performance. Like, we're getting ready to add a portable flywheel, which will be really, it'll complement BFR really nice, right? So you got the cuffs, you got this flywheel that can literally attach anywhere. What more early? And it's really also catering to, like, a lot of our pro sports teams,

if you can believe this, when they're out there traveling. So they're getting hotel gyms that really, they don't have anything, if you can believe, right, very minimal, right, bikes, a couple people. Yeah. So how do we maximize training in those environments? and that's where I think saga we're going to with the flywheel like I love flywheels by the way and so like and I end the blood flow restriction I just didn't know that bald owns I'm going by the way to Australia next month to hang out with those guys we're going to be person yeah so like yeah I'm speaking at the their big thing and like I just found out two weeks ago and like so super fantastic that's a lot more excited now yeah super excited so I'm sorry, but the evil combination of flywheel with BFR. That's what I was thinking. For those of you guys that, yeah, I haven't done flywheel, the flywheel is the equivalent

of stop hitting yourself because you pull it and that charges it up and then you get hit with our hard, you put the force into it. And let me tell you, you'll be surprised that you're on strength, especially if you do that on a dead left or a squat, and it'll snap you down if you're not ready. because it it's like catching a body that's dropping on you not like oh like let me bend my knees and i'll lower the weight on the squad here you know man i've always thought that you know the the answer to the ACL you know tear was been like either or you fly wheel your bf because these athletes travel they you know they're they're playing year-round you know you'll it's so common for especially

female soccer players who just they play or volleyball players they play year-round now they never have a break and it's so hard for them to train. And so you have this ACL epidemic. You'd have to call it what it is. And there's been no answer for it. And I always thought if you could just get like flywheel and or BFR on the road with them so they can get some work in to, you know, keep the, you know, keep strengthening the, you know, the tendons, the ligaments, obviously the musculature. To have things balanced out, you could you could put a big bent in. some of these percentages that we're seeing right now. And it's good to hear.

You guys are thinking about doing a portable flywheel. Brilliant. And I feel like every single travel team should invest in that, unless they don't care about their athletes. Yeah, you're testing. So your question that could be useful on a game show is the fact that flywheel technology is actually what they try to use on like the space station. Yeah.

NASA. Exactly. You don't need gravity. And so hence why that can be a lot more affordable. Right. And yes, again, you load it up at your own peril and when it hits you, it hits hard. Like it's, yeah, you bet you're right. The ACL thing is multimodal, but the idea of again, that unholy love child of combining

those two at the same time, that just sounds like, what's the safe word that we use for that workout? Exactly. So yellow, yellow. Yeah. Well, someone wants to try this for the first time. What's like the easiest application for like an absolute beginning of the never done it before and they want to just kind of get a feel for what it's like like where do

what size cuff do they need where do they put it what exercise is like the easiest to like just kind of again just get a feel for it where you go oh cool I know this guy's talking about I see I see what they're I see what all the fuss is about super low hanging fruit right I would go so you get the regular bundle which they'll give you arm and leg cuffs but if you're I don't want both get the leg cuffs um because right drive a little more hormonal response unless you're looking for a great arm pump, but completely passive, right? So maybe you're, I don't know, you're into lifting or maybe you're more running, like marathon, triathlete, all of these different things, but we all want to prioritize recovery. You're on the couch. Put the cuffs on. You can download so the new version

of the app has what are known as pressure cycles, completely automated. You set your pressure, your time, your rest, and the number of cycles, and you just set your phone down or flip on Instagram, watch your YouTube video, your TV, and it'll cycle the pressure on and off. And that is, I worked with the gentleman. He had a bascar necrosis of his formal head. And we were using passive BFR to get rid of his pain to just allow him to walk around the house because it was excruciating. He had such a reduction in pain. It was like the straw that broke the camel's back, though. He had a reduction in pain. Went to work the next day, right? He's a plumber. Walk three miles. Yeah. I was like, oh, no, why?

He's like, well, I was feeling great. And that just made things go worse. But that pain reduction, that recovery aspect, and it's in the literature, right? They use it before practice. They use it at competition. A couple years ago, we had data. It was used in the middle at halftime of the Super Bowl. One of the players was having need.

He had significant knee pain. We knew it throughout the playoffs. People were in, they were heavy users, BFR. And we were able to look at the data. And it was like, hey, his account lit up. while it was at half time and he was running recovery cycle. So he can't be understated. That alone, real low-hanging fruit, too, I'm going to put you on.

And again, I'm thinking more general, but a BFR walk, right, 40 to 60 percent, you see people all the time, right? Like, in my mind, maybe it's a teacher in me, just trying to help people, right? Again, I think the amount of people that are sedentary, that aren't doing enough moving, because BFR, one of the little known, and we're seeing it more, one of the little known benefits, it helps fat loss, right, visceral fat. BFR does a wonderful job. And so the, how does that happen?

Explanation, right? So I'm glad you asked. Type 1 muscle fibers, very energy inexpensive, right? That's why the body prioritizes them for low, low intensity activities because it's easy to use, so to speak. Type 2 muscle fibers, the body only prioritizes them later, right? You've got to work for them because they're more, they're more costly. Well, because BFR reduces the recruitment of type 1 means we reduce oxygen,

the body has to use more energy expensive type 2 muscle fibers. So now we're burning, right? You do three sets of 15 bicep curls, and they do three sets of 15 bicep curls with BFR, you are going to burn more energy with BFR applied versus not using BFR. And so I believe it or not, I've been at multiple conferences completely unprompted, right? Like I'm just hanging out there in between sessions. I've had physical therapists, athletic trainers, talk to be like BFR melt the belly fat. I'm going to tell you right now.

And that early on, I'd be like, really? Like one guy, I remember I was at a private practice symposium this year at the APT. and he's like, I use it specifically because it helps me stay lean. He's like, so I'm used to with all my patients. Oh, yeah. So BFR walking. You want to add more to your walk, improve your VO2 max, right? Improve your, I think, hamstring strength, which I think a lot of us laugh due to,

we spent a lot of time sitting, right? And then very quad-dominant. So because that BFR walking hits the hamstring, and then speaking to that ACL point, I think that hamstring and that weakness, or a lack of endurance, whatever you want to call it, I think that's a major issue with a lot of our athletes. Because you go into a lot of these weight rooms. So I sit on the Michigan Advisory Board for the NSCA,

and one of the, our big focus is over there. Where it was explained to me is get more in touch with the high schools, right? What are we doing in high schools? Are these guys certified? A couple of high schools I've been into where I've kind of like coached up, worked with these coaches. It's bench squat deadlift, right? Which is great.

but those hamstrings never get touched. And it's always add more weight to the bar. And that's where we've seen, and I've seen it locally. There's increases in soft, you know, how are you training? I talk to the kids and there's been an increase in soft tissue injuries. Non-contact ACL tear. So I'm starting to, you know, what's providing structure to that? The hamstring provides stability to that ACL.

So let's hit the hamstring more. BFR does that with simply a walk. And then you want to get real crazy. Add your BFR to your Nordics for the hamstrings. And now we're tapping into something. And we started doing those recently. And that is, so just put, we put the pumps on the side. It doesn't matter where they go.

And I got one of those Nordic benches, um, lifted up, right? Because I'm, no, no, I ain't parallel. No way. I got a little angle there. I'm like at a 20%, 20%, 15% we're going up and down. I mean, you feel it's different the way it engages those hamstring.

You just feel more connection to those muscles. though, you know, obviously I like that idea. Let me guess they're doing more trapbar deadlift and even conventional deadlift, really, to avoid trying to use their hips on them. Yeah, not surprised there. And then you can think about the glued meat, but I'm glad you brought up that endurance factor because you've got a lot of athletes that get strong, but that work capacity is not there. So hence why, you know, women's basketball, soccer, you see more ACL tears, second half of game, not first half of game, because when an athlete's under fatigue, that's when they compensate or they can't hit that brake pedal.

So, yeah, I just do for my own personal anecdote, what I do for my own conditioning hell is I put on the BFR cuffs on the arms and legs and then hop on an iodine and then do... Oh, yeah, yeah, no, trust me. I'm getting ready to grab my...