Occlusion - A Novel Application for Hypertrophy

A few weeks back we discussed the theory behind occlusion training. This is type of 'blood flow restriction' (BFR) which momentarily reduces blood from leaving the working muscle due to a band being tightly wrapped around the top of the muscle. The idea is that we can enjoy better a hypertrophy response with less weight being lifted. 

Let's jump into how we can take the theory of BFR and apply it in the gym. But before we do, if you haven’t read this previous blog on the topic, jump over HERE now and have a read.

First things first. What muscle groups can most effectively be targeted with occlusion and where you should place the cuff? 

MUSCLES SUITED TO BFR TRAINING

Biceps - Depending on the size of the cuff, the type of bicep exercise you are doing and your preference, the cuff for a bicep set can be placed either above the deltoid, running over the coracoid process and through the armpit or at the very top of the arm where the deltoid inserts into the humerus.

The coracoid location generally requires a slightly wider cuff, whereas the arm cuff tends to suit a thinner cuff.

Triceps - Same as the bicep

Deltoids - The cuff should run over the coracoid process and through the armpit

Forearms - Wrapped either immediately above or below the elbow joint.

Quadriceps - The cuff for a quad set should be wrapped at the very top of the quad, running between where the adductor meets your pubic symphysis and as high up the quad as possible, often running over where the glute inserts into your upper leg.

Hamstrings - Same as the quadriceps

Calves - Wrapped just below the knee joint. Wrapping above the knee joint is not advised.

HOW TO ORGANISE A BFR SET

All too often I see people using BFR as a means to elicit pain as opposed to understanding the principles and using it for benefit. Currently the research supports a couple of approaches, with one primary approach being recognised as the ‘gold standard’.

Stepping outside of this gold standard approach may or may not be beneficial, so instead, I suggest you stick with the guidelines of BFR and use it appropriately as opposed to using it in your own wacky way just to inflict more pain.

Remember… more pain does not equate to more growth!

There are two considerations for an occlusion set:

1. How tight do you wrap the cuff

2. How many reps and sets should you do and with what rest period

Cuff Tightness

As a general rule, using a scale of 1-10 for cuff tightness is the most common approach, however, with BFR training becoming increasingly popular, there are now cuffs with numbered scales on their bands or even better some use a pump system to control the pressure using a pressure gauge.

If your band does not have a numbered gauge or a pressure system attached, the most common approach is to aim for a 7 out of 10 tightness on all muscle groups, however, some can handle more than the others.

Upper limb - Aim for a 7-8

Lower limb - Aim for a 7-9

To gauge whether or not your cuff is suitably tight, not tight enough or too tight, you should be able to complete the below set, reps and timing parameters with approximately 20-30% of your proposed 1RM of the exercise you choose.

If you can do more, the cuff was too light and if you couldn’t make the last set rep target, it was far too tight.

Set Parameters

To clarify, the cuff you use during a BFR set should remain on the entire time and is not to be removed between sets.

My favourite approach is to use BFR for 5 sets, with the first set being a preparatory set and the ensuing 4 sets being the working sets. The approach is simple:

• Choose a weight that is 20-30% of your proposed 1RM

• Wrap the limb of choice with your cuff

• Complete 30 continuous reps with the chosen weight

  • Rest 30 seconds

• Complete 15 continuous reps with the same weight

  • Rest 30 seconds

• Complete 15 continuous reps with the same weight

  • Rest 30 seconds

• Complete 15 continuous reps with the same weight

  • Rest 30 seconds

• Complete as many continuous reps with the same weight as you can

  • With the goal being 10-20 reps

• Remove the cuff and note final set achievements

In short, it is 5 total sets with the first set being 30 reps and the next 4 sets being 15 reps.

If you have chosen an appropriate weight, the final set should reach mechanical failure (no forced reps) in a rep range of 10-20 reps.

Note - A BFR set is not a style of training that you need or should be focusing on progressing with weight like a traditional progressive set with additional mechanical tension, but rather, appears to work on more of a metabolic concept.

Provided you are failing within the range of 10-20 in the final set, the working weight is adequate enough to achieve the desired effect.

EXERCISE CHOICE CONSIDERATIONS

There are 2 primary considerations you should think about when choosing what exercise to complete a BFR set on:

1. Safety

2. Strength curve/tension relationship

Safety

This is a relatively simple consideration, so I will keep it short.

BFR is a highly fatiguing training modality and can often leave you failing a repetition with little warning. Because of its metabolic component also, you should be taking your final set to repetition failure, and thus, taking into consideration whether or not failing in an exercise is even an option without a spotter, should be thought about prior.

Using BFR on a free weight back squat or bench press for example would not be advised.

Choose exercises you can fail on safely (machines, cables or dumbells)

Strength Curve/Tension Relationship

BFR tends to combine well with exercises that support a positive strength curve and those that control the tension throughout the full range of motion.

I find that using machines with CAM shafts or cables tend to yield the best results as the strength curve is controlled in a manner to minimise the impact of weak points throughout the range of motion (ROM) and also to control the amount of tension throughout the ROM as well.

There are some dumbbell exercises that are still effective, however, machines or cables are often your best choice.

WHEN IS BFR MOST EFFECTIVE?

What about when?

When can you use BFR within a training block to achieve the best results?

I like to use BFR in 3 phases, with the top 2 being my preference and the 3rd simply being an additional option should you choose to use it.

1. During injury

   1. This is more about muscle maintenance than hypertrophy

2. As a means to accumulate more hypertrophy with low risk

   1. Smaller muscle groups in big compound volume blocks

3. During a deload

   1. When an intensity regression is the focus.

BFR is a great tool to use in times of injury, and if you have read the theory article previously (you should have), you will know this is actually where the concept was founded as well (post ACL surgery).

So there is no denying its efficacy there.

The other time I like to use BFR is to overload a smaller muscle group like the delts, biceps or triceps in a weeks training program whereby I do not want to be forcing a bunch of tonnage or heavy intensity sets on those muscle groups as this (in my experience) often leads to impaired performance in the bigger compound stuff long term.

And we want those exercises (squat, bench, dead, leg press, shoulder press etc) to be as effective as possible, not limited by small muscle fatigue.

It’s also a great way to tack on some additional, yet highly effective, isolated volume with a metabolic component to it at the end of a session for a smaller a muscle group as well, without having to load in a bunch of junk sets.

FINAL THOUGHTS

BFR is simply one tool of many that you can use to enhance the opportunity for optimal muscle hypertrophy.

What BFR isn't, is a replacement for the bread and butter of muscle growth, which is the progressive overload of mechanical tension over time.

BFR should never replace your standardised hypertrophy and strength training but it can absolutely be used as a complimentary exercise modality when implemented appropriately.

As my good friend and very smart man, Broderick ‘The Evil Genius’ Chavez always says…

“Right tool for the right job”

Choose your tool appropriately!

PS. BFR is VERY uncomfortable, so be prepared for a muscle burn that you have never experienced before.

Diet Smart. Not Hard.

Team Flex Success