This episode examines how low-load Blood Flow Restriction (BFR) training can enhance outcomes during Phase 2 of ACL reconstruction rehabilitation. Building on Part 1—which covered pre-operative and acute post-operative strategies—this instalment focuses on integrating BFR into early strengthening when high mechanical loads are still contraindicated.
Key findings from several clinical trials demonstrate that BFR can:
• Improve early quadriceps strength recovery compared with traditional low-load rehabilitation.
• Produce hypertrophy comparable to heavy-load training but with much lower joint stress.
• Reduce pain, swelling, and functional deficits during the early post-operative period.
• Assist with restoring long-term limb symmetry, even months after surgery, through modalities such as BFR walking.
Together, these studies highlight BFR as a valuable adjunct in ACL rehabilitation, particularly when protecting the graft and surrounding joint structures while still driving meaningful physiological adaptation.
📚 References
Hughes, T., Paton, B., Rosenblatt, B., Gissane, C., Patterson, S. D., & Contreras, B. (2019). Comparing the effectiveness of blood flow restriction and traditional heavy load resistance training in the post-surgery rehabilitation of anterior cruciate ligament reconstruction patients: A UK National Health Service randomised controlled trial*. Sports Medicine, 49, 1787–1805.
Ohta, H., Kurosawa, H., Ikeda, H., Iwase, Y., Satou, K., & Nakamura, S. (2003). Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction. Acta Orthopaedica Scandinavica, 74(1), 62–68.
Lu, Y., Mallow, M., Li, J., & Goh, E. L. (2020). Perioperative blood flow restriction rehabilitation in patients undergoing ACL reconstruction: A systematic review. Orthopaedic Journal of Sports Medicine, 8(3), 1–11.
Cutisque, L. P., Buckley, J. G., & Rodacki, A. L. F. (2025). Walking with blood flow restriction on lower limb muscles post-ACL reconstruction: A within-subject trial. PLOS ONE, 20(10), e0333200.
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Thanks for listening and remember to keep the pump.
Chris
