Blood Flow Restriction and Faster Recovery
Recently a patient who ruptured their Achilles tendon while playing racquetball was referred to Superior PT by their surgeon. The patient explained to their physician that “I don’t want to have the muscles in my leg to atrophy while my repaired tendon is healing in the boot.” The physician asked what we could do to more aggressively strengthen the leg at a time where loading the Achilles would ruin the surgery. Our answer is Blood Flow Restriction.
Presentation: The patient presented in our office for his first visit walking with crutches and a boot with limited motion, swelling, healing surgical incisions, and weakness. He was having pain at night, 6/10 throbbing pain during the day, and exhibited pain with limited ankle motion. While his pain was his number one struggle on day one, his biggest concern was avoiding atrophy that would slow his ability to get back to racquetball.
Treatment: PT started with a clinical examination of his foot and ankle. The exam identified the main problems and gave us the prioritized list for his care. From there, treatment is focused on reducing the pain and inflammation, gradually restore full pain free motion and strengthen the ankle musculature and retraining responses for balance and stability. Additionally, one of our main tools for strengthening is Blood Flow Restriction (BFR).
Blood Flow Restriction (BFR) therapy has emerged as a valuable tool in physical rehabilitation, particularly after Achilles tendon rupture and reconstruction. By applying controlled pressure to restrict blood flow, BFR allows patients to perform low-intensity exercises that elicit similar muscle growth and strength adaptations as high-intensity exercises, while minimizing stress on the healing tendon. This is especially helpful after surgery when weight bearing or loading restrictions are in place in order to protect the surgical graft or sutures. This approach significantly reduces muscle atrophy, a common issue following prolonged immobilization, and accelerates recovery. Studies have shown that BFR can preserve muscle mass and strength in the lower extremities, helping athletes return to sport more quickly post-surgery (Hughes et al., 2017; Patterson et al., 2019).
Bibliography:Hughes, L., Paton, B., Rosenblatt, B., Gissane, C., & Patterson, S. D. (2017). Blood Flow Restriction Training in Clinical Musculoskeletal Rehabilitation: A Systematic Review and Meta-Analysis. British Journal of Sports Medicine, 51(13), 1003-1011.
Patterson, S. D., Hughes, L., Warmington, S., Burr, J., Scott, B. R., Owens, J., & … Clark, B. C. (2019). Blood Flow Restriction Exercise Position Stand: Considerations of Methodology, Application, and Safety. Frontiers in Physiology, 10, 533.
Return to Sport Testing…Are you ready? It doesn’t do much good to spend weeks of hard work in rehabilitation for Achilles recontruction, just to return to sport and reinjure. At Superior Physical Therapy, rehabilitation is a process of protection of tissues and simultaneous restoration of function. With the assistance of BFR, muscle function can more easily be maintained while protecting the healing tissues. Then, at the appropriate healing times, progression to more aggressive strengthening, and then ballistic movements (running, cutting and jumping) can be safely introduced. Our anti-gravity treadmills and pool therapy are a fantastic way to bridge the gap in the middle phase of graft protection while pushing higher level function.
Proactive Action: No matter what surgical situation you find yourself in, there is a better way to get back to life without risking further injury. Click and make an appointment or call 208-233-2248 to get in with a Board-Certified Doctor of Physical Therapy and get better faster in Pocatello, American Falls, Fort Hall, Idaho Falls and Rexburg. Our rehab specialists are ready to get you back in the game!
Sincerely,
Bart McDonald, MPT, ECS, FMSK
President of Superior Physical Therapy
