How Blood Flow Restriction Training Can Speed Up Your Gains w/ Chris Gaviglio (SSOF Ep 80)

Chris Gaviglio0:40

Probably in hindsight, my main craft is strength and conditioning, so I ran this on the side and probably should have went a little harder with it. But my passion is performance training, and consequently my use of BFR over the years has evolved from just that rehab sense to actual, "How can we use it in that performance setting?" Which I think, in terms of potentially what you're trying to get out of this podcast, is that there's multiple uses for BFR, not just for when you are injured.

James de Lacey3:34

Yeah, for sure. We'll dive down those roads. I actually didn't realize you were a rugby guy too. I've had probably over half the podcast have been rugby people. My background's rugby. I was with Romania rugby as my most recent gig and various things there. I'm watching the World Cup intensely, so it's nice to have more rugby people on the pod.

But let's dive into some of the practical sides of Blood Flow Restriction, because man, there's so many different ways to use it, the ways people are using it. And as you mentioned, if you're injured, not injured, you have active, passive, there's all sorts going on. Just dive into maybe a general overview of the different modalities you can do, and then we can maybe go into some specifics.

Chris Gaviglio4:32

Yeah, definitely. When you look at BFR, I think most people think of BFR as that at 20 to 40% of your one rep max, you can get increases in muscle size and strength equivalent to that of high-load lifting. That's pretty amazing when you start to do the maths in your head. So if you have a 200-kilo squat, if you had a big squat, that's 40 kilos.

What it does is, because you're partially restricting blood flow—we're not totally occluding, and that's a real distinction that we need to make—is that we don't want to be achieving total occlusion but partial restriction, because we want to have a little bit of that blood return.

What we do is, I kind of liken this as, well, one way to explain this is it's all about total stress on the system. So traditionally when we go to the gym, we put lots of load on the bar and that's mechanical stress. Traditionally, when we think, "Well, the only way to get strong and to build muscle is to go 70% of one rep max or just lift heavy," but what this does is, because we're partially restricting blood flow, we have this accumulation of metabolites, and it's called metabolic stress.

So if we had a cup, for example—we got a cup here—normally in lifting we'd have to fill it to 70% full of metabolic stress to get that stimulus for the system, for all the mechanisms and for all the pathways to switch on and go, "Right, it's time to increase protein synthesis, get all those anabolic hormones firing." But if you lower the load to 20 to 30%, well, you've got to fill that cup somehow, and that's where the BFR comes in. It comes in, creates this metabolic stress, so the total stress on the system is enough to stimulate those same pathways.

So I guess that's the basis of it. But as you would realize, you need lots of repetitions. Traditionally, people talk about the 75-rep protocol, where your first set is 30 reps followed by three sets of 15.

In my years of doing this, there's another BFR—I guess it originated from Kaatsu, which originated out of Japan, and they are the OG, so I think we need to sometimes go back and read what that was all about before—because whereas BFR is more, in my mind, research-based, and the first set is key when you're using low loads. So you need lots and lots of repetition, lots of metabolic stress. You have lactate increase because you get that burning feeling, and that lactate is that signaling molecule which goes, "Okay, time for all these pathways to switch on." And that's the key.

Do we need 30 reps? And I've advocated in a lot of my own posts and podcasts is that I actually don't think we do. If you'd never used BFR before and you say, "Right, we're going to add this new stress called BFR," which can be quite daunting the first time, have you used it before?

James de Lacey7:43

Yeah, I have, but not with an actual cuff. I just used some voodoo floss bands. I did it around my arms. I did some arm training, like, I'm just going to go hard and do some arm training with this. And I did one set and I had to take it off because I couldn't handle how much it—

Chris Gaviglio8:18

Yeah. And then all of a sudden you say 30 reps. Now, if you—I love my low reps, I love heavy load. I hate 30 reps. I'll be just saying, "You're kidding."

However, a more natural way of saying it is, what we want to do is we want to do lots of repetition, get that feeling of fullness in the body, about one to two reps shy of technical failure, because we want to make sure there's really good form. Short rest, go again, 30 to 60 seconds. And then in the 75-rep protocol, we talk about 75 reps, four sets.

Two to three sets and you're done. And in the, I guess, real world where we're doing multiple exercises, we might be doing a bilateral squat, then a walking lunge or sled push or something like that. There's multiple sets and multiple opportunities to create this wonderful metabolic stress. Therefore, I truly don't think you need—you have to be going, "I need to do four sets," because if you're doing 75 reps, it's a brutal session. It can be just as effective doing high reps, three sets of 15, but ensuring you get that feeling of fullness.

So that's, I guess, where everyone sees BFR sits: you put them on, you do your leg extensions, you do your bicep curls, and you feel really good. But, as I alluded to, and as you wanted me to go into detail, there are a lot of other uses for it. And where do I start on this one?

James de Lacey9:36

I guess maybe let's start around injury, and then we—

Chris Gaviglio10:07

I guess maybe let's start around injury and then we can work towards maybe performance. I mean you've already touched on muscle size anyway, but we can go into performance and some other things around there too after the injury side.

Definitely, some really cool high load stuff which I think yourself and the listeners will be pretty interested in. So if we talk about when we're injured, first thing is pain. It's really great for decreasing pain in joint and tendons and some of the markers associated with that. There's an endocannabinoid marker which, as we know, cannabinoids can actually help with pain relief anyway, releases these markers of pain relief. So it's really great, for example, if you have an arthritic knee, a sore knee, tendonitis is really good, and you could use that as a general movement prep before your session.

I used to do that when I was doing a lot of or competing Olympic weightlifting. If you had bad knees you do—I think obviously Kelly Starrett old stuff where you're literally Voodoo floss band above or below the knee or over the knee and do a bunch of squats but with it really, really tight. And then taking it off and your knees would feel like brand new going into the session.

James de Lacey11:10

Yeah, definitely. And this is just another methodology.

Chris Gaviglio11:10

So, for example, I had someone had a—you picked a tendon and it doesn't really matter. And I think this is the cool thing about it, and in that I'll say this before we go back in the tendonitis is that exercise selection is key.

If you have—so where the placement is, if we're doing upper body, we put them on the upper part of our arms. If we're doing our lower body, we put them on our thighs because there's lots of meat around there. We don't want to be putting them on our calves because there are superficial nerves and blood vessels as well. So we just want to protect them.

And so if you're having issues with your Achilles or your calf, you need to be doing some kind of movement that activates those muscles, moves through those range of movements, through those joints. If you want to be working on your hamstrings, you just need to incorporate hamstring work, glutes, same forth, so you kind of get the idea.

Even on in the upper body—so well, how can I improve my chest, I can't put a cuff around my chest—and there actually some really great studies on you put them on the arms, they actually had increase thickness in the pec as well as increase in strength as well. So movement is key, and I think that's probably you don't need to be changing too much in terms of how you would prescribe as a strength coach.

So, well, in a normal rehab for an Achilles, you'd be doing some form of isometric holding or eccentric. But what you would do is you'd use general movement to actually decrease the pain. So if we use the Achilles, for example, put them on in the morning and then you just do some real gentle small range of movement. And that's another cool thing: you don't need massive ranges of movement, you need lots of repetitions to get that feeling of fullness to activate those pathways, to decrease the pain.

Do some calf raises, walk in, walk out, hold isometrically, two sets. I've seen so many people just walk away and go, 'Pain's totally gone, totally knocked out.' So, parasol, you have pain in the tendons or the joints, sore knees, just sit on the edge of a table, just some simple leg extensions, bodyweight, just nice and slow, lots of repetition, feeling full and some small squats, just get movement through the knee. So we decrease the pain, which I think is really important because then also there's an increase in muscle activation. So we're hitting two birds, one stone.

And if the stimulus is high enough, there's a lot of great anabolic hormones—natural, of course—testosterone, growth hormone, IGF-1, which all relate to increases in improvements in muscle size and strength. But also help that repair process. And when we talk about injuries, we want to promote this—I guess how the muscle can get those mechanisms. And so cell recruitment is really important in that. And there's a really good paper that just talks about the pathways which are associated with, you know, coming in, removing the damaged or dead muscle, coming out, and help laying down new layers of muscle, activates those pathways.

So consequently I've had people who have had torn calves back in a week. I have an athlete that I coach who, grade two hamstring, went to the Olympics—and well, he was going to the Olympics three weeks out, tore his hamstring, grade two, little bit of tendon within. So he said—well, the staff said—within 12 days you need to run at 95% of your maximum speed. So this guy is like a 10.65 runner, he's not like an 11.2, 11.3, he's a quick guy.

And within 12 days, 95%, no problems. Had to do his long jump run-ups, his high jump curve, so really quite dynamic. Within three weeks completed 10 events over two days, full decathlon, no problems in the hamstring at all. So, and I've got multiple stories on accelerated recovery from muscular injuries which would normally take up to four to six weeks is taking one to two weeks.

James de Lacey15:17

Wow. Would you ever go into detail of what that training looked like, bringing the hamstring injury back to competition?

Chris Gaviglio15:56

Yeah, definitely. So it's all about how often can we activate these pathways, and I'm just thinking about this: if the hamstring is injured and we can't train it, we've got three other limbs that we can train. So on, the cuffs on the upper body and we're doing upper body circuits in the hotel room because he can't walk around. On the other leg, we've got the leg on and he's doing single leg squats in the hotel room because we're in a hotel, we're in a camp situation at this time.

And there's this thing called a contralateral strength training effect, which means that you can train one side and you have small effects going to the other side, which is pretty amazing. You don't get—there's not that kind of 100% magic, but it's better than doing nothing.

And then on the injured side it's just passive. He's just sitting there and he's just inflating, deflating, and that's actually a really nice recovery tool. Some may call it ischemic preconditioning, so ischemic is low oxygen, preconditioning, you're preconditioning the area or the muscle, and they say there's like a protective mechanism around that area from doing that. There's actually some really cool recovery and performance benefits, and I'll talk about that briefly then go back to the hamstring.

So, for example, if you had repeat bouts within a day or on multiple days, there's lots of evidence about you would do passively because we don't want to be expending too much energy before we go and compete. So you would sit there on your main muscle group, so you'd be your legs, you'd be inflating and you'd sit there for three minutes, deflate for a minute, four cycles, and then you'd go and warm up—take them off, go and compete. And then if you had another bout or another competition in the afternoon, you would do it before the warm-ups and then you would do it after.

And those people who do this passive BFR performed better than the athletes who didn't perform it. Now, this is in repeat sprints, kayak and rowing, but it's high energy, high lactate, and I think about fighting as well. It's repeat effort, it's continuous, it's intense. How do you help recovery between bouts? So whether it's, you know, obviously wouldn't be day after day, but in some scenarios in some sports you may have to at a younger age group be able to back up.

So each day I'm probably getting about four different stimuluses or stimuli of this BFR, thinking it's all about these mechanisms. And then it's well, if—because we can't maintain his cardiovascular system through any kind of intensity because we have to drop the intensity out—we have to somehow maintain a level of fitness. Put the cuffs on, on the bike, steady state. So every other day he's on the bike, 20 minutes, just turning the legs over. That's been shown to increase VO2 max and actually strength and size as well.

Now, in athletes—most of this is not done in elite athletes, so it's done within recreational athletes or just people who don't do much exercise. So I genuinely think that if you're listening to this going, 'Oh, Chris said 20%, I have to put 40 kilos on the bar,' you have to do a bit more. I think it's more around 40 to 50%, that's just my gut feel. And so you need a little bit more intensity with athletes or with well-trained people.

So I'm thinking about how do I maintain his level of fitness so he can sustain and keep improving strength or getting that strength back. And then every day he would wake up, and then how do we test the difference of where his hamstrings at? Now we didn't have access to a force plate, on a step we got a set of bathroom scales, and he'd lay down. He'd push on his good leg, 'Okay, you could push 37 kilos.' On the injured side, 'How much can you push?' '12.' 'Okay, we're not quite there yet.' Let's do a drag test and where's it at.

And every day he's out there, and it's 'What can we do? So can you jog?' So the first day he would literally just walk, it's all he could do. And then interesting to see him—

Progress it. And then from a skill point of view, it's, well, how do we maintain his skill? So a lot of visualization. He couldn't hurdle because he couldn't get his leg out because it was still repairing. So I'd make, to his frustration, I'd make him getting the block start and then visualize the gun, visualize him going over the hurdles. And we'd go around to all the events and do that. And I said, look, I know you don't like doing it, but we need to touch on the events somehow. And that connection between mind and body, as I'm sure you'd be aware of, is very important.

So it's every day, how can I continually stimulate his system to create growth and repair? And it was remarkable how quickly we got our strength back. A lot of it was confidence as well. But probably about four times a day we'd be putting the cuffs on. He'd be training, he'd be working.

James de Lacey21:18

So even with that walking and everything, that's all with the cuffs on?

Chris Gaviglio21:18

Yeah. So before his running sessions, we'd put the cuffs on and he would walk with them on, do some whatever squats he could do, like some body weight squats within whatever range, pain—everything's pain-free, of course. And do a little movement routine: some squats, some calf raises. If you're into your glute bands, you can do some mini band walks. And he'd just get everything feeling good, decreasing if there's any pain or any creakiness and anything, decreasing as much pain as we can, activating as much musculature around that area as possible.

Because when we're injured, we have a lot of inhibition. So how can we ensure that as much as we can is activated, so everything's switched on, everything's working for him?

Take the cuffs off and jog. How much can we get through? And then systematically measuring everything. Okay, and I'd be timing every single rep. How does that feel? Okay, but the stimulus was too low to get any kind of benefit. It's more about just running because he has to run.

Then we'd hop on the bike. We'd finish that, we'd go into the gym, put the cuffs on his legs and push out 20 to 30 minutes continuous, steady state on the bike, because we couldn't put any intensity in the cycling. And within a week, remarkable change. Within 12 days, it was time to do the test.

We'd even be breaking the skill down into—so for him it's a block start. So he'd go up into the block start and push, and say, well, how does that feel? Into isometric. And isometrics is really cool when you're injured, because you get in that joint specific. So whichever sport you're in, you start thinking about your sport. You go, well, I'm injured, but I can kind of do this movement. And I can do an isometric push. And there's a strength benefit as well. It's helping that neural pathway from the brain to the musculature, say, got to activate, got to activate. And just keep building, keep pushing.

So traditionally when we're going to Olympics or any major competition or fight, you start to take, we're starting to freshen up and feel good. And he's looking at me going, I'm doing all this work, but the intensity is low. And there's the recovery component, because at nighttime he's doing passive BFR as well. And he's look, he's got good physio, good nutrition.

We're using the Game Ready, and there's the foam rolling, massage, we got everything there. But something that would take six weeks, we took 12 days. And within three weeks, he competed with no problems. I think is a testament that there's something pretty amazing going on.

James de Lacey24:15

I hope you're enjoying the chat so far. Before we get back to that, I just want to let you know that Sweet Science of Fighting is more than just a podcast. We have a full training app with strength conditioning programs for strikers, grapplers, and MMA athletes, so you don't have to think about what you're doing. And you're getting access to the latest scientific methods to improve combat sports performance.

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So what are you waiting for? Jump down the description. You can check out the Sweet Science of Fighting Underground. Otherwise, enjoy the podcast.

Yeah, that's awesome. And I want to touch a little bit on, try and bring a little practical as well for the listeners around the passive BFR scheme, preconditioning, obviously what you mentioned: 3 minutes on inflated and then 1 minute deflated. So I'm assuming that's with certain BFR cuffs that inflate to bring the pressure and then down, versus a lot of people don't have cuffs and they kind of use whatever they have—knee wraps and things like that. Is that something—is there a way to be able to gauge the pressure if you don't, if you're not using air-pressured cuffs versus maybe using just a band?

Chris Gaviglio26:05

Yeah, it's a tough one. Look, there's a load of research on what we call practical BFR, which has been put out there. And it's been shown to be just as, or similar, to be effective. Seven out of 10 is typically, how tight do you want the wraps? It's not scientific, but if there's people out there going, hey look, this is all I've got, this is all I can afford, the best ones are your knee elastic wraps, as opposed to the ones which you like a tourniquet and you pull tight.

Now the reason why—and we'll go a little bit briefly into some safety things—is that the advantage of a pneumatic cuff, or let's just say you can only afford an elastic knee wrap, is that you want as much complete or the same kind of compression around the limb as possible. So the ones where you pull really tight—apologies if someone's listening, that's what they use—but you have that little pinch point where there's added pressure or a little bit more pressure, so it's not even.

So we need to look after the vasculature, we need to look after our limbs. So it's important to keep it as even as possible. And that's where those elastic wraps can be quite good.

Seven out of 10 it is. So one being pretty much nothing, and 10 being the most intense thing that you've ever experienced. I'm sure, being a fighter, there's certainly been some 10 out of 10s. And some real practical things to say, well, is my pressure correct or is it too tight?

The first one is the color of the limb. If it's blue or it's purple, it's too tight. It should be a nice dark reddish color. That's probably your key. And depends on what color of your skin. So I've trained some athletes who are very fair-skin, so you'll see that tinge of a little bit of blue, especially in colder weather.

So temperatures can make a big difference as well. If you're in cold temps, or we're in Australia, it's warm most of the time, so we don't need to go to those high temps, high pressures. So it changes the perception. Dark reddish. If it doesn't change any color, it's probably not tight enough.

The other one is called capillary refill type. Don't need to worry about what it's called, CRT. But it's important to know how we can test it, and it's really simple. Now, if our limbs turn this dark reddish color, all those capillaries which are on the superficial to our skin, dark reddish. So if we're doing upper body work, it's the meat of our palm under our big thumb. And we just push it in, and we should be pushing all the blood out of the capillaries. Hold it for a few seconds, let it go, and then that color should return, that dark reddish color, in about 3 seconds.

If it's 6 seconds or longer, it's too tight. So if it's too tight, the blood can't get back through again. So that's a—and our lower body is our VMO, that teardrop in our quad. Push that in, make it turn white, turn it off, count around 3 seconds. Don't stress out if it's 4 or 4.5, but if it's taking 6, 7, 8, go, oh, and you're going, how does that feel? And go, oh, I feel like my limb's about to drop off. Maybe it's a bit too tight. You need to just loosen it off.

And we try and keep it continuous. For the upper body, 15 minutes in one continuous bout, and in the lower body, 20 minutes for one continuous bout. If you are doing a session and it's 25 minutes, don't stress out. If you're doing a lower, a gym session and you, let's just say you do a squat and then a lunge, for example, inflate it, do it for your squat set, deflate it in between so that you're probably, might be, sitting around 15, 18 minutes. Just deflate it, pack all your equipment, reset your next exercise up, re-inflate or rewrap the limb because you're about—

To do another big bout of exercise with the cuffs on. And I don't think that that gap in between is going to make any difference. And look, if it's too much, just lower it down because the guides say 50 to 80% of what would be the pressure that would occlude our limb. So it's a guide and we need to be really practical and pragmatic with this. If it's too much, let it off in between.

Continuous—intermittent is when we inflate, deflate, inflate, deflate. That's been shown to be really effective. And if the athlete you're training, or if you're training out there, you're going, "Chris, I can only hold it for two sets," yeah, cool, release it in between. But you know, do you have that fatigue, those drop in sets? Yes. Do you have decrease in joint pain? Yes. Do you feel like you're working hard? Yeah, you're ticking all those boxes.

And it's all about that longitudinal approach to this training. It's not about, we're going to be getting massive guns within two weeks. You probably notice a difference, but it's that long-term approach to this type of training which I think we need to all employ.

James de Lacey31:35

Perfect. Let's dive into some of the performance aspects, and maybe we can touch on a little bit of the, I guess, building muscle side at some point, maybe near the end. But maybe just in terms of sports performance, how do you see Blood Flow Restriction Training in that situation?

Chris Gaviglio32:01

Yeah, the two ways: one, in your warm-up, how to prepare the body in a time-efficient and effective manner using the cuffs is a great way to warm up. And warm-ups—I love my warm-up, but at the same time, there are there are days where it's I just need to get into my session. I mean, the tide, it's been a long day. I just want to get in, I want to get out.

So if I'm doing—if I'm starting with squats—sometimes I'll put the cuffs on, I'll walk around with them on. I've just got the bar, I'm just doing 20 kilos, I'm repping out, feeling good. Then it might be 30 or 40 kilos, taking my time in the first few sets. And then within about three or four sets, warm-up sets at really low loads, I'm sweating, everything's active, everything's ready to go. Then I get in my main session, as opposed to hopping on a bike, riding, rolling out, doing my little exercises.

Because everything's getting active, do I need to be doing my mini bands and my glute bridges and whatever? Probably not, because everything's on fire at this stage. And then also you think about from a hormonal aspect, how do we know that our testosterone is up and about? Very hard to say. But if you think about this, we all think about this as a really good aggression hormone. It's a really good behavior hormone as well.

So if our testosterone levels went up, that actually has been shown to behaviors like aggression, as we all know, determination. And also in strength training, they've actually done these studies where people with high levels of testosterone concentration actually put more weight on the bar. They train more. So we put more weight on the bar, we train more, we have more stress on the system, we adapt better long-term. So it's a win-win.

I always think if I'm feeling good and I'm just, the beats are good, I'm in a really good mood, I think something good's happening there. And lo and behold, the session goes on. Does it really matter if your testosterone concentration is up or not? No, but I'm having a good session.

The other one is moving into that high-load BFR work. Now, there's not a lot of studies on that, but there is actually a body of evidence around this. And then I'll talk a little bit about my own stuff that I've personally done, because everything that you read, I go out and I do, so then I can talk about it from a personal aspect.

And the big one is that, traditionally, they all say it's got to be low load, 20 to 40% 1 RM. But there's tons of evidence around 70, 80, 90% of one RM. So the stress—the metabolic stress—is really high. Now, the thing with this is, we go back to my cup analogy: if the stress is really high, we only need a little bit of metabolic stress, only a touch, because there's enough stress on the system.

And when we look at the studies that have been done out there, and I'll talk about my work in a bit, is that when you look at barbell velocity, putting the cuffs on and lifting and monitoring the barbell velocity is greater with the cuffs on than with them off. So then we start to think about velocity-based training. When we look at those kinds of studies longitudinally, if we do put a six training study—six weeks of training together—those people who have higher velocities in their major lifts tend to have greater testing results at the end of that block.

I've done that myself. There's tons of camera systems on your phone that you can put up there, and I've definitely found that I was faster on using the cuffs on. And they seem to think that it's a mechanical advantage from the material of the cuff, which is kind of interesting. So the cuff is giving some kind of energy to the system. Therefore, I would use it as a warm-up. I'm warmed up, I put it on, and I'm benching, squatting, and I've got the velocity going.

And then I've done an eight-week training block, and all my metrics have gone up when I retest, whether it's squat vertical jump, high pull velocity, bench press, bench press 1 RM, submax velocities. So then all of a sudden it's money for jam.

And in some people who—so I've got a bit of a dodgy right knee, so I can't load maximally with a squat. That kind of loading, my body doesn't like. So then we start to think, for any kind of fighter out there, or any athlete out there, you might say, "I've got that one knee, or I've got that issue with my lower back, but you can tolerate 70 to 80% one RM."

Because in athletes, load is still key, and I think that's really important. By saying this, I don't want you to then say, "Well, Chris said I only have to lift 20% on one RM but do high reps." As an athlete, you do—I really do think you still need to be hitting that 70% plus. But if you do have that chronic shoulder or elbow or whatever joint or tendon it is, you can just drop 5 kilos, put the cuffs on, have intent in your lift, have a bit of feedback. And you'll find that you won't lose anything in terms of performance.

And I think that sometimes, as a strength and conditioning coach, it's letting go of your 1 RM. Well, actually, lifting at high loads—my 1 RM in the bench definitely went back up again. But it's at the end of the day, it's about how we perform. So I'm not as sore because I'm not trying to grind out a really heavy weight. So a little bit less loading, a little bit less tension through those all those attachment sites.

There's a recovery aspect with the BFR. Am I getting a bit of that? I don't really know. But I definitely do know that I haven't got that—when you do a really hard session and you're just sore the next day. I just don't get that.

And then you start thinking about, well, when you're traveling, if you've got to go away either on holidays, you're going away for a tournament, and how do you maintain some level of strength when you're going to a subpar gym? Well, there might be a bar and a little bit of weight. And I've done some work with isometrics and low load and BFR. There's lots of evidence around just pushing against that immovable object, and my submax stuff went up. My 1 RM disappeared because you're not lifting 1 RM stuff, but all my submax velocities went through the roof.

And again, the next day I'm ready to rumble. So if you think about if you're fighting, for example, or you're doing lots of training, you can do a really good quality session, still have a reasonable loading on the bar, get that effect that you're looking for in your strength training, but then not have that as a detriment to your real training. Because at the end of the day, when you're out there on the mat, they don't say, "Oh, what'd you bench press?" It's, well, how can you apply that strength on the mat, I think, is really important.

James de Lacey39:22

Awesome. The people listening to us are probably, "Okay, I want to play with Blood Flow Restriction Training and start implementing into their own routine." How would you recommend someone go about cycling this? Is that something you can use as part of every session you do? For example, someone's doing two, three times a week—let's just say a full-body strength training program for grappling, MMA, whatever. Is blood flow something you would do in every session, for example, in the warm-up or as part of the accessories? As some you cycle in the main lifts, maybe six to eight weeks and take it out? How do you...

Chris Gaviglio40:11

Well, I'm addicted, so every day, any opportunity. I guess I look at things about how can we max every single session that we do. There are sometimes where the cuffs don't have a need. There's actually, why don't you actually get more specific and put them on when you grapple? That sounds brutal, but think of it from a specific strength perspective and an energy system perspective.

High levels of lactate—you're getting in there and grappling, and your forearms and your fingers. How do you—it's all good and well, as I said, to have these really nice numbers in the gym, but where the rubber meets the road is—I'm sure you've got those fighters that just, they talk about the farm strength. They're okay in the gym, but man, they grip, they get in there, and they're like, "Whoa." The best way to train it is to train the action.

If you're a boxer, put them on the arm and that's specific strength training. And that's where we get the true transfer of performance.

James de Lacey41:18

That's awesome. So for the people looking to get into it, use them for your sport or use them in the gym whenever you feel they can be useful for you—warmups, accessories, sometimes with the main lifts.

But for people who maybe aren't competitive fighters or athletes and maybe they just train to look good, build as much muscle as possible, but also kind of use their fight training as cardio, quote-unquote—would you recommend using Blood Flow Restriction Training over regular hypertrophy training? So basically just adding cuffs to your normal hypertrophy program, that would yield better results that you could just run indefinitely?

Chris Gaviglio41:46

Yeah, I would. I can get in and out in two sets what would take you three sets. You want to be muscled, especially if—unless you're going for a bodybuilding comp—but every time you go in and do a repetition or set or an exercise, how do you maximize the stress in the system so that everything is active?

And then traditionally it's either a lot of load and a lot of repetitions, or a little bit less load and lots and lots of repetitions and lots of sets because we need lots of stress. You still need to do the same things with the cuffs, but if we are not a professional athlete but we're a little bit time-poor, you can actually just do two sets. And what's wrong with that?

So your finisher—so back to your question, which I didn't really answer, and I apologize. But so I put it on when I warm up, when I main lift, and I'll actually swap my upper and lower set, and then I'll have my finisher at the end.

So for me, as I'm now an aging ex-athlete, ex-thrower—I think about the only thing that my joints at the moment, which are on my shoulders, so I can bench press, but all my ancillary work, I need to make sure my back's good, my triceps for my pushing is really good. And so I can then say, well, I need to do a tricep, a back workout, and I do something that flows.

But I've got a family to quickly finish up my session and go to, or I've got my next job to go to, so I need to be in and out. So in that case, because I'm not peaking for a competition, it's like, well, I'm going to pick two or three exercises, I'm going to max out next exercise, max out, so that those giant sets—or I have my Friday finisher where I'm just going and I need it to flow, I need to be quick, and I'm just looking around at something and I can just get it done.

And then, so it might be—well, if you don't like using it on your—let's just say you say, "I want to squat raw"—use it as your warmup set and then take them off and then squat with them. If you're fighting and you wake up in the morning, you're like, "Oh, I'm just a bit sore today," put them on and just do general movement.

So I'm doing what we call circles—wrists, elbows, shoulders, shrugs—and then just moving through, no weight, and then two sets through. And then all of a sudden, it just takes that creak and groan out. And then take it off and then do your normal warmup and you're grappling or whatever your session is.

But it just makes that creak and groan out. And we have got a day job. So I'm a lecturer now, so I'm sitting down creating content or lecturing all day, so I'm not up on my feet coaching as much. So I need to make sure I'm thoroughly warmed up, because otherwise, because I'm sitting down more and driving a little further, if I'm not warmed up properly, I'm going to injure myself.

As we age, I'm getting a little older, so we want to look after our bodies, and warmups are key. And you spoke about voodoo flossing, so it might be, well, hey, voodoo flossing I find's really good on my knee. Cool, don't throw that one out. But what you might do is you might then put them on your thighs and do a little squat routine, some lunges, and get some slowly get into the movement so when your first movement on the floor, on the mat, just feels a little bit better.

James de Lacey45:40

Hey guys, it's me again. I just want to let you know that I also have Sweet Science of Fighting rash guards and shorts, so you can represent Sweet Science of Fighting on the mats and within competition. We have the classic, just like the shirt I'm wearing, rash guard—Sweet Science of Fighting on the front, and we have the logos on the sleeves and Exmars on the back. We also have that in a shorts variation, same thing with the Sweet Science of Fighting writing on one leg and we have the logo on the other.

But my personal favorite—this is my personal favorite, far—we have this in black and white, and it is the taniwhā, protector guardian version of the Sweet Science of Fighting with the logo on the back. This was designed by a Maori designer back in New Zealand, so a bit of my heritage on this jersey. It represents the acknowledgment of battle and war. It also represents strength and stability and also has the New Zealand silver fern.

But even if you're not a Kiwi, cop this—this is an awesome design. It is a custom-made design. You will not find it anywhere else. So check that. That'll also be down in the description with a discount code. But back to the podcast.

What is there, or have you used it, or is there any evidence to suggest using Blood Flow Restriction for pure power velocity work? I know you mentioned about high pulls and things, but even things like medicine ball throws, plyometrics and things—is that something where it can be a place?

Chris Gaviglio47:02

Plyometric is really difficult, I'll be honest. There's some sprinting studies out there, but they weren't really high level. So I've actually had athletes run with them on, but it's more tempo-based work. When you want to do all-out speed, you need them off. When you want to do all-out plyometrics, you need them off.

If you want a training more of an energy system training effect, I'll decrease the pressure a little bit. Olympic lifting, they're fine with, but I'll use them on my upper body as opposed to my lower body because the cuffs get in the way. Jump squats you can still use, but the higher the velocity, it is actually quite difficult to do it.

Medicine ball throws, though—if you put them on your legs, it's hard. I'll actually put them—depends on what my superset is. Sometimes it might be a squat into a medicine ball throw, and that will be fine in terms of performance and so forth.

But if we put them on our upper body, it's like you have that feeling of fullness, and then we've got to then ask, what are we doing the exercise for? If we're doing it to learn how to express power, we need to take them off because we really want to ensure that the contraction quality of the muscle is really good. So take them off for that.

And then, so it can—if you're supersetting, so a squat into a max vertical jump, decrease the pressure, you may have to take them off, which becomes a bit of a time issue. And just in that case, it might be like, well, my vertical jump's really important, you just need to look at how you put your session together.

It might be you start with a good warmup and then do all your vertical jumps, and that could be your potentiation stimulus, and then you get into your squats. So it's just about reworking your session in that respect.

James de Lacey48:56

Gotcha. And when you're using cuffs like your ones—I think it's thebfr.co, that's the one—obviously you have the—is it air pressure, right?

Chris Gaviglio48:56

Yeah, that's it.

James de Lacey49:27

So what level are you looking to get to? Obviously changes by person, and you mentioned obviously with the weather and things too.

Chris Gaviglio49:27

Yeah, so that's a really good point as well, is that we want to try and individualize the pressure according to the user. And a big thing is limb circumference. If you have someone, a big giant of a guy who got massive quads, you need a lot more pressure, even at 50%.

So what we do is when we calculate our training pressure, we work out the pressure that it takes to totally stop blood flow, and then we multiply that by 50 to 80%. And what then changes—well, is it 50 or is it 80? There's several factors, and that usually comes down to the cuff that you use.

So if you use a thin cuff, you need a higher percentage of occlusion pressure, that's what it's called, because you've only got this little bit of material to create that occlusion or that pressure. Whereas if you have something a little wider, you only have to multiply by 50%, so the total pressure is less and it feels a lot more comfortable.

So we go back to example—we got our big Andre the Giant, massive quads. You need a lot of pressure to include or stop blood flow, so we multiply by 50%. Still, say it might be like 300—so that's actually probably like 400 millimeters of mercury. So then we multiply by 50%, that would be 200.

Whereas you got, 60-year-old gen pop, has a little tiny quad, little tiny quads, you need a lot less pressure. So that might be like, say, only 200 to stop the blood flow, multiply that by 50%, which is 100. So that's 100 to 200.

That's really important, is to have that individualization. And then also then to then realize that it's the cuff that you use—it's the brand, it's the type of material, how much stretch. If you be using the elastic bands, that's why a seven out of 10 and using skin color and capillary refill time can help those cross checks in your mind going, is it a six or a seven?

James de Lacey51:32

Wow, great question.

Chris Gaviglio51:32

It's all individualized, and that's what a seven is to me and a seven is to you is totally different. And that's why, because I'm working with athletes, I'll advocate in an ideal world I'd like to create a pressure because it has that level of objectivity. But realize that, man, there's been some great people out there that have had awesome success with just put some elastic bands on.

James de Lacey52:02

Perfect, perfect. Now I think that's everything I wanted to ask you. Where can people find you and follow you with everything Blood Flow Restriction and what you've got going on?

Chris Gaviglio52:02

Yeah, it's all related to thebfr.co of what I do. And then there's a podcast, BFR Radio, all things BFR, where there'll be a host of article reviews. I'm doing one on the role of BFR and improving brain function. Some really cool evidence around markers associated with exercise and improved brain function, and also then people who then exercise with BFR cuffs, how their brain function in certain tasks has improved as well. And these protocols are simple—it's like putting them on, going for 15-minute walk, so it's not like we're recreating the wheel where we have to be doing something different.

Anyway, so BFR Radio. And one thing that I do get from time to time as people ask me questions, and one thing that I'll do is I've started actually just answering like this, where I will set it up and I will drive in my car and I'll answer your question. And I'm actually going to start posting that, so my "Questions in Cars" episode is about to start pretty soon.

So therefore, if you have a general question to say, "Well, how would I use it in this sense?" I had a gentleman, rugby player, who had an Achilles tendon, and if I would type you a reply it would take me days and days. But if I can just talk and give you practical examples of saying, "Well, you'd use it this in the morning, this in the gym, and before you train and after you play," and then all of a sudden the penny drops and goes, "Okay, I now understand how I could use it."

So thebfr.co, hit me up there and send me your questions. And I think that's one of my advantages in this space, is that I use it, I live and breathe it. I can show you how to apply it from injury, from the most brutal injury, through to how do you improve performance at the top end when we're looking for the one percenters.

James de Lacey54:45

No, that's perfect, perfect. So everyone get on to that—that'll be down in the description too, whether you're listening on YouTube or Spotify, etc., it'll be down there. But thanks for coming on, Chris, appreciate it.

Chris Gaviglio54:45

My pleasure, James, and all the best.