Blood Flow Restriction and Its Function in Post- Operative Anterior Cruciate Ligament Reconstruction Therapy: Expert Opinion



1 Johns Hopkins University, BA, USA

2 Rock Valley Physical Therapy, USA

3 Midwest Orthopaedics at Rush, Chicago, USA

4 Morrison Community Hospital, USA


An increasingly popular method for post-operative rehabilitation of an ACL reconstruction, as a substitute for traditional
therapy, is blood flow restriction therapy (BFR). BFR therapy utilizes a pneumatic cuff to simulate strenuous exercise
in an effort to stimulate muscle recruitment, mitigate atrophy, and promote hypertrophy in patients with load-bearing
limitations. Because this is a relatively new form of therapy, there is a lack of established literature and protocol that
is preventing widespread use of the therapy. This article will seek to confirm the value and validity of the utilization of
BFR therapy. In order to validate the utilization of BFR, an evaluation of the science underlying BFR will be discussed
as well as the technique and exercises preformed during therapy. Furthermore, analysis of other BFR literature will be
utilized to lend further credence to the obtained conclusions. Based on the literature, BFR therapy mitigates atrophy
through type II muscle recruitment while also stimulating hypertrophy in patients, supporting its use post-operatively.
Moreover, positive results from BFR case series also lend credence to its value as a substitute for traditional therapy
in patients who have weight-bearing limitations, specifically those who are recovering from anterior cruciate ligament
Level of evidence: V