The Good Kind of Pain - A Study on BFR in Physiotherapy

In the spring of 2017, BfR Professional teamed up with two physiotherapist students focusing on the qualitative aspect of blood flow restriction training, and how people perceive the use of this still very new training method. Below you can read more about their interesting findings from their bachelor project. 

Buckled up and ready for training

- A qualitative study based on interviews

By Højfeldt R. Jeanette, Jensen H. Pernille, BA. Physiotherapy, VIA University College Aarhus, Denmark.

Background and purpose

The project includes six participants. A physiotherapist, two patients with varying injuries and three self-trained subjects, one with an injury. In addition to using physiotherapists, all participants have been using blood flow restriction training in time periods spanning from three weeks to three months. 


The analysed data can be grouped into topics with key findings:


Blood flow restriction training is versatile in its use and can, for instance, be used to max out in the last part of your session after high load training, or to prevent further pain from an injury during training. When tightening the band, some participants express a problem. They aren't sure whether the band is too tight or too loose, which is a common concern among the participants. This means that every individual has their own strategy to ensure the correct use, and therefore the tightening is self-perceived. Despite this issue, the band is reported easy to use:

Even though the band is tight, it gives the muscles room to expand during training.

Physical experience 

A common experience is accelerated muscle atrophy compared to regular training. The participants observed visual changes in the veins, as these became more proinent and with a blue and red colour. This is an observation that the physiotherapist confirms. Another observation during training is a fast burning and a lactic feeling in the muscles. Several participants described blood flow restriction training as having a different feeling to its compared to regular training. The exhaustion was somehow different. One of the participants described the post experience like this:

It gives a soreness, where I almost couldn't sit down or get up.. My legs were really sore. I had to hold onto the railing when going down the stairs. It felt like jelly legs.
It really doesn't hurt - it's a good kind of pain.


Three out of six explain that blood flow restriction training has prevented pain from a current injury when training. One of them says that:

Back then, before I used the bands, I could barely do my exercises without feeling pain in my injury - I went home without working my muscles. It just hurt enormously.

 Mental experience

The participants express great joy and satisfaction when using blood flow restriction training. Some mention that this kind of training is: fantastic, different, awesome, effective, a short and hard workout. In particular, they justify the relieving ability of the bands which causes the muscles to be stressed before the joint:

Just as annoying the soreness has been, it felt equally amazing - it's great because I feel alive.

Some of the participants report struggles with the low load training and motivation at the beginning:

At some points, it's demotivating not to have the usual kilos for someone who's used to training with a high load. But suddenly, I can take far more repetitions, and I came to notice that my legs become really tired, even without hurting the joints.

Among the participants, the feedback is an overall positive one concerning motivation for doing blood flow restriction training. For some, it was the applicability, for others, the competition and socialising.      


The participants feel safe using blood flow restriction training. This is explained by the fact that they don't associate low load training with high risk of injury, despite tightening problems and a lack of knowledge:

I can go crazy while knowing I'm not going to break. I feel safe using it because I know the muscles get tired long before it ever gets dangerous for me.

Some of the participants report that the perception of safety is being created by the connection with the physiotherapist.


All participants found blood flow restriction training to be effective and said that it had a positive impact both physically and mentally. However, there is an issue with the subjective tightening of the bands, which requires more knowledge. The informants experienced a lactic and burning sensation, as well as an increased soreness, but this was not experienced as pain. This training method will suit both the elite and patients with injuries. However, consideration should be taken because blood flow restriction training can affect blood circulation.

Hope you enjoyed this read!

Team BfR Professional

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