If you’re pushing (or have pushed past) 40, want to build muscle or increase strength, and aren’t doing blood flow restriction, you’re screwing up.

Blood flow restriction, or BFR, is an advanced training technique that has some surprisingly potent, evidence-based effects on hypertrophy and strength.

Why is BFR particularly potent for middle-aged gym rats? Because its main selling point is directly relevant to one of the most frustrating parts of aging:

You don’t have to lift heavy or do full-body exercises that tax your bones and joints. BFR turns light-weight lifting into heavy-duty gains. Let’s break down how it all works.

How To Build Muscle After 40 With BFR

The big idea behind BFR is simple. Contrary to what most people think, blood flow restriction isn’t about preventing blood from entering muscle tissue — it’s about stopping blood from leaving your muscles. The result? A permanent, skin-tearing pump.

Arteries pump blood from your heart to other parts of your body, like your muscles, and are found further away from the surface of the skin.

Veins shuttle blood back to your heart, and are found close to the surface of the skin.

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BFR involves constricting certain veins with a wrap, binding, or tourniquet, to stop blood from leaving your muscles. The end result is the best pump you’ve ever had of your life, but training for the pump alone doesn’t build much muscle. What gives?

The scientific research shows that BFR flips physiology on its head:

A 2012 paper in the European Journal of Applied Physiology found that BFR replicated the motor unit recruitment and metabolic stress of heavy training, without having to lift heavy. (1)

Similar data revealed that BFR training increased maximal quadriceps strength more than standard high-intensity lifting, and may even dampen the expression of the myostatin gene, which inhibits muscle hypertrophy. (2)

A 2011 meta analysis determined BFR has a significant effect on strength development, but was not much more effective at creating muscle growth than standard lifting. (3)

In the simplest terms, BFR provides a similar physiological effect to your muscles as heavy lifting with only a fraction of the actual weight.

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How To Do BFR for Muscle & Strength

You must have a wrap or tourniquet to perform blood flow restriction training. You can purchase a medical tourniquet for your arm on Amazon or similar, or use a pair of knee wraps for leg exercises.

The binding should be wound to a tightness level of 8-ish out of 10. It should be just a little uncomfortable before you start, but not painful. The pain comes later.

Perform 30 repetitions of any arm or leg exercise with an extremely light weight; around 25 to 30% of your estimated max.

After 30 seconds’ rest, perform 3 to 4 sets of 15 repetitions with the same weight, resting 30 seconds between sets.

BFR isn’t dangerous, but if you follow the protocol properly, it will be extremely uncomfortable in the beginning.

Recent evidence suggests you don’t need to perform your sets to failure in order for BFR to be effective. (4) You can build muscle after 40 and bolster your strength without having to rely on heavy barbell exercises — or, better yet, in combination with them.

What You Should Know Before Using BFR

Consult with your doctor if you have a history of high blood pressure or suffer from any related medical condition.

BFR is best used on leg or arm exercises, since you can easily occlude the veins to your limbs.

The technique works great for biceps, triceps, forearms, quads, hamstrings, and calves. Don’t bother trying to do, say, BFR upper back training.

You can use BFR to build muscle, strength, or especially as a time-saving tool if you don’t have hours to dedicate to a robust strength training routine.

It also works well as a way to stay fit while traveling; you can do some BFR just about anywhere with two tourniquets and a resistance band.

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Pump It Up

Blood flow restriction is one of the most slept-on techniques to build muscle after 40. While the existing literature isn’t convinced that BFR is better than traditional heavy lifting, it seems to be roughly comparable.

This doesn’t mean you never have to touch a 1-rep max again. Heavy, free-weight strength training improves other aspects of health such as bone mineral density, proprioception, coordination, and athleticism.

BFR belongs in your bag of tricks on days you feel particularly beat up, are battling an injury that prevents you from lifting heavy, or when you’re strapped for time — all of which are factors that can affect the over-40 gymgoer’s quest for gains.

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References

Suga T, Okita K, Takada S, Omokawa M, Kadoguchi T, Yokota T, Hirabayashi K, Takahashi M, Morita N, Horiuchi M, Kinugawa S, Tsutsui H. Effect of multiple set on intramuscular metabolic stress during low-intensity resistance exercise with blood flow restriction. Eur J Appl Physiol. 2012 Nov;112(11):3915-20. doi: 10.1007/s00421-012-2377-x. Epub 2012 Mar 14. PMID: 22415101; PMCID: PMC3474903.

Laurentino GC, Ugrinowitsch C, Roschel H, Aoki MS, Soares AG, Neves M Jr, Aihara AY, Fernandes Ada R, Tricoli V. Strength training with blood flow restriction diminishes myostatin gene expression. Med Sci Sports Exerc. 2012 Mar;44(3):406-12. doi: 10.1249/MSS.0b013e318233b4bc. PMID: 21900845.

Loenneke, J.P., Wilson, J.M., Marín, P.J. et al. Low intensity blood flow restriction training: a meta-analysis. Eur J Appl Physiol 112, 1849–1859 (2012). 

Bjørnsen T, Wernbom M, Paulsen G, Berntsen S, Brankovic R, Stålesen H, Sundnes J, Raastad T. Frequent blood flow restricted training not to failure and to failure induces similar gains in myonuclei and muscle mass. Scand J Med Sci Sports. 2021 Jul;31(7):1420-1439. doi: 10.1111/sms.13952. Epub 2021 May 7. PMID: 33735465.

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