Rotator cuff strength is not augmented by blood flow restriction training

Abstract

Objective: Blood flow restriction (BFR) training utilizes a tourniquet applied to the upper or lower extremities (UE or LE) to occlude blood flow while exercising. BFR training may help augment strength in muscles that are proximal to BFR cuff application. However, prior studies have failed to demonstrate augmented strength gains in the rotator cuff when the tourniquet is applied to the UE. The purpose of this study was to evaluate if a protocol consisting of LE exercises, performed with BFR, followed by rotator cuff exercises was superior in augmenting strength, and cross-sectional area (CSA) of the rectus femoris, in untrained subjects when compared to a non-BFR training group.

Design: Randomized controlled trial.

Setting: University.

Participants: Thirty-five subjects (mean age 25.8 ± 1.6 y) randomized to a BFR or non-BFR group.

Main outcome measures: Muscular strength measured via hand held dynamometer and the CSA of the dominant rectus femoris was measured by diagnostic ultrasound.

Results: Both groups experienced significant gains in LE and rotator cuff strength. Strength increased in the BFR group by 11.6% for the supraspinatus, 34.1% for shoulder ER, 23.4% for the quadriceps, and 17.1% for the hamstrings. Strength increased in the non-BFR group by 7.3% for the supraspinatus, 20% for shoulder ER, 12.8% for the quadriceps, and 10.7% for the hamstrings. However, there were no differences in strength gains between groups. Neither group experienced a significant increase in CSA for the rectus femoris.

Conclusion: The BFR protocol used in this study did not augment strength for the rotator cuff in subjects who also performed LE exercises under occlusion.

Keywords: External rotators; Occlusion training; Shoulder; Supraspinatus; Therapeutic exercise.