Kaatsu/Occlusion Training?

Hahah thanks man,

This podcast should help:

Like I said, to use BFR:

  • Apply cuffs
  • do a few sets of higher rep training

That’s it, the rest is details

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@pettersson ,

I know this is an old thread but happened upon it today and didn’t see some of your main questions answered, so I thought I’d revive the topic! I use BFR daily, with myself and my clients.

Is it good for hypertrophy? Yes. Many, many studies have shown the benefits of BFR for hypertrophy. The mechanisms are via fast-twitch muscle recruitment, increased protein synthesis, and increased production of growth hormone, IGF-1, and testosterone. If done correctly you should be getting a huge pump and burn (lactate). High levels of lactate production triggers the brain to release anabolic hormones and reduced cortisol (stress hormone).

Is there any programs or protocols to follow? Yes. The original protocol devised by Dr. Sato (inventor of KAATSU, the original BFR; more on that below), prescribed a 4 set protocol of 1st set of 30 reps, next 3 sets to 15 reps, with only 30 seconds rest between sets; all sets to failure using loads ~ 30% of 1RM. I prefer a 3 set protocol (as shown below). Here’s an overall breakdown:

Intensity/load: 20-30% of your 1-rep maximum (easy to calculate if you are using free weights); when using bodyweight, TRX, or bands, just start out using a lighter/easier load and adjust from there based on the reps you get the first time. Find a weight that allows 10 strict reps, then lower to 30% of that weight

Frequency: 3-6 times a week; most research shows that to take advantage of the occlusion training, we need to do it at a higher frequency

Volume (set/rep protocol): There are some different protocols, but we use this:

  • 3 Set protocol:
    Set 1 = 25-40 reps to failure (can’t continue in perfect form)
    Set 2 = 10-20 reps to failure
    Set 3 = 5-10 reps to failure
    30 second rest in between each set; rep cadence is 2-3 seconds up, 2-3 seconds down; so, it takes 4-6 minutes to get through one exercise depending on how many reps you are getting each set
  • Once you can hit 40 strict reps on the first set, you can increase the load (stronger band, deeper stance on the TRX, etc.); I literally increase by only 2.5-5lbs for upper body and 5-10lbs for lower body and it brings me right back down to the low end of the rep range.

Band Location: As high up on the arms as possible, which is generally between the deltoids and biceps; As high up on the legs as possible, which is generally between the glutes and hamstrings. Do NOT band arms and legs simultaneously

Band Tightness: The bands are put on to a level 5-7 out of 10 tightness for upper body & 7-8 of 10 for lower body; you can check for capillary refill on the palms of the hands and on the leg just above the kneecap:

  • Press hard into the skin, then let go
  • You should see blood refill the area in 3 sec or less
  • If it takes longer the bands are too tight; if your hands/feet get numb or cold, the bands are too tight.
  • The limbs will appear darker/redder due to the increased blood flow

Length of Time Banded:

  • Lower body - The max you want to keep the bands on is 20 minutes
  • Upper body - The max you want to keep the bands on is 15 minutes
  • You can always take the bands off, wait a few minutes, then reapply and continue with more exercises

Contraindications (when not to use; these are relative to the individual):

  • Pregnancy
  • Anyone taking blood thinners
  • History of arterial aneurysm or stroke
  • Post-surgical: Occlusion should not be done for 4-6 weeks after major surgery; It is often possible to perform occlusion within 1 week of smaller surgeries (e.g. arthroscopic procedures on the knee)

What equipment/device/bands is the best? In my opinion the KAATSU bands (the original) are the best. But, they are also the most expensive. I have used many brands, and I would categorize them in 3 basic categories:

  1. Elastic Bands: BFR Bands is a brand name example and one I have used. They sell from their website and on Amazon. There are other brands that are essential similar versions. Elastic bands with varying types of locking mechanisms. Latest versions have numbers & tic marks so you can set them at the same place each time. Works fine, I used them for years. Better for arms than for legs though, as it is difficult to get the leg bands tight enough, especially after you get used to it. Prices vary but generally about $30 for arm bands and $40 for leg bands.

  2. Hand-Pump Bands: Brand like B3, SmartCuffs, etc. These have an internal bladder that fills with air via a hand pump like those used with blood pressure cuffs. The SmartCuffs brand actually has an electronic device that fills the bands. Advantage is that you can fill to a specific pressure. I have B3 bands and used them for a couple years. Disadvantage of this type is that the overall band can get pretty rigid and I found that it hindered some range of motion (but I’m short and have short limbs, some may not be an issue for all). If I’m being honest, I did not see a huge difference in pump, burn, fatigue, or results between these and the elastic BFR Bands. Prices range from $400-500.

  3. KAATSU Bands: The original, invented by the creator of BFR, Dr. Sato of Japan. By far the most comfortable of any BFR bands I’ve used. Bands are filled with a small handheld device. What sets KAATSU apart is a patented “Cycle” mode, in which you keep the device hooked to the bands and it fills them up for 30 seconds, then automatically drains the pressure for 5 seconds, then refills. Great for rehab, circuit workouts, pain clients, and recovery (like a mini Normatec boot). The Cycle feature allows you to wear them for longer than the prescribed times. It also has a “Constant” mode in which you fill to the desired pressure, then unhook from the device like all other BFR devices. The best results as far as increased strength and hypertrophy I’ve gotten using KAATSU, and that was after years of doing BFR, so I was already highly adapted. Cost is $1000. Steep, for sure. But easily the best investment I’ve made in a long time. Significantly helped with a hip issue I was having. I only use KAATSU with my clients.

Do you have any personal experiences to share? See above. One bodybuilder client of mine gained 1" on his arms and 2" on his legs. A powerlifter client has gained muscle mass and strength and his back and knees don’t hurt anymore.

Coach Pat

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That was fantastic my man, thank you for that write up!

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@j4gga2 ,

Hahaha… no problem, brother. Sorry, a little late to the party…

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Agreed! Thank you. This is something I’ve been playing around with recently, so this was very helpful.

Great! Glad I could help! Let me know if you think some overall programming ideas would be helpful.

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I think I speak for many of us when I say that would be helpful; we all geek out on training.

I know @Andrewgen_Receptors and I have both been playing with using bands to add frequency/ volume to arms as a bit of an specialization alongside a more traditional lifting program.

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Sorry for the delay. I’ll drop some BFR programming in here this week!

Coach Pat

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BFR Programming Ideas - Hypertrophy Focus:

  • The original/most traditional way to use BFR
  • Use 1-4 exercises per workout
  • Use the 3-Set Protocol, w/ 30 sec rest between sets:

    Set 1 = 25-40 reps
    Set 2 = 1-20 reps
    Set 3 = 5-10 reps

  • Use a load that is 30% of your 1RM
  • If you can get 40 reps on Set 1, you should increase the load next workout (slightly)
  • If your weights are dialed in correctly, you will generally get around 1/2 the reps on Set 2 that you got on Set 1, and 1/2 the reps on Set 3 that you got on Set 2.
  • ALL sets should be to muscular failure in good form!!
  • Keep rest between exercises to only 1 minute
  • Example Workout for a 4-Days/Week Plan (all exercises w/ 3-Set Protocol above):
    Day 1 (Monday):
    Upper Body Push:
    - Barbell Bench Press
    - Dumbbell Overhead Press
    - Triceps Pushdowns
    Lower Body Posterior Chain:
    - Trapbar Deadlift
    - Dumbbell RDL
    - TRX Hamstrings Curls
    Day 2 (Tuesday):
    Upper Body Pull:
    - Barbell Bent Rows
    - Kneeling Band Pulldowns
    - Incline Dumbbell Curls
    Lower Body Anterior Chain:
    - Goblet Squats
    - Walking Lunges
    - Standing Calf Raises
    Day 3 (Thursday):
    Repeat Day 1 using same of different exercises for Upper Body Push & Lower Body Posterior Chain
    Day 4 (Friday):
    Repeat Day 2 using same or different exercises for Upper Body Pull & Lower Body Anterior Chain

I’ll continue to post more BFR programming ideas.

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Thanks! Just to clarify, are all exercises in the above done following the BFR protocol? I’ve honestly not considered doing something like a bench press; it just seemed I’d fatigue my triceps first, which already were a potentially weak link. I was going to do lunges this week, though, because that seems awful - so I guess that’s a similar idea.

Yes, all in the BFR protocol for this program. Kind of a push/pull-full body hybrid.

I like doing three exercises, at least for the upper body, because that will be about 15 minutes which is about the longest you want to have the bands on. Not that you couldn’t do say two exercises with a BFR bands on, then take them off for a minute or two and do two more.

Also, if triceps are concerned you could reverse the order and do the triceps first while they are freshest, and then the shoulders and the chest exercises

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Awesome - thanks!

Hey, so not to go poking at your methods compared to the methods of others, but most coaches/trainers recommend using the 30/15/15/15 reps BFR protocol and 45seconds rest between sets. They also recommend 20-30% 1RM weights for this.

Curious, why do you recommend a different approach? Your method does align more with the Rest-Pause method, which I find to be one of the most effective approaches to rep-weight progression.

NOTE:
I’m currently implementing BFR training in my routine, though only for arms. I tried the BFR thigh straps and frankly I’m unable to get them tight enough to do what is needed… a ratchet strap may need to be introduced to achieve the desired feedback effect lol.

Oh, and thank you for your thoughts on this. Please don’t think this is me challenging you on your methods, it’s me trying to understand different methodology for a nuanced lifting approach.

Snippet explaining others’ methods (which I’ve seen repeatedly recommended):

  • Frequency: 2 to 3 times a week during a heavy lifting phase for an extended period (over 3 weeks), or alternately, 1 to 2 times a week (for less than 3 weeks) during a de-load phase to shock the musculoskeletal system.
  • Limb Occlusion Pressure (LOP): This term refers to the minimum pressure needed to completely restrict both arterial and venous flow, but gangrene isn’t what you’re shooting for. Instead, you’re shooting for a percentage of LOP. Arms should be wrapped to 40-50% of LOP and legs should be wrapped to 60 to 80% of LOP.
  • Number of exercises per session: It’s variable, but most studies use either one exercise per muscle group, like leg extensions, while some other studies employed two exercises per muscle group, using one multi-joint exercise and one single-joint exercise.
  • Rep scheme: The studies support higher reps, such as sets of 30, 15, 15, 15. Alternately, you can do multiple sets to failure, although that will, of course, increase recovery time.
  • Maximum wear time: No more than 10 to 20 minutes, total. In general, though, deflate (or remove) after two exercises and wait a minute before re-inflating.
  • Loads: 20 to 50% of 1RM.
  • Tempo: 1-second concentric, 2-second eccentric.
  • Interset rest: 30 to 60 seconds.
  • Before or after heavy lifting: After.
  • Multi-joint or single-joint exercises: Both.
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Or the Smart Cuffs! They are expensive, but I promise you that you’ll be able to get them tight enough.

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I looked into these, but wanted to test it with the cheaper version before committing to a 3-bill investment. I still have them earmarked for a rainy day.

@Andrewgen_Receptors

No worries, thanks for the questions. I’ll discuss the set protocols first. As I mentioned in my first post, the 4-Set Protocol (30-15-15-15) was the original as developed by Dr. Sato for the KAATSU protocol. I am KAATSU certified and this protocol is still mentioned in their training, but they also discuss the 3-Set Protocol I described. I did the 4-Set Protocol many years ago for several years, then tried the 3-Set Protocol for a while, and I prefer the 3-Set Protocol for the following reasons:

  • I found no great difference in pump, burn, fatigue or hypertrophy gains; if anything, I found the 3-Set Protocol to be better (see below)
  • The goal is to reach momentary muscular failure on each set; with the 4-Set Protocol of 30 reps on the first set and 15 reps on the following 3 sets I found it difficult to truly get failure on all sets, while trying to hit those reps goals (even with some fudging over/under) - the first set ends up being too easy and the last set you can’t get anywhere close to the reps goal
  • So with the 3-Set Protocol, using the rep range guidance per set, it was much easier to dial in the right load, and get true muscular failure each set, AND it gave a true point of when you should increase load - when you can hit 40 reps on the first set

Rest between sets: The original protocol from KAATSU says 20-30 seconds rest between sets. I think 45 seconds is too long, offering too much time to recover and for lactate to shuttle out (albeit still significantly inhibited due to the veinous restriction). I generally find 20 seconds to be not quite enough rest, making it difficult to hit the next set’s rep range goals. Having said that, we all have different percentages of fast twitch/slow twitch, which can make a difference. Example:

  • My biceps lean more fast twitch and my triceps lean more slow twitch, so after that first hard set of the higher reps, I struggle to make the low end of the rep range in my second and third sets for biceps; whereas I almost always get higher reps in the second and third sets for triceps (still in the rep range)
  • Thus, I could likely just rest 20 seconds for triceps and be fine, but my biceps definitely need the 30 seconds

Load: Yes, 20-30% 1RM is what I recommend as well (and is the original KAATSU recommendation); over the years I have found 30% the best for me and most of my clients; Of course, the reality is that most folks do not know what their 1RM is except for perhaps barbell bench press, squats and deadlifts… So another way to calculate is using 40% of your known or estimated 10RM. I find this gets you very close to 30% 1RM, and you can modify the load after that first set - if you didn’t get at least 25 reps, its too heavy and if you got over 40 reps its too light.

Getting bands tight enough/Limb Occlusion Pressure (LOP): Yes it can be tough if you are not using devices that show the pressure; see my notes in my first post about the elastic-type bands as well as the part about band tightness and how to check for capillary refill so they are not too tight.

Rest-Pause: Not quite sure I’m following you on this one - do you mean the short rest period of 20-30 seconds between sets being similar to Rest-Pause?

Let me know if you have any other questions!

@Coach_Pat_Marques

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Rest-pause being 1 ‘set’ with 3 ‘mini-sets’ broken up by 20-30second breaks. There is a prescribed rep-range (total reps being say 20-30 reps) and the goal is to always do at least one more rep than last time. Adjust weight upward if eclipsing top-end of range, knowing reps performed will be reduced.

Ironically, most ‘mini-sets’ in Rest-Pause are about half of the reps performed on the previous ‘mini-set’ - which lines up with your prescribed rep-ranges almost identically (albeit different upper and lower-end ranges).
This stems from Dante Trudel’s DoggCrapp training, if you are familiar.

Thank you for taking the time to explain this - I may end up adjusting my BFR protocol to align moreso with your methods than Dr. Sato’s methods.

@Andrewgen_Receptors ,

Yes, definitely similar with regards to short rest periods. I’ve always considered “Rest-Pause” training to be much shorter breaks between mini-sets (5-10 seconds or 2-3 breaths) such as Mike Mentzer used, but I agree with you that it is a similar principle (e.g. just enough rest to get some reps, but not enough to get the same amount of reps).

What’s cool about BFR is that the increased fatigue due to the lactate buildup drives fast twitch muscle fiber recruitment with light loads!

Later this week I hope to post another programming idea for strength/powerlifting + BFR.

@Coach_Pat_Marques

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Looking forward to this! The BFR intrigues me, and I get a good pump, but I don’t love it enough to use it exclusively in a session. I like the idea of a little of this, a little of that.