Kaatsu, How BFR Was Invented and Sciency Bits About Its Benefits
[Courtesy of kaatsu.com]
This is the second post in a series trying to bring more attention to Blood Flow Restriction training, and give myself more of an education in using BFR to train with. I did a brief introduction to what BFR was an some of the benefits. I thought I would do a thorough, more in depth post, providing some of the history of BRF, how it was created and some of the important benefits of using blood flow restriction.
Week #1 Post is located here:
@run.vince.run/blood-flow-restriction-training-week-1
I remember a few years back, when I first heard of Blood Flow Restriction training. It was from a Ben Greenfield Podcast where he does a deep dive with podcast guests, and also provides an in-depth look at the specific Kaatsu equipment, and how it works.
BRF Kinda Started With Dr. Yoshiaki Sato
I say kinda, because, its a pretty common assumption that BFR started with Dr. Sato, but when you read into things a little more, you'll find that Sato is trying to distance himself from the mainstream concept of BFR training. Hopefully, I'll be able to give a good breakdown of the concepts and differences from Sato's methods.
In most things you read about BFR, Kaatsu is credited as being the originator of BFR, specifically Dr. Yoshiaki Sato. In 1966, when Sato was 18 and attending a Buddhist ceremony, and found himself sitting in the traditional "seiza" position for an extended period of time. The seated position caused his legs to become numb, leading him to apply pressure on different parts of his legs to relieve the discomfort. From this experience he observed significant changes in his body and began to conceptualise what the blocking of blood flow had had. He realized the numbing sensation, caused by restricted circulation, felt similar to the "pump" experienced in bodybuilding.
In initial experimentation Sato began testing this concept by using various items, including bicycle inner tubes, ropes, and elastic bands, tieing them around his limbs to restrict circulation while exercising and after breaking his ankle and tearing ligaments in his knee, Sato used his primitive restriction bands while doing isometric exercises on his legs. He achieved full recovery in six weeks, far faster than the predicted six months, with no muscle atrophy. This lead to Sato developing the pneumatic Kaatsu device which provided a formalised method with controlled protocols.
The term "Kaatsu" translates to "added pressure", with the original intention of manipulating blood flow to improve strength and rehabilitation, rather than just cutting off circulation.
From Japan To The Rest Of The World
Kaatsu and BFR remained almost unknown to the rest of the world with Sato not speaking any English or travelling outside of Japan. It wasn't until Steve Munatones who was coaching the U.S National Swim Team in Japan, so swimmers using them. After approaching Sato, he took Munatones under his wing for 13 years, teaching him Kaatsu to allow him to share with others.
[Courtesy of kaatsu.com]
Direct links to the Kaatsu products from there website:
- The B2 pictured as the title image at the top of this post: https://kaatsu.com/products/kaatsu-b2
- The C2, cheaper product pictured above: https://kaatsu.com/products/kaatsu-c4
Blood Flow Optimisation vs Blood Flow Restriction
Kaatsu is always credited as being the original and the start of how BFR came about, but when you look further into the history and through there own documentation and research, Kaatsu explains itself as not being BFR, but Blood Flow Optimisation, and also suggests that there methods are safer, more gentle and more effective.
While both Kaatsu and traditional BFR use the modification of blood flow to enhance exercise, the approaches they employ differ significantly. Kaatsu, rather than restricting a specific percentage of blood pressure as is recommended with BFR products, it instead starts with no restriction. Then very slight pressure is temporarily applied to the upper limbs by the bands.
KAATSU’s methodology is predicated on the principle of optimising blood flow, rather than merely restricting it to a specific percentage of systolic blood pressure as is recommended with BFR products. While it may seem like a nuanced difference, KAATSU begins at homeostasis where there is no occlusion or impedence of the arterial flow (i.e., blood flowing out to the limbs) or venous return (i.e., blood returning to the torso). Then a very slight pressure is temporarily applied to the upper limbs by the oval-shaped AirBands.
BFR on the other hand usually involves constant high compression levels and simultaneous use, on sometimes, all four limbs often cause discomfort, with the higher pressure of BFR, may not be optimal for individuals of all ages and with diverse conditions.
The Science Behind BloodFlow Restriction Training
Weather we're talking about Kaatsu or other BFR training, the research highlights the same benefits of BFR training and how these mechanisms are produced. In brief, increased stress with less weight or effort, causing muscle growth and increase in hormone levels, cellular swelling, and recruitment of more muscle fibres.
Key mechanisms detailed in the research include:
Metabolic Stress and Accumulation: Partial arterial inflow and total venous outflow restriction create a hypoxic environment, causing rapid accumulation of metabolic byproducts like lactate, hydrogen ions, and inorganic phosphate. This stimulates muscle growth by triggering muscle protein synthesis, increased anabolic hormones like human growth hormone and apparently inhibits myostatin which blocks muscle growth
Cellular Swelling (Muscle Pump): The restriction of venous blood causes fluid to accumulate in the muscle cells, which is believed to trigger protein synthesis and inhibit protein breakdown.
Fiber Type Recruitment: Due to the early fatigue of Type I (slow-twitch) fibers in a low-oxygen environment, the body is forced to recruit Type II (fast-twitch) muscle fibers earlier than in traditional training, even with light weights.
A quick list of research I used to get the above list of mechanisms and benefits
https://pmc.ncbi.nlm.nih.gov/articles/PMC11865041/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9234289/
https://pmc.ncbi.nlm.nih.gov/articles/PMC12282689/
https://pubmed.ncbi.nlm.nih.gov/30011262/
Disclaimer: This article is for general information only and does not constitute medical advice. Exercise involves risk, and what’s appropriate varies by individual health, fitness level, and medical history. Before starting any new exercise programme or training regime, especially if you are pregnant, have a medical condition, are recovering from injury/illness, take medication, or have any concerns, seek approval/advice from a qualified healthcare professional. Stop exercising immediately if you feel unwell or experience pain, dizziness, chest pain, or shortness of breath, and seek medical help where appropriate. Use your judgement, train within your limits, and follow safe technique.
I honestly can't speak to the benefits of Kaatsu, as I haven't been able to use or afford one of their machines. I can comment on my own training that originally first implemented BFR pressure which caused me a lot of pain. I had no idea how I'd be able to implement something like this in coaching other athletes. But as time went on I learned the pressure does not need to cause pain for it to be effective and hopefully still create a benefit from their use.
P.S. I have found effective alternatives that don't even cost a fraction of what the machines in this post cost. More on that to come in the following weeks.