84 : Blood Flow Restriction Training w/ Johnny Owens, MPT

Johnny Owens is a Physical Therapist who currently serves as the Director of Education at Owens Recovery Science. Previously, Johnny spent 10 years as the Chief of Human Performance Optimization at the Center for the Intrepid (See Video Below).  Here he treated service members, including Ryan Miller from Episode 79, who suffered severe musculoskeletal trauma. I heard Johnny speak at the AMSSM conference this past May in San Diego and was amazed by the incredible knowledge he was sharing on Blood Flow Restriction (BFR) and the implications it has for athletes recovering from injury.  Johnny has been published extensively for his work with BFR in the peer reviewed literature and his work has been featured on 60 Minutes, Time Magazine, NPR, Discovery Channel and ESPN.  I have no doubt many of the athletes who listen to this episode can benefit one way or another by adding BFR to their rehab protocol or training regimen.

As many of you know, I have been rehabbing from an Osteochonral Autograft Transfer (OATs) surgery I elected to have back in January of 2016.  I have been struggling with moderate to severe kneecap pain and atrophy  since 6 months out from surgery.  The pain has diminished greatly since working with Dr. Danielle Clarke over at Parabolic Performance and Rehab in Little Falls, NJ. However, when I heard Johnny talk about BFR at the AMSSM conference I first thought, I need to get this guy on the podcast and then thought, this could be a potential solution to my lingering knee pain! Johnny told me he thought I would be a good candidate for BFR training.

For athletes like me who can't build muscle through lifting heavy loads because it is painful, the anaerobic properties of BFR training have been found to stimulate a similar biological response in the muscle with much lighter weights.  In the above picture, I am performing a step-up with a slow eccentric descent.  Trust me, you have never felt muscle fatigue until you have tried BFR.  It's a deep burn (Insert Ron Burgundy voice).  The single leg squat on the Total Gym is by far the most difficult and uncomfortable, but after having limited use of my quad for over a year, it's also glorious. Since recording this episode with Johnny I have been doing BFR on my leg for the past 3 weeks at Edge Physical Therapy & Sports Medicine.  Considering the large number of physical therapy practices in my area, most of them do not have Owens Recovery System certified PT's.  You can find a list of certified providers in your area on Johnny's website.

Since working with Lawrence and Johanns at Edge, I can definitely feel a big difference in the strength of my left leg. Normally when I go out for a ride on my road bike or do some intervals on an Assault Bike, my non-surgically repaired right leg feels like it is doing all the work.  However, I feel much more symmetrical in the last couple rides and workouts I have done. I am excited to see the progress in the coming weeks.  Keep an eye out for some videos on social media of my BFR training.

Below you will find notes on my interview with the BFR legend himself, Johnny Owens:

  • BFR is an individualized tourniquet system and is meant to reduce blood flow into an extremity.

  • If you are able to exercise at a low blood flow, you can use lighter weights to get similar results that you would expect from lifting heavy weights.

  • BFR isn't as new of an idea as you might think.

    • Early physiology studies from decades ago look into anaerobic muscle response.

    • Yoshiaki Sato noticed bigger pump effect with BFR.

  • Population

    • Perfect for person recovering from injury because those patients cant handle heavy loads.

    • Geriatric population.

    • Battling sarcopenia after 50, body doesn’t respond to muscle protein synthesis.

    • Athletes in season, won’t beat up the body.

  • Both lower tourniquet pressures have an effect and high pressures have an effect.

  • Why not just use a tourniquet?

    • Clinically you can’t ignore the tourniquet literature.

    • Wide and tapered devices to avoid pressure gradients.

  • Contraindications list:

    • Cardiovascular compromised

    • Cancer

    • “Sick person List”

    • Young pediatrics

  • Certification process

  • The science:

    • Who wins?

      • lifting light or lifting light with a tourniquet?

        • Tourniquet

    • Johnny believes lifting heavy still wins overall, but not everyone can.

    • Increase in lactate

    • Growth hormone elevation

    • Proximal changes around the tourniquet

      • Ex. Quad gets so fatigued that the glute has to work harder

        • Downstream fatigue effect

  • Johnny’s work with Active Duty service members starting back in 2004

    • “The best and most honorable experience I had in my life”

    • Limb salvage population

    • Needed a strength and hypertrophy response and that’s where BFR came in.

    • What goes into the decision to save or amputate a limb?

  • Loading is going to make you bigger and stronger overtime

    • Once you are injured, the body goes haywire

  • Attitude is number one on the list in leading to successful injury outcomes

  • Identity struggles for athletes and veterans

    • How Psychologists and Nutritionists can help in this process.

  • It was hard to ever feel bad for yourself at the center for the intrepid.

  • Johnny's story of 3 ACL injuries:

    • Grew up in west Texas and was the son of a mechanic (That just sounds tough).

    • Played High school football in the same district as Permian High School from the Book "Friday Night Lights".

    • Eventually gravitated to soccer:

      • Blew his knee out playing soccer on a non-contact play in the rain.

      • Eventually re-tore the repaired knee.

      • Johnny talks about the evolution in ACL surgeries and treatments since his initial injury.

      • Got hit by a car and tore it a third time while at The University of Texas at Austin.

  • The third injury was an eye opener for Johnny, because he realized he couldn’t rely on becoming a pro soccer player.

  • Johnny's advice to athletes going through the transition to life after sports is, "what you do does not define who you are".

  • Why staying at the Center for the Intrepid was “Fail better” and how athletes should seek out non-health-hazardous opportunities that makes them uncomfortable.

  • The definition of toughness from the son of a West Texas mechanic.


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