REVIEW article
Front. Physiol.
Sec. Exercise Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1683442
This article is part of the Research TopicImpact of Blood Flow Restriction Device Features and Methodological Considerations on Acute- and Longitudinal Responses to Blood Flow Restricted Exercise - Volume IIView all articles
Physiological Adaptations and Practical Efficacy of Different Blood Flow Restriction Resistance Training Modes in Athletic Populations
Provisionally accepted
- 1Xi'an Binhe School, Xi'an, China
- 2Shanghai University of Sport, Shanghai, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Blood flow restriction resistance training enhances athletic adaptations via distinct mechano-metabolic pathways. This review synthesizes evidence comparing three blood flow restriction resistance training modalities: Low-load resistance training with blood flow restriction (using 20%-30% of one-repetition maximum) prioritizes metabolic stress (lactate and hydrogen ion accumulation, cellular swelling), activating growth hormone (GH)/insulin-like growth factor 1 (IGF-1)/mechanistic target of rapamycin (mTOR) pathways to promote type I muscle fiber hypertrophy, making it suitable for joint-sparing rehabilitation scenarios. Supplemental blood flow restriction resistance training programs combine high-load tension (utilizing 75%-90% of one-repetition maximum) with additional blood flow restriction to produce an acute synergistic effect. This method enhances the recruitment of type IIa/x muscle fibers and prolongs mTOR phosphorylation for over 48 hours. Combined blood flow restriction resistance training employs alternating cycles of high-load phases (70%-85% 1RM) and blood flow restriction phases (hypoxia-inducible factor 1-alpha (HIF-1α)-mediated angiogenesis), optimizing phosphocreatine resynthesis and neural drive to achieve specialization of type IIx muscle fibers. Periodized application requires matching modalities with training phases: combined blood flow restriction training for hypertrophy during the preparatory phase, supplemental blood flow restriction training for strength maintenance during the competitive phase, and low-load resistance training with blood flow restriction for active recovery. This mechanistic framework supports evidence-based blood flow restriction resistance training programming to maximize athletic adaptations while mitigating injury risk
Keywords: Blood flow restriction, Resistance Training, muscle hypertrophy, skeletal muscle, Athletes
Received: 11 Aug 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 He, Zhu and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chuang He, hechuang0121@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.