Welcome back to the blood flow restriction podcast. Two episodes. In one week, we are on a roll and today's topic is exercise selection. So. We know BFR can be a powerful tool for building muscle while training at lighter loads or with less weights. But we often get the question will that's great. But what exercises or movements should I do? And in this episode, very similar theme.
We're going to provide a framework for how you can systematically come to your own conclusion on what the best exercises may or may not be when you're training under BFR instead of just simply providing a list of exercises. That said, we are going to go through each body part to some degree and provide a bit of a starter list for you. Uh, including guidance on, rep ranges, rest intervals, what you should look for. Et cetera. So let's get right into this.
And it's important to note that although BFR is a specialized modality, It should still adhere to standard principles of good exercise selection as they apply to traditional resistance training as well. So when we're thinking about any exercise, blood flow restriction or not. Ah, there's a few things that we need to run through to help identify. Is this. Exercise or movement advantageous for building muscle. And we're going to get into that specifically.
I promise this will tie into BFR, uh, but the first kind of prerequisites, this is like bare minimum. Is does this movement allow you to sufficiently produce force through the target muscle? Sounds very obvious. Which is why. You know, when you see something like, uh, this is very common on Instagram, especially with pro athletes. Unfortunately. You'll see somebody doing something like a one leg. Stand with a resistance band, pulling you one direction, a blindfold on.
And another resistance band pulling you the other direction. And the athlete's doing a single arm cable fly. Which perhaps the athlete or their trainer has some sort of. Unknown goal in doing that. But in general, if you were to look at that exercise as it relates to building muscle in the chest, The lack of stability does not allow that athlete to put any sort of meaningful force through their chest. Uh, terrible exercise for building muscle. In your chest.
So I guess our prerequisite is, does this allow you to sufficiently produce force through the target muscle? So stability is a factor. And that's just important to reference, But once we've established. That an exercise or movement allows us to put sufficient force through the target muscle. There's there's more to consider that's that's step one and there's no better guide to this. Then Mike is retells stimulus to fatigue ratio indices. And stimulus to fatigue ratio.
We've talked about this briefly on the podcast. I've talked about it before. But it says that for every exercise, we know that there should be some level of stimulus, right? We shouldn't, there's no point in training if we're not providing a stimulus, whatever that stimulus is. But for every bit of stimulus comes a certain amount of fatigue. So we've all seen this. Uh, in the session.
So as you, if you do a set to failure on bench, you, it is very unlikely that you'll be able to repeat a second set at that same weight, with the same. Amount of reps, uh, because we start to fatigue in the session and then over time, days, weeks, months, fatigue, accumulates. And the training is really a balancing act, sort of managing this dichotomy of. Fatigue is not necessarily a bad thing.
It's sort of along for the ride, but we should try to focus on maximizing stimulus and minimizing fatigue. There are certain exercise movements and modality that drive a ton of fatigue that really don't drive a lot of stimulus. And so if we can identify the ones that, that drive a lot of stimulus at a minimal cost of fatigue, well, then we can accumulate a ton more quality volume. Build muscle, build strength, improve our performance over time.
So. That sounds great, but how do we actually identify those movements? Examples tend to be helpful. So I'm going to give an example of a bad stimulus to fatigue ratio work we can abbreviate is SFR. Something like 10 by one on a max effort. Back squat. So. There's tension involved. We're moving a pretty heavy weight. Uh, so we're, we're probably going to get some muscle growth from this. But it's going to be minimal because at the end of the day, you're doing 10 total reps over the course of.
You know, gosh, if you do a max effort wrap, you're probably gonna have to rest some or 3, 5, 7 plus minutes in between each rep that you do. Uh, so not only is that not very time effective, but you know, you just spent 30 minutes or more actually. An hour doing 10 reps on squat. You might get some growth, but an incredible amount of fatigue. Your joints are probably going to be fairly stressed. There's even psychological fatigue that comes along with that.
So that would be an example of something that drives a as far as muscle growth goes. Very poor stimulus to fatigue ratio. A contrary example would be something like a, if we're going to stick with the squat example, if you're looking to grow your quad, something like a heels elevated, you know, slow east centric, or at least controlled east centric with maybe a little pause at the bottom. Uh, squat. Which, you know, the, the slow and control just would ensure that you're managing a weight.
Uh, that you can handle. That your structure can move efficiently. And then the heels elevated allows your knees to travel forward. More, placing more emphasis on your quads as you start to. Shoot your hips way back. You get into your hips and glutes way more. Which is not, I'm not saying it's a bad thing to train your hips and glutes, but generally when you're squatting.
If the goal in this example, particularly is quad growth, the elevated heels allows you to drive a ton of stimulus to the quad. So something like maybe three by 10. With heels elevated control the centric. Pause at the bottom. Much more stimulus for most people. Through the quads. And again, the weight is going to be something that you can manage. So your joints should be in a much better position, less fatigue.
Hopefully that the example of those two kind of helps paint the picture of stimulus to fatigue ratio. So, okay. That's great for quads, but how do you actually apply this? You know, systematically. For every body part. Again, this is where. Huge appreciation for Mike is retelling and what he's built To my knowledge. Nobody else has, has been able to build an indices quite like this.
So we're going to run through this briefly because it's relevant to BFR training, of course, but it's a foundational kind of structure that you can apply to your training that hopefully I know you came to this podcast for BFR specifics. Um, but you know, where it makes sense, try to apply broad training theory. Um, and this will tie into BFR specifically. So hopefully this drives a lot of value to your training, whether you're you've got BFR cuffs on or not.
Um, so I'm going to try to breeze through this as fast as possible. Uh, but this is the SFR indices. And there are two sort of scoring groups. We have stimulus and fatigue, very simple. Now the way this works is there categories that help us identify subjectively how much stimulus and exercise gives us? And then there are categories that help us identify subjectively again, how much fatigue that exercise comes with. So on the stimulus side, we have mind muscle connection.
Pump effect and muscle disruption. And we're going to score each of these. You don't actually have to do this on every exercise. Uh, but it's a good example to walk through and it'll at least put something in the back of your mind as you're training and selecting exercises, traditional or BFR moving forward. You'll kind of reference this and go, oh, that actually is pretty helpful. So I'm going to run through mind, muscle connection, pump effect, and muscle disruption and how the scoring works.
And then we'll move on to fatigue. So mind, muscle connection. Now, this is not everything we hear this term a lot. Uh, and a good example of this is, you know, you might feel your biceps a lot when you flex them in the mirror. Uh, if you were to just, you know, supinate your wrists, turn your Palm kind of towards the sky. And, you know, bring your hand towards your shoulder and then flex it as hard as you can. Your bicep is going to, you're going to feel that.
That's not driving a ton of muscle growth. Uh, so I'm certainly not suggesting that, you know, the mind muscle connection, just feeling it, uh, is necessarily everything for growth. But the perception of tension is a pretty good north star to include among Indic other indicators, which we'll get into, um, that you're you're training the target muscle. They are actually driving stimulus to that muscle. It is worth noting though that it's, this is going to be more relevant on higher load sets.
So when you're training with heavier weights, Um, it's going to be slightly less relevant with BFR. That's why I'm getting out of the way first. Um, because with BFR, the weights, the loads are going to be generally lighter. So it's going to be harder to kind of feel that perception of tension. If you're doing a set of 30. For the, for the, for the first bit, you might not feel at a ton. Uh, whereas something like a set of five. Uh, you're the perception of tension is going to be very high.
That said it's still important to factor. So mind muscle connection. This is part one of three under the stimulus category. And you're gonna rank this. Uh, in exercise zero to three, and I'll go through examples of all of this, uh, shortly. So mind, muscle connection, mind, muscle connection, part one, it gets a score out of zero to three. Next would be pump effect. So this is much more relevant. With BFR.
Uh, which we're going to hit on shortly, but, you know, What to look for is does the target muscle get a pump? And the pump is just another term for cell swelling. So your muscle cells are actually swelling. Uh, which is probably a pretty potent contributor of muscle growth itself. So the pump think about the pump and the burn in the target muscle. They're good indicators that the target muscle is doing work and you're also driving a specific. Muscle growth stimulus to those muscles.
So the pump effect, you're going to rank that zero to three. Obviously I should've clarified earlier. Zero would be the worst, you know, I don't feel any pump three being, you know, while my, my bicep feels like it's going to pop Again, I'll go through example shortly. So part three of the stimulus section is muscle disruption. So this can kind of be identified. Uh, by fatigue, so reduced capacity to move weight. From your first set to your third or fourth, whatever set.
Uh, did you, did your strength fall off? That's probably a good, pretty good indicator. Um, are you, does the muscle feel fatigued? Uh, the term perturbation gets gets used often. It just does something kind of feel off. A good example would be if you did, you know, three by 10 on squat, or, you know, A lower body workout. That feeling of trying to walk down the stairs. You can't quite put a label on it, but you just know, geez. You know, something is off here.
And then a lagging indicator that you'd be able to tell a day or two after your session is, are you sore? So is there soreness in the target muscle? That's another good indicator that you probably worked the target muscle. Uh, not saying that you need to be sore or that soreness is necessarily a good or a bad thing. It's just an indicator. Okay. Cool. So hopefully I'm moving through this quick enough. Uh, but that's muscle disruption.
So that's going to get a score of zero to three from the exercise based off. You know, fatigue, perturbation and soreness, potentially as a lagging indicator. So we have my muscle connection. Pump slash burn and then muscle disruption. Each of those, getting a score of zero to three. Uh, and that's going to round out our stimulus scoring. So I'm going to go through an example in a second, but you know, if each one of those gets a one, you've got a total of three. In this stimulus category.
Very obvious example there. I'm pretty sure everybody listening knows how to add one, three times, but Hey, here we are. Okay. All into fatigue. So. Three categories in the fatigue section. So we've got joint and connected tissue disruption, which I've talked about quite a bit on the show. RPE or rate of perceived exertion. And then unused muscle fall off. Simple again, each of these are going to get a score from zero to three. And I'm a briefly gonna run through each of these three. I promise.
We'll, we'll get moved on to BFR specifically shortly. So under the fatigue category, joint and connective tissue disruption, very relevant to blood flow restriction training. We know that higher loads tend to induce more disruption. Two joints and connective tissues. Which is why BFR can be of benefit because you can train it letter loads and kind of spare the joints, connective tissues, but separate topic. For right now. Uh, this joint and connective tissue disruption identifier is.
Does the exercise or movement cause a ton of pain. You know, and your knees, shoulders, elbows, et cetera. And this could be for several reasons, whether it's, maybe your technique It could just be, you know, your own biomechanics. It could be the machine set up. Not every machine is built for every person. Uh, sometimes the position that you need to be in on that specific machine creates unfavorable force factors.
I've sat on machines before where it just, I just couldn't get a rhythm going with it. There's plenty of machines out there ringing in my head right now that I'm like, I know I don't like that machine. Um, ultimately, you know, we want to train muscle. And if we're causing a lot of pain, In our joints and connective tissues, not only does that risk injury, but it also is going to reduce our output. Uh, which is not a good thing. So that's category one.
Um, under the fatigue section is joint and connective tissue disruption rank at zero to three. RPE is next. So most people are familiar with this term rate of perceived exertion. Uh, very simple. Just how much kind of global fatigue does this. Cause you. Again, it's not to say that fatigue is bad. It's just something that we need to manage. Uh, whether that's in our session or globally over time. And, you know, something like a heavy deadlift is going to be very systemically fatiguing.
Your, your whole body is going to feel some level of fatigue after, you know, 3, 4, 5, 6 sets of heavy deadlifts. And if you were to try to move from there, even in that same session into something like barbell bent, rose, your spinal erectors and just global, uh, fatigue level would probably prevent you from getting a ton out of those barbell rows, just because the deadlifts completely shot you. So high RPE exercises. Of course aren't bad.
Uh, but if muscle growth is the goal, we just need to consider fatigue and how it plays into our goals. For the remainder of, you know, the current session we're in. And the days and weeks ahead. So RPE category two on the fatigue scale is getting a zero to three ranking And we are on two unused muscle fall off. And this is just referencing muscles that aren't. Uh, the primary movers or the primary kind of target muscles in the movement.
Um, How much fatigue do they accumulate or how kind of worn out do they get by the end of your set sets, et cetera? Because if we have the assumption that, you know, the primary mover in an exercise is going to be getting the most stimulus, a good example would be, you know, a incline bench. Uh, we're generally doing that for chest. And we'll see that. Of course, the triceps in front Delta involved.
And they're going to get some growth from it, but incrementally compared to, or I guess, insignificant growth compared for the triceps specifically compared to maybe a tricep extension or a school crusher. So if we can just make sure to pick movements that. Uh, drive most of the stimulus to the target muscle. You know, a good example might be. It's a certain machine press.
When you do it, you kind of feel your chest, but you feel like your triceps are getting eaten up, but if you just move one machine over the other chest, press, the setup is just a little bit better where you feel mostly chest and minimal triceps, much better exercise for building the chest. In most cases. So unused muscle fall off. That's the last category in the fatigue. Section, and that's going to get a score of zero to three. So let's bring this all together.
We've got three categories for stimulus and three for fatigue. So as a recap, under the stimulus section, we have mind muscle connection, pump effect. And target muscle disruption. Then under the fatigue section, we have joint and connected tissue disruption. RPE rate of perceived exertion and unused muscle fall off. Let's go through an example and I'm going to do the math here for you. Let's let's look at a chest supported hammer row.
So for the stimulus side, mind muscle connection, let's say it's, you know, it's pretty good. Zero to three. We're going to give it to, you know, we feel a good deal of tension. Maybe not as, as much as some other movements. Um, but mind muscle connection. We're gonna give it two out of three. Pump effect your two sets in and you're back. Uh, it feels like it's going to explode huge pump effect. We're going to give that a three at a three.
Target muscle disruption by your, your last set, your, I mean, you can feel a noticeable difference in your back. strength is, has dropped off. Uh, you can feel kind of that perturbation or, you know, Disruption to the back. That's going to get a three. So you've got two for mine, muscle. Three for pump three for target disruption. Um, can everybody do the math here? B three plus three plus two. So stimulus is going to get an eight. And now we're on to fatigue.
So joint and connective tissue disruption, zero, you're thinking, you know, this movement feels great. My shoulders feel good. Elbows feel good, nothing, you know, no disruption of the spine. so that's a zero RPE. We're going to give a one, you know, you're feeling pretty good. Your chest is supported. So your spinal erectors aren't, you know, you're, you're not trying to fight or battle spinal flection. Um, RPE is a one and then unused muscle fall off. We're going to give this a two.
Let's say you feel a good deal of your biceps. Um, is what it is. So zero plus zero for, for joint disruption, one for RPE, two for biceps. So fatigue is going to get a score of three. So we have an eight in the numerator three in the denominator. So we're going to go eight divided by three, roughly 2.7. I should've just picked a round number for this example. Um, but what we're looking for here, Is the higher, the number that we end up with the better. So a good way to think about this.
Is you definitely want to be north of one because if we get an eight for a stimulus in that, like we did in that example, but if we also get an eight for fatigue, You know, eight divided by eight equals one. That means we roughly got the same amount of fatigue as we did stimulus. Not the best. Trade-off. Um, Again, I know that this is all subjective, but that's sort of until we have certain measurement technology that's, uh, maybe we'll be here in 2030 or 2050 that tells us all this information.
We kind of have to rely on some subjective, you know, self-analysis. So that is stimulus to fatigue ratio wrapped. Um, It's a good framework for identifying productive exercises and movements that stimulate the target muscle without a ton of teak spillover. Okay, tangent over and we are on to BFR specifically, but again, that's something that you can take with every movement you do. Uh, and of course you can take it with you on your BFR movements.
And now we're going to kind of now we're, we're filtering through that and we're the layer two is going to be okay. Now with that in mind, how do we choose exercises for BFR? And there's going to be a checklist of three things. So in general. You want to think distal think slow and think Rahm. So let's break each of these down. I promise it'll all make sense. So distal. Uh, by distill, I mean, muscles that are away from the cops.
So for your upper body BFR training, this would be, you know, your biceps, triceps, forearms for lower body. This would be your quads, hamstrings calves. No, I'm not going to go into a full review of blood flow restriction physiology on this episode, if you want more detail there, go back to our, one of our first episodes called what is BFR training?
Now, but in general, the muscles that are going to benefit the most from BFR are the muscles that are actually occluded or, you know, blood flow to them is restricted. So less blood and less oxygen going to them and no blood leaving the muscle. So because of that, we get cell swelling. We get metabolite accumulation. These all have a favorable impact. On hypertrophy. And if you know, a separate topic of endurance, um, Again, for more detail, you can reference plenty of our other episodes.
But for the purposes of this episode, think distal. Now there's a, a separate conversation around, you know, can you build your glutes with BFR? Or can you build your chest because. technically in, in, in the example of, uh, upper body training, your triceps will fatigue faster. Uh, so, you know, will you rely more on your chest, et cetera? That's probably a separate episode. Uh, but in general, you know, think distal.
If you're thinking about maximizing the effects of blood flow restriction training. That said. Uh, if you want to simply implement VFR into your existing routine. You know, and you're doing a ton of compound movements. There's absolutely nothing wrong with that. Pull-ups push-ups bench other multi-joint exercises. Uh, that involved multiple muscle groups. You can absolutely do those under BFR and actually some of the exercises that I'm going to reference on this episode.
Are, you know, multi-joint exercises. The suggestion around distill is just because we know, uh, from the literature that those muscles will capture probably the most benefit since they are actually the ones that are included. Um, But again, this is just a guiding framework. It's not dogma. And we'll talk more about compound movements under BFR. Another time. Okay. So that's step one. Think distal to think slow, which this probably sounds odd. When you first hear it. What do I mean by that?
What I really mean is think about low velocity movements. So we'll often see folks doing, you know, box jumps, power cleans, sprints. Med ball throws under BFR and w while I'm not necessarily saying there's no place for this. Actually that might be what I'm saying. Uh, It doesn't seem to adhere to specificity for any sort of fitness goals. So if you're training for max speed or power, you probably want to do so as close to max output as possible. Um, and we've got BFR cuffs.
Preventing blood flow into your limbs, blood and oxygen. Uh, just seems to violate that principle. and if you're training for muscle, we know just sprints box jumps, power cleans. Aren't the best strategy. They're awesome. And they certainly can help make you faster, more powerful. Uh, but in the context of muscle growth, don't make a ton of sense. So, this is why I say to think slow.
And it's not to say that you have to physically move slow on the movements you're doing, you know, on squats or whatever else. Just that you should broadly stick to exercises where the resistance, the load or movement naturally puts you at a kind of controlled velocity. So really just to think about the simply. Not sprints jumps or Olympic lifts. Okay, so that's 0.2, think slow 0.3. Think rom, so range of motion.
What I mean, here is in general, greater range of motion, puts more total tension through muscle fibers, which is good for growth. So even aside from BFR, it's a, it's a good principle to remember. But with BFR specifically. We're generally going to be sticking somewhere in the 15 ish to 30, 40 rep range. So this means the loads are going to be light, something like 20 to 30% of your one RM. And if you pick a movement with.
You know, low range of motion or minimal range of motion, you may never get close enough to failure. A good example would be something like quarter squats. Some people. Love to do those. It's one thing when you're super loaded. E super heavy, loaded, super loaded. Uh, when the load is super heavy, um, you on a set of five or something, you would actually understand if you're getting close to failure because the load is so heavy.
Uh, that the tension would be pretty high, but how are you going to. Understand if you're close enough to failure on a set of 30 reps of quarter squats. You may end up just more frustrated than anything else, because you'll feel like. I am fatigued, but I also feel as though I could do another hundred reps. Where greater range of motion. Uh, just as a principle also helps you adhere to the other points I mentioned, because it kind of pushes you to more controlled, low velocity movements.
Um, but again, I'll say this a hundred times. There's no dogma here. Uh, there's probably always cases where there may be an override on these principles, but a majority of time, I think they provide a pretty good framework for what exercises to think about. When you're doing BFR. So bringing this all together, I promised that I would give specific examples. So let's go through upper body first. So remember we're thinking distal, we're thinking slow. And we're thinking range of motion.
So. Any bicep curl variation. There's. It probably a hundred different bicep curl variations, cable curls. Dumbbell curls, barbell curls. Uh, of course. Curls with different setups on the cable. Uh, and then with triceps, you have cable extensions. There's a ton of setups you can do for tricep. Extensions. Skull crushers be another one. Uh, any sort of tricep extension movement. Uh, dips are another good one and they are a multi-joint movement.
Like I mentioned earlier, there'd be a couple of those. And in general, if you're thinking of focusing on triceps, And you may feel this. If you do dips, if you bring your feet, if you try to shift your kind of center of gravity, where your feet are behind you. Um, that's going to put more emphasis on your chest. And then if you do the reverse, the farther, your feet travel forward, or your lower body travels forward in front of you. The more emphasis that'll put on your triceps.
Um, So dips with a tricep emphasis or tricep push-ups push-ups with the focus on tricep. These are a couple. Good examples of bicep and tricep movements you can employ under BFR. But again, absolutely no problem at all. With compound movements, pull ups. Rose. You know, bench. Uh, but again, I mentioned think distal. So in most cases, the benefit of the muscles that are going to benefit the most are going to be those that are distal to the cuff.
And then lower body quad extensions are a good one. Uh, for some reason that exercise seems to be contentious. Some people seem to believe that it is going to make your knees fall off. Uh, but quad extensions, hamstring, curls, seated, or prone. Uh, calf raises different cafes variations. squats, of course, there's a ton of variations of squat. That makes sense here. Goblet squats, uh, that I think about BFR is that generally the load is lighter. So it, even for somebody who can squat.
You know, the house. That makes a goblet squat a little bit more realistic of a movement because you're, you're working at something like 20 to 30%. Of your one RM. Uh, so just doing the math. If you could squats, you know, 200 pounds that that'd be a 40 pound, 40 to 50 pound ish dumbbell or GABA, you know, kettlebell, whatever you're holding. Not, I'm not saying 200 pounds is squatting the house, but if we scale that up 400, you're looking at, you know, maybe an 80 to a hundred pound.
Kettlebell. So. It makes it a little bit more feasible. A front squat. Of course I mentioned earlier, elevating the heels will drive a ton of stimulus to the quads. And then we've got RDE, ELLs, uh, reverse or walking lunges. Split squats are an awesome one. There's certainly more, I'm not listing here, but this should be at least a good place to start. As far as load and rest goes. Think about generally something somewhere around 20 to 30% of your one rep max, in most cases.
So something that you can handle about 15 to 30 or 40 reps with. Uh, if you want more detail on this. Listen to our 30 15, 15, 15 protocol explained episode. Uh, but for now that should wrap up this episode. So to recap, rank exercises based on stimulus and fatigue for any exercise, again, thanks to. The people over at RP, Dr. Mike for this one. And then as it relates to BFR, think distal think slow and think range of motion. I hope this episode was helpful. Stay strong, have a great week.
And we'll see you guys on the next episode.