| | | Occlusion Training 102: Applications

Author / Carl Case


In Part 1, we established the mechanisms of occlusion training and showed that it wasn’t just a gimmick. In Part 2, we are going to explore the possible applications of the training. Because of the mechanisms and benefits, it has lead researchers to start exploring other areas this style of training can be implemented. It can be a valuable tool used for a multitude of scenarios which go deeper than just hypertrophy. Remember: determining the proper application of any training “tool” comes down to the answer to our golden question…. What are you training for?


Increase in muscle hypertrophy: Less = More

The mechanisms of occlusion training proposed were increased fast-twitch recruitment, elevated free testosterone, growth hormone secretion, and cellular swelling, all of which have positive effects for creating a larger muscle.  Interestingly, studies have shown that hypertrophy can be achieved in a shorter period of time when compared to normal heavy resistance training. Studies by Takashi Abe and colleagues found that vascular blood flow restriction training can produce hypertrophy gains in little as one week of training. It isn’t uncommon for a strength and conditioning coach to have limited time with their athletes in between seasons. In this case, occlusion training could be just the form of accelerated adaptation needed.

Expansion of overall strength: Beyond Numbers

A number of studies have shown a positive increase in strength when comparing groups who supplemented with occlusion and those that did not. In a study conducted on NCAA Division II American football teams, there were significant increases in squat 1RMs for those athletes that used traditional high intensity training supplemented with occlusion training when compared to the other three training programs (2). Another study also used football players and investigated the effects of occlusion training on strength, but this time from Division I. Their study found an increase in the squat of 8% compared to the 4.95% of the control group. Bench press showed a significant improvement as well, 7% compared to the 3.2% of the control group (5).

Interestingly, in a study that was done on rugby union players they not only saw an increase in squat and bench 1RMs but also in the more explosive test of maximal sprint times and counter-movement jump power (1). A big driver of these results was the increased fast-twitch muscle fiber recruitment that occlusion training brings.


Post injury intervention

We know that low intensity resistance exercises combined with occlusion training have a positive effect on growth hormone secretion as well as hypertrophy. Researchers have started to look into how this can be implemented post-op to diminish muscle atrophy.

One study examined two groups; one group received an occlusion stimulus while the other did not. This was examined and implemented from the third day post-op to the 14th day. This is a crucial time period because the fastest rate of muscle atrophy takes place within the first initial one to two weeks, after which the rate slows down (6). When measuring the knee extensors and flexors the the non-occluded group had muscle atrophy of 20.7 +/- 2.2% and 11.3 +/- 2.6%, while to occlusion group had muscle atrophy of 9.4 +/- 1.6% and 9.2 +/- 2.6%. This indicates that a postoperative intervention of occlusion training diminishes the atrophy from disuse (3).

Yoshiaki Sato, the creator of the KAATSU Training System, fractured his ankle and damaged the ligaments of his knee, resulting in the need for a cast. He repeatedly applied KAATSU pressure on and off while doing isometric exercises for 30 seconds on and a few seconds off three times per day. When the cast was removed the doctors were astonished with minimal muscle atrophy.  Being a month out from ACL reconstruction myself, I found the positive effects occlusion training has on the muscle atrophy to be very interesting.

Elderly Populations

Occlusion training isn’t just for us meatheads. As we age there is going to be a progressive loss of muscle strength and mass. Because of this, increasing muscle strength and mass are of great importance to the maintenance in elderly. Resistance training is encouraged to offset this process, however it may not be suitable for all of the elderly population.

Studies are starting to look at how it can be used as an alternative with elderly populations. In a study done with 14 men and nine women, with age ranging from 59 – 71 years old, they found that occluded training produced similar results to that of the heavy resistance group in regards to muscle strength and size. Now, just because the occlusion group wasn’t superior doesn’t mean there is no use for it. That is actually where the benefit lies. We can decrease the load by 50% but still drive the same adaptation.

During the 2016 Power Athlete Symposium, Dr. Tom presented occlusion training and mentioned that with his elderly clients he wasn’t even loading them. He simply occluded their legs and had them walk. The possible implication of using occlusion training for elderly populations could be huge in helping them maintain their independence as well as avoid injuries (4).  

In-Season Training Use

In studies conducted by Takashi Abe and his colleagues, results show that occlusion training minimizes muscle damage, perceived muscle soreness, and reduces delayed onset muscle soreness. All of these would be beneficial to help athletes in-season maintain overall strength and size. The problem with normal heavy resistance training is that volume is more difficult to recover from than intensity. This is the reason we reduce volume during the in-season training protocol. In doing so, we allow our athletes to be better recovered; however they lose the benefits of volume.  

Occlusion training could be a supplemental component to reap the benefits of volume but not suffer the negative side effects.

occlusion training
PAHQ Taking occlusion training to the next level.

Ain’t nothing to it, but to do it!

Now, I am sure after reading Part 1 and now Part 2 you are dying to give occlusion training a go if you haven’t already. Here is a workout to get you started with that we did at the Power Athlete Symposium.

On the proximal end of the bicep wrap a band tight enough that it would rate a 7/10 on tightness, but error on the side of loose, rather than too tight especially in the beginning.  Remember: you should maintain capillary refill. Start with 30 reps of plate curls with a 25 pound plate. Then 30 reps of reverse curls. Rest 30 seconds and then start the next set. Rest 30 seconds between each set. Lastly, and this part is critical, don’t forget the post occlusion training selfie!

Plate Curls x 30. 20. 20. 20

Reverse Curls x 30. 20. 20. 20



  1. Cook, C. J., Kilduff, L. P., & Beaven, C. M. (2014). Three weeks of occlusion training can improve strength and power in trained athletes. Int J Sports Physiol Perform, 9(1), 166-72.
  2. Luebbers, Paul E., et al. “The effects of a 7-week practical blood flow restriction program on well-trained collegiate athletes.” The Journal of Strength & Conditioning Research 28.8 (2014): 2270-2280.
  3. Takarada, Y., Takazawa, H., & Ishii, N. A. O. K. A. T. A. (2000). Applications of vascular occlusions diminish disuse atrophy of knee extensor muscles. Medicine and science in sports and exercise, 32(12), 2035-2039.
  4. Vechin, F. C., Libardi, C. A., Conceição, M. S., Damas, F. R., Lixandrão, M. E., Berton, R. P., … & Ugrinowitsch, C. (2015). Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly. The Journal of Strength & Conditioning Research, 29(4), 1071-1076.
  5. Yamanaka, T., Farley, R. S., & Caputo, J. L. (2012). Occlusion training increases muscular strength in division IA football players. The Journal of Strength & Conditioning Research, 26(9), 2523-2529.
  6. Verkhoshansky, Y., & Siff, M. C. (2009). Supertraining. Verkhoshansky.


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Carl Case

Carl Case has been an athlete his whole life, playing both football and rugby in high school. After high school, he directed his focus to rugby where he went on to become a collegiate Midwest All Star. Carl continues to play rugby on a mens team near South Bend, and was part of a National Runner Up team. He found CrossFit and then Power Athlete as a way to fuel his rugby performance. He has been following the Power Athlete methodology since it’s launch in 2009 and attended his first CrossFit Football seminar in August of 2009.

After an introduction to CrossFit in 2007, Carl became a certified coach in 2009 and co-owner of CrossFit South Bend in 2011. In addition to coaching CrossFit and Power Athlete inspired classes at the gym, Carl has been coaching high school rugby since 2009. He uses the CrossFit Football and Power Athlete concepts to help his young athletes identify their goals and provides pointed instruction to help achieve those goals.


  1. Ingo "Joey Swole" B on March 30, 2016 at 6:53 pm

    Anecdotally, I’ve found that wearing a band at say, 4-5 on the tightness scale for the entire workout, regardless of what is assigned, results in hypertrophy. After about 2 weeks, I noticed a difference.

  2. Rego on March 30, 2016 at 9:59 pm

    We’re you supaswole Info? 8)

    Coming off my VBall season I’m pretty wrecked (worse thing is a pinched C6 nerve which is causing some numbness in my index finger and thumb. Sounds like I could reduce the weight and still get some gains.

    • Carl Case on April 20, 2016 at 9:26 am

      @Rego a lot of the studies compared loading of 20-30% with occlusion to normal resistance training of 70%, and they showed that they drove similar adaptations, and in some studies occlusion was superior. So yes you could train with lighter loads while drive the same adaptations that you would see at higher intensities.

  3. Matt S on March 30, 2016 at 11:29 pm


    Great article. I read article 1 back when it was posted and thought “I should probably try that at some point” but then made the usual mistake of thinking “I’ll research that later”. Fast forward a few weeks and I ruptured my right achilles (actually tore it in half), a week later I had surgery and two weeks after that I was staring at my atrophied leg as it was being cut out of a cast. It looked like a foreign object but over the past 4 weeks it has started to come back to life. The speed at which the leg shrank and subsequently grew makes me think that I experienced sarcoplasmic atrophy and hypertrophy (which is the cellular swelling that you eluded to in article 1?). All of the benefits that you’ve listed make occlusion training (seem) like the perfect weapon to assist my rehab. I was thinking that I could A. wrap my calves when performing calf raises (with a slow eccentric component to carefully load the tendon) and B. Wrap the top of my thighs / hamstrings when performing wall squats (wall squats mean I can get some weight through my legs with limited risk of going into dorsiflexion and re-rupturing my tendon). Obviously I’d be dumping a lot of blood into a surgically repaired area. From my basic understanding of healing this would be a good thing but I’d really like someone to co-sign my bullshit! I’m also unsure as to whether I would experience increased tendon healing using the occlusion method. My guess would be yes but it is only a guess!
    Feel free to tell me to pull my head in and / or fuck off and google it for myself (which would be implied by not replying) but you are obviously knowledgeable on the subject (and the subject of tendon rehab!). I will do whatever it takes to go from guy with 1.5 legs to normal human as quickly as possible (I am already on track with my diet, sleep, supplements, rehab exercises, physio and I’ve even been using a marc pro extensively – the hardest thing for me is being patient).

    Thanks for taking the time to read this selfish post,

    Ps I’m 7 weeks post surgery on Monday. Should be able to get rid of the walking boot next week.

  4. Ingo "Joey Swole" B on March 31, 2016 at 7:30 am

    Yeah, Rego. When all my blocks were coming off my biceps, I knew something had changed.

    Glad to see you’re still around. Get well soon.

  5. menacedolan on March 31, 2016 at 8:54 pm

    Fantastic work @carlcase!

    Matt S, speak to your PT/ATC that is doing your rehab. Bring all the information you can, also include your Orthopedist that did the surgery. As long as there is no subsequent swelling/inflammation after your training w Occlusion I don’t see the downside. Increased healthy blood flow and helpful hormone levels are all paramount to accelerated healing. I have used it on rehab patients of mine and all has turned out positively. They were all knee injuries though, I have yet to have an ankle/Achilles to work with this season.
    Post back after you speak with both of your Med Professionals and let us know what they said.


  6. Matt S on April 11, 2016 at 2:32 am


    Firstly thanks for the response. Your positive experiences were enough to volunteer myself as a guinea pig or lab rat or space monkey (or whatever).

    I no longer have access to the registrar or surgeon who preformed / was present for the operation as I went through the public system in a very busy hospital. Those guys spend all of their day either operating or giving 60 second slots to many, many people. They do a great job but they have no time to read new research and stay up to date on cutting edge methods. I was given conflicting advice post surgery about weight bearing: surgeon told me no weight bearing and blood thinners for 6 weeks then did a back-flip on that advice when I walked back into the hospital 5 weeks later after doing my research and finding that early mobilisation and weight bearing is key for accelerating recovery. As a result they were never going to be able to help in this discussion but because I didn’t listen to them I am well ahead in terms of the “normal” recovery time frame.
    I did however have a long discussion with my physio and we decided that it was fine for me to give it a go as long as I start with little to no weight, a 5/10 occulusion and significantly less reps. Once there are no adverse effects then I can move to a 6 and then 7 before moving up reps and eventually adding weight. As I’m only 8 weeks post surgery I’m going to stick with seated calf raises but I have got to a 7 out of 10 with no weight for 4 sets of 10. I can see the calf has definitely put on some size already (but I am also walking unassisted now so that will have also caused a change). Once I get to 5 sets of 30,20…20 I may add weight but that is probably a long way off. I guess as with all things rehab it is important to test boundaries slowly and methodically as opposed to jumping in with both feet and breaking 1!
    I really hope that in 3 months I’ll be back playing and I can also post a picture of some massive calves (I am definitely on course for that goal and this should help)! Either way I will post back.


    • Carl Case on April 20, 2016 at 9:22 am

      Matt I would definitely default to @Menacedolan as far as rehab protocols go. Definitely keep us updated on how your rehab is going, and what role occlusion played in it.



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