Blood Flow Restricted Training for Endurance Performance Gains

Blood Flow Restricted Training

There’s a type of training regimen out there that you may not have thought of using before. It’s called Blood Flow Restriction Training. I don’t know about you, but even the name kind of freaks me out a bit. I mean, cutting off my blood flow so that I can increase my performance? Are you crazy? But after delving into the research of it and having first-hand experience with it myself, it’s not as scary as it sounds, and it’s plenty effective.

How Does It Work?

Simply put, Blood Flow Restriction Training, or BFR for short, is a type of training in which you reduce the load and intensity of the exercise, while simultaneously restricting the blood flow to the working muscle.

But what does cutting off the blood flow actually do to the working muscle?

Well, there is still much debate on the topic, but many experts believe that cutting off the blood flow to the working muscle creates a metabolic overload that is usually seen in muscles that are performing higher intensity work, such as lifting very heavy weights or running at a very fast pace [1]. Not only this, but it also may be related to the decrease in myostatin that this type of training creates. Myostatin is a protein that actually inhibits the building of muscle and strength. Something that we do not want for sure. #gainsbro

What Does This Have To Do With Endurance Training?

Although much of the literature that exists on BFR revolves around resistance training, there is still plenty of evidence to show that it has benefits for endurance athletes as well.

One 2018 study illustrated that applying BFR to an 8 week cycling protocol was able to enhance quad strength and hypertrophy, as well as VO2 max more significantly compared to the group who performed the cycling protocol without the BFR [2]. What makes this very surprising is that this was achieved while producing less total volume than the non-BFR group. This could be a huge benefit from the time crunched athlete!

Implications for the Time Crunched Athlete

What we should also look into here is the greater opportunity for efficiency that BFR gives us as endurance athletes. If you’ve read my previous articles, you’ll know that it’s important to not only train for your particular activity but to also add in occasional strength training sessions throughout the week, as this is able to enhance your performance. However, the problem with this lies with the fact that it requires more total training time. This potentially takes away from other obligations you may have in your life, which can be quite inconvenient.

But with BFR, you’re able to simultaneously receive a strength training stimulus whilst also completing your regular endurance training activities. In the same study, an increase of 9% in strength was seen. While not as notable as a standard resistance training program would provide, it provides the endurance athlete with a “best of both worlds” scenario.

Interestingly enough, cross-sectional area was increased to the same level as resistance training would provide. Cross-sectional area is a measure used to quantify the size of the muscle and is most often utilized as a measure of hypertrophy. Though not the only factor associated with hypertrophy, evidence appears to be leading us to the fact that endurance training with BFR will be able to provide us with simultaneous strength and hypertrophy gains.

This isn’t just shown in a study in isolation either. What can be known as a benchmark in the BFR research world is a study by Ozaki and colleagues that showed us how 20 minutes of walking 4 days a week for 10 weeks was able to significantly increase the cross-sectional area of the thighs compared to walking without restriction [3].

Increased Variation & Possibilities

Probably the most remarkable aspect of BFR is the number of ways it allows you to vary up your training, while still providing you with the same amount, if not possibly more, of the training adaptations that you’re after.

Let’s look at injuries for example. When we’re pushing our bodies to the limit each and every day, they’re bound to happen at some point in our training career. With BFR, however, it allows us to train with much less load and intensity, which are two factors that would most certainly aggravate the injury further.

Another benefit that can be received from BFR during injury is the blood flow restriction aspect itself. One of the blood’s primary functions is to provide nutrients to organs and tissues throughout the body. What BFR does is keep the blood in the working muscle for longer periods of time. In essence, we are speeding up its recovery time as well, given that the working muscle is the one that is injured, or is associated with the injured tendon, ligament, or other neighboring tissue.

Another way to look at the possibilities with BFR is simply providing variation of to your training regime. The mind is probably our most important training tool. And if it begins to wander and won’t allow us to focus, then our training sessions are going to be half-assed and subpar at best. BFR provides a unique and non-traditional way to progress your training. Throwing this into your routine every so often and combining it with your standard training schedule will allow you to stave off boredom in your training. In this way, you’ll be able to stick to your training goals for the long haul… Remember, Fitness = Consistency over Time.

Simple BFR Protocol

  1. Choose a blood flow restriction device.

    This can be a compression band, wrap, or other tourniquet-like device.

  2. Wrap the material around your upper arm or upper thigh.

    DO NOT wrap your lower leg or lower arm. Doing so can result in nerve damage. ONLY wrap the UPPER portions!

  3. Choose your pressure.

    I suggest using a pressure of 4-5 / 10 for the upper body and 6-7 / 10 for the lower body.

  4. Do your workout.

    I’d suggest cutting the workload down by HALF. This can be accomplished by reducing reps, weight, or sets. Try it once a week to see how it affects your other training sessions.

BFR Example

Below is an example of an athlete utilizing BFR during a training ride. Notice he has the compressive force around the UPPER portion of his legs.

***You should consult your physician or other health care professional before starting this or any other fitness program to determine if it is right for your needs***


More and more research is being released each and every day regarding BFR, both in the realms of resistance training and endurance training. We’re really beginning to see how truly beneficial this type of training can be to stave off boredom, aid in rehabilitation from injuries, and even to help older individuals who may have limited functionality to train.


  1. Loenneke, J. P., Abe, T., Wilson, J. M., Ugrinowitsch, C., & Bemben, M. G. (2012). Blood Flow Restriction: How Does It Work? Frontiers in Physiology, 3. doi:10.3389/fphys.2012.00392
  2. Conceição, M. S., Junior, E. M., Telles, G. D., Libardi, C. A., Castro, A., Andrade, A. L., . . . Chacon-Mikahil, M. P. (2018). Augmented Anabolic Responses following 8-weeks Cycling with Blood Flow Restriction. Medicine & Science in Sports & Exercise, 1. doi:10.1249/mss.0000000000001755
  3. Ozaki H, Kakigi R, Kobayashi H, Loenneke JP, Abe T, Naito H. Effects of walking combined with restricted leg blood flow on mTOR and MAPK signalling in young men. Acta Physiol (Oxf). 2014;211(1):97–106.

Strength Training Programming for Endurance Athletes

In my last article, I discussed WHY it’s so important to implement strength training into your endurance training regime about 2-3x per week, especially during your preparation phase. Then I gave you a little preview of what such a resistance-training program would look like.

Well, in this installment, I’ll dive in deeper into HOW you can structure your very own strength training program that best suits your specific endurance training goals. We will be going over example training protocols for:

  • Long-Distance Runners
  • Cyclists
  • Cross-Country Skiers
  • Long-Distance Triathletes

After examining the rhyme and reason as to why these plans are structured the way they are, you’ll be able to copy these exact workouts to introduce yourself to the world of strength training. After you gain the necessary experience, you’ll be able to tailor any of these programs to your specific needs and preferences!

Long-Distance Runners

A systematic review, which is a collection of many studies that are used in order to come to a conclusion, found that the most significant improvements found in running after strength training was best illustrated in time-trial performance, running economy, and surprisingly even VO2 max [1]. However, it’s important to note that improvements in VO2 max were only seen with explosive and reactive-strength training, which are essentially ways of training for both power and strength, as opposed to just strength.

This type of training consisted of sprinting, jumping, and strength training exercises. Examples of these types of exercises included

  • Running sprints (5-10 sets of 30-150 meters each)
  • Jumping exercises (calf jumps, hurdle jumps, squat jumps)
  • Isolation exercises (knee extensions, knee flexions)

The primary principle that the subjects followed during this time was a focus on low loads and high-performance velocities [2].Because of this, if we want to primarily increase our VO2 max levels, which is the priority of many long-distance runners, then training for power first and strength second would be the best move here.

Example Training Program for Runners

Exercise Sets Reps Rest Time
Sprints 5 100 meters 30 seconds
Squat Jumps 2 15 30 seconds
Squats 2 15, 20 30 seconds
Knee Extensions 2 20 30 seconds
Knee Flexions 2 20 30 seconds


Optimal training for cyclists is going to look quite a bit different than for what’s best for runners. This is due to the greater emphasis on lower musculature strength in cyclists compared to runners.

For cyclists, it’s best to participate in heavy-load strength training. More specifically, maximal velocity should be achieved by the athlete while in the concentric phase (the “lifting-up” phase), as opposed to pure explosive power throughout the entire lift. While a focus on power is still important, placing greater importance on strength will help cyclists to increase maximal velocity during each pedaling cycle.

Example Training Program for Cyclists

Exercise Sets Reps Rest Time
Front Squats 2-3 6-10 90 seconds
Single Leg Stiff-Legged Deadlift 2 8 60 seconds
Bulgarian Split Squat 2-3 8 60 seconds
Kettlebell Swings 2 15-20 30 seconds

Cross-Country Skiing

The primary difference here with cross-country skiers is that they’re going to have to concentrate more so on upper-body strength as opposed to lower-body strength. Exercises that would be included in an optimal protocol are lat-pulldowns and triceps presses [4].

This aforementioned study primarily illustrated to us that strength training shows its improvements most in the double-poling performance of cross-country skiers, as well as time to exhaustion.  This is great news, as this proves to us that performance is able to be maintained even after long-duration exercise.

Since there isn’t nearly as much data available on strength training’s effects on cross-country skiers, practical considerations for sets and reps aren’t as apparent. However, given the nature of the sport, it can be safe to assume that moderate loading and rep ranges would be a well-tolerated. Cross-country skiing doesn’t require as much pure strength as cycling or as much explosiveness as running, so less emphasis can be placed on these variables during the strength training sessions.

Exercise Sets Reps Rest Time
Lat Pulldowns 3 10 60 seconds
Dumbell Row 2 per arm 10 60 seconds
Bench Press 2 10-12 60 seconds
Squats 2 10-12 60 seconds
Triceps Pushdown 2 12-15 60 seconds

Long-Distance Triathletes

For these types of athletes, the most significant improvements were found in peak treadmill velocity (VO2 max) following a maximal-strength training intervention [5]. Hopping power (to determine maximal mechanical power) and training economy were shown to improve in the group that performed strength training compared to the group that only performed endurance training.

The training protocol that would be most optimal for this type of athlete would be one that focused on primarily lower-body exercises, such as the leg press, squat, and leg extension, with occasional upper-body exercises thrown in. It’s important for these athletes to train quite heavy; in the 3-5 rep range most of the time, occasionally increasing the reps to avoid injury. These athletes need not be as explosive as the previously mentioned types of athletes. Rather, the focus on strength is more important.

Exercise Sets Reps Rest Time
Barbell Row 2 5 90 seconds
Lunges 3 6-8 60 seconds
Back Squat 2 5 90 seconds
Glute-Ham Raise 2 8 45 seconds
Dips 2 5-8 60 seconds

Important Consideration

It’s important to remember what the common theme is here. In order to increase your endurance performance with strength training, you must follow the theme of what’s called specificity. Basically, specificity is training that involves similar muscle groups and imitates the sports-specific movements of your particular activity [3]. The reasoning behind this is the adaptations that occur in the nervous system during training, as well as structural changes that happen inside the muscle fibers.


Now go give these programs a shot and see for yourself the benefits you’ll see from them. Again, as you become more accustomed to this type of training, you can gradually ramp up the difficulty level by increasing the weights, reps, sets, and decreasing the rest times. After that, you can start to experiment with different exercises so that you can see what works best for you.

Good luck!

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1.Beattie, K., Kenny, I., Lyons, M., & Carson, B. (2014). The effect of strength training on performance in endurance athletes. Sports Medicine, 44(6), 845-865. doi:10.1007/s40279-014-0157-y.

2.Mikkola, J., Rusko, H., Nummela, A., Pollari, T., & Häkkinen, K. (2007). Concurrent Endurance and Explosive Type Strength Training Improves Neuromuscular and Anaerobic Characteristics in Young Distance Runners. International Journal of Sports Medicine, 28(7), 602-611. doi:10.1055/s-2007-964849

3. Rønnestad, B. R., & Mujika, I. (2013). Optimizing strength training for running and cycling endurance performance: A review. Scandinavian Journal of Medicine & Science in Sports, 24(4), 603-612. doi:10.1111/sms.12104

4.Øfsteng, S., Sandbakk, Ø, Beekvelt, M. V., Hammarström, D., Kristoffersen, R., Hansen, J., . . . Rønnestad, B. R. (2017). Strength training improves double-poling performance after prolonged submaximal exercise in cross-country skiers. Scandinavian Journal of Medicine & Science in Sports, 28(3), 893-904. doi:10.1111/sms.12990 5. Millet, G., Jaouen, B., Borrani, F., & Candou, R. (2002). Effects of concurrent endurance and strength training on running economy and .VO(2) kinetics. Med Sci Sports Exerc, 34(8), 1351-1359.

Does Strength Training Improve Endurance Performance?

So, you’re looking to increase your cycling speed, your mile time, or improve whatever other endurance goals that you may have. You bring this up to your friend; a fellow cyclist. He tells you that he’s started to get more serious about lifting weights in the gym and has added a strength training routine to his cycling regimen. “But how would that improve your cycling ability?” you think to yourself. “That doesn’t make much sense.”

Does Strength Training ACTUALLY Help With Your Cycling Abilities?

It actually makes quite a bit of sense. So much so that there are quite a few studies illustrating your friends’ case to be true. In one study of 19 elite female duathletes (meaning that they were both runners and cyclists), they were divided into two groups; either endurance training alone or endurance training combined with strength training. The strength training group performed lower-body exercises such as squats and leg presses, progressing to heavier weights as the 11-week study continued.

What this aforementioned study primarily discovered was that including strength training in conjunction with their endurance regimens was able to increase the athletes’ power output during 5-minute maximal cycling testing. Plus, this was performed in a fatigued state, as they had already performed both the strength training protocol as well as a 180-minute prolonged cycling session beforehand. Another related study with moderately-trained cyclists illustrated a significantly improved cycling economy and time to exhaustion after strength training. So we can definitely see here how strength training can help out with endurance performance!

Not so Fast, my Friend…

Although strength training is a great tool for us endurance athletes, it’s also not going to be your primary training focus. You should always prioritize your cycling-specific training over strength training. I say this because although significant parameters such as cycling economy and time to exhaustion were improved, more important endurance performance variables like VO2 max did not improve. They stayed exactly the same between both the study groups.

How About for Running?

There is much more data available about this than there is for cycling. In fact, there is so much evidence that authors of a 2018 paper were actually able to publish a systematic review on the topic. Basically, a systematic review is the combination of the results of similar studies within the same topic of examination.

Here, it was illustrated that for long-distance runners, running economy was improved by as much as 2-8% in 20 out of the 26 studies. Interestingly, this was seen in runners of all levels of experience; ranging from moderately-trained to elite-level athletes. And although adding strength training won’t improve your VO2 max as previously mentioned, it doesn’t hinder it either. This is a major plus, as there is a commonly misleading belief in the endurance athlete community that participating in strength training will cause a shift in adapting too much to non-aerobic training and will cause them to lose their endurance performance since these are two very different training stimuli. Fortunately, this doesn’t appear to be the case. The ability to train concurrently, meaning the utilization of two different training methods in order to reap the rewards of both, is definitely possible while mitigating any potential negative effects.

Inter-individual Variability

However, what we do have to keep in mind, just like with the cycling studies, is that inconsistencies do exist in the scientific literature. This is due to several hosts of factors, such as differences in a studies methodologies, which would be the way in which the researcher conducted the study. This would include things such as what variables they measured or what sort of training program they put them through. Also, science has a natural error associated with it due to the number of differences, or what we call in the scientific literature, “inter-individual variability”, between athletes. This is why researchers randomize subjects in their studies, however, although this may limit the effect that this variability plays, it still does exist to a slight degree.

Because of this, applying these previously mentioned strength training recommendations to your routine should be made with caution. Even though “the science” may say it works, everybody is unique and responds optimally to different things, so utilizing trial-and-error here is a must. But you’d be missing out if you didn’t at least try to apply strength training to your endurance routine for at least a 6-week time frame to truly see if it makes a difference in your performance.

How Do I Get Started?

I’d replicate what many of the studies in the systematic review used. In this way, you’d be using a training program that has been previously validated by researchers, which is what you want. This is what most of the studies in the systematic review used for their training programs:

Training Program Basics:

  • 2-6 sets of 3-10 reps per exercise @ 70% of their 1-rep max
  • 2-3x per week on average
  • Utilize at least 1 multi-joint exercise, such as a squat or leg press
  • Use a combination of both free weights and machines
  • Utilized the concept of Progressive Overload, which basically states that you must increasingly challenge your body with each and every workout, such as by increasing weight and reps, decreasing rest time, etc.

I’d start out on the lower end of the set range, such as 2-3 sets for about 8-10 reps, which would allow you to work with lighter weights. In this way, you avoid burnout and you’re more likely to stick with the training program. Then, as you get stronger, you can progress from there.


So give this a shot. Chances are, as illustrated by the vast amount of scientific literature that’s available, it’ll help you improve your endurance performance more than your previously-held beliefs led you to think. The great thing about this is that it doesn’t take much additional time either; only 2-3x per week for about 45-60 minute sessions. This includes approximately 45-60 second rests between sets, so it won’t fatigue you too much, allowing you to keep up the same intensity in your endurance-specific training. Alright, now you’re armed with the tools, now go put it to good use. Let me know how it works out for you!

Looking for a strength and conditioning plan tailor made for endurance athletes? Check out our plan here!

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Blagrove, R. C., Howatson, G., & Hayes, P. R. (2017). Effects of Strength Training on the Physiological Determinants of Middle- and Long-Distance Running Performance: A Systematic Review. Sports Medicine, 48(5), 1117-1149. doi:10.1007/s40279-017-0835-7

Sunde, A., Støren, Ø, Bjerkaas, M., Larsen, M. H., Hoff, J., & Helgerud, J. (2010). Maximal Strength Training Improves Cycling Economy in Competitive Cyclists. Journal of Strength and Conditioning Research, 24(8), 2157-2165. doi:10.1519/jsc.0b013e3181aeb16a

Vikmoen, O., Rønnestad, B. R., Ellefsen, S., & Raastad, T. (2017). Heavy strength training improves running and cycling performance following prolonged submaximal work in well-trained female athletes. Physiological Reports, 5(5). doi:10.14814/phy2.13149