Pneumatic Compression vs Blood Flow Restriction for Muscle Soreness

Overseen By Bailey McLagan, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Southern California

Must be taking: Hormonal contraception

Disqualifiers: Blood clots, Cancer, Fractures, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

Duration: 1 day

33 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether blood flow restriction (using pressurized cuffs) or pneumatic compression (a massage-like device) can reduce muscle soreness after exercise. Both treatments are believed to aid recovery from exercise-induced muscle damage. Participants will join one of three groups: a control group with no treatment, a group receiving pneumatic compression, or a group undergoing blood flow restriction. This trial is ideal for recreationally active individuals without current musculoskeletal injuries who do not routinely train for trail running. As an unphased trial, it offers participants the chance to contribute to innovative research on exercise recovery methods.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, women must be on a form of hormonal contraception to participate.

What prior data suggests that blood flow restriction and pneumatic compression are safe for reducing muscle soreness?

A previous study showed that intermittent pneumatic compression (IPC) can reduce muscle soreness without affecting muscle and nerve function. Another study found that IPC might lower inflammation, as indicated by a decrease in C-reactive protein, a blood marker for inflammation, and help with delayed onset muscle soreness (DOMS). These findings suggest that IPC is generally well-tolerated and safe to use after exercise.

For blood flow restriction (BFR), research has shown mixed results. Some studies have reported increased discomfort, soreness, and effort levels with BFR. Common side effects include tingling and muscle soreness, though more serious issues like severe muscle breakdown (rhabdomyolysis) and fainting are rare.

Both treatments offer potential benefits but also have possible side effects. Participants should consider these factors when deciding to join a trial. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for muscle soreness because they offer potentially innovative approaches to muscle recovery. Pneumatic compression is unique because it uses controlled air pressure to boost blood flow and reduce inflammation, potentially offering faster relief than traditional rest or ice methods. Blood flow restriction (BFR) stands out because it enhances muscle strength and recovery by applying pressure to limit blood flow, stimulating muscle growth without heavy exercise. These methods could provide quicker, more efficient recovery options compared to standard treatments like rest, ice, and anti-inflammatory medications.

What evidence suggests that this trial's treatments could be effective for reducing muscle soreness?

This trial will compare the effects of pneumatic compression and blood flow restriction (BFR) on muscle soreness. Studies on pneumatic compression devices have shown mixed results. Some research suggests they might aid in muscle soreness recovery, while other studies found no significant benefit. In contrast, BFR, another treatment option in this trial, has shown promise in reducing muscle soreness and pain. Some studies even suggest BFR can help increase muscle strength and recovery. Both treatments have their pros and cons, but BFR appears to consistently yield positive results for relieving soreness. ^{1 2 4 6 7}

Are You a Good Fit for This Trial?

This trial is for individuals experiencing muscle soreness after exercise, specifically delayed onset muscle soreness (DOMS). The study aims to find out if two different treatments can help with recovery. Details on who can join or reasons for exclusion are not provided.

Inclusion Criteria

Recreationally active population

Women should be on a form of hormonal contraception

Must answer 'yes' to all PAR-Q questions

Exclusion Criteria

Individuals that routinely train trail running

I experience pain when I run.

I have cancerous growths.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants undergo exercise and receive either pneumatic compression or blood flow restriction therapy

1 day

1 visit (in-person)

Follow-up

Participants are monitored for muscle soreness and function post-treatment

24 hours

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Blood Flow Restriction
• Pneumatic Compression

Trial Overview The trial is testing the effectiveness of Blood Flow Restriction (BFR) and Pneumatic Compression in reducing symptoms of exercise-induced muscle damage. BFR involves pressurized cuffs on limbs, while pneumatic compression mimics massage by applying pressure.

How Is the Trial Designed?

Group I: Pneumatic compression Experimental Treatment 1 Intervention

The participants will be asked to refrain from exercise 24 hours prior to and following the exercise. Participants will complete all pre-exercise tests (DOMS, CMJ, MVIC). The exercise consists of running on a treadmill situated at a -10% grade at 9 km/hr (5.59 mph) for 20 minutes. This is proceeded and followed by 5 minute warm-up/cool-down periods. Those allocated to the "pneumatic compression" group will receive 20 minutes of pneumatic compression at 100 mmHg.

Group II: Blood flow restriction Experimental Treatment 1 Intervention

The participants will be asked to refrain from exercise 24 hours prior to and following the exercise. Participants will complete all pre-exercise tests (DOMS, CMJ, MVIC). The exercise consists of running on a treadmill situated at a -10% grade at 9 km/hr (5.59 mph) for 20 minutes. This is proceeded and followed by 5 minute warm-up/cool-down periods. Those allocated to the "BFR" group will receive 4 rounds of treatment: 3 minutes will be spent at 100% of resting limb occlusion pressure, followed by 2 minutes of 0% occlusion.

Group III: Control Active Control 1 Intervention

The participants will be asked to refrain from exercise 24 hours prior to and following the exercise. Participants will complete all pre-exercise tests (DOMS, CMJ, MVIC). The exercise consists of running on a treadmill situated at a -10% grade at 9 km/hr (5.59 mph) for 20 minutes. This is proceeded and followed by 5 minute warm-up/cool-down periods. Those that are allocated to the "control" group, will not receive treatment after the downhill running protocol.

Who Is Running the Clinical Trial?

University of Southern California

Lead Sponsor

Trials

956

Recruited

1,609,000+

Published Research Related to This Trial

In a study involving 12 women, blood flow restriction (BFR) during resistance exercise showed similar neuromuscular fatigue responses for both a high-repetition (BFR-75) and a sets-to-failure (BFR-F) approach, indicating that both methods can effectively stimulate muscle adaptation.

The research found that muscle activation, measured by surface electromyography (sEMG), increased significantly during the first three sets of exercise but plateaued afterward, suggesting that optimal muscle engagement occurs early in the workout, regardless of the BFR method used.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neuromuscular Responses to Failure vs Non-Failure During Blood Flow Restriction Training in Untrained Females. Proppe, CE., Aldeghi, TM., Rivera, PM., et al.[2023]

A study involving 136 Brazilian professionals in physical rehabilitation found that blood flow restriction (BFR) is primarily used with resistance exercise to promote muscle growth and rehabilitation, especially in young adults aged 20 to 29 years.

While 92% of professionals reported observing at least one side effect from BFR, most were mild, such as tingling and delayed muscle soreness, indicating that serious side effects are rare when BFR is applied correctly in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Application and side effects of blood flow restriction technique: A cross-sectional questionnaire survey of professionals. de Queiros, VS., Dantas, M., Neto, GR., et al.[2023]

A systematic review of 8 trials involving 118 participants found insufficient evidence to determine the effect of blood flow restriction (BFR) on delayed onset muscle soreness (DOMS), indicating a need for more rigorous studies.

Preliminary data suggest that high restrictive pressures during BFR may increase inflammation with eccentric exercises, while postconditioning BFR might help protect against DOMS.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Blood Flow Restriction Technique on Delayed Onset Muscle Soreness: A Systematic Review. Rodrigues, S., Forte, P., Dewaele, E., et al.[2022]

Blood flow restriction (BFR) training with either elastic or nylon cuffs of the same width (5 cm) produces similar effects on muscle fatigue and perceived exertion during low-load resistance exercises, based on a study involving 16 participants.

The study indicates that both types of cuffs can effectively create comparable levels of blood flow restriction, suggesting that the choice of material may not significantly impact the efficacy of BFR training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Blood flow restriction: effects of cuff type on fatigue and perceptual responses to resistance exercise. Loenneke, JP., Thiebaud, RS., Fahs, CA., et al.[2014]

In a study involving 19 participants (12 women and 7 men) aged 18-35, blood flow restriction therapy without external load did not improve muscle recovery after induced fatigue and soreness compared to a sham therapy.

Measurements of muscle strength (torque) and soreness at multiple time points (10 minutes, 24 hours, and 48 hours post-treatment) showed no significant differences between the blood flow restriction and sham conditions, indicating that this method may not be effective for enhancing recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Blood Flow Restriction Therapy on Recovery After Experimentally Induced Muscle Weakness and Pain. Wong, V., Dankel, SJ., Spitz, RW., et al.[2022]

Elastic knee wraps provide a more fatiguing stimulus during low-load resistance exercise compared to high-load and traditional blood flow restriction (BFR) methods, suggesting they can be an effective alternative for muscle training.

Participants completed more repetitions with BFR at lower pressures compared to elastic knee wraps stretched to a high length, indicating that the method of applying pressure can significantly influence exercise performance and muscle activation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Muscular Responses to Practical Low-Load Blood Flow Restriction Exercise Versus Traditional Low-Load Blood Flow Restriction and High-/Low-Load Exercise. Thiebaud, RS., Abe, T., Loenneke, JP., et al.[2021]

Blood flow restriction (BFR) training is effective for improving muscle growth and strength even at low exercise intensities, making it beneficial for both healthy individuals and those in clinical settings.

The design of BFR cuffs, including factors like cuff width, material, and pressure settings, can significantly influence the effectiveness and safety of BFR training, highlighting the need for further research on these variables as more BFR devices become available.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice-A review of the current state of the research. Rolnick, N., Kimbrell, K., de Queiros, V.[2023]

Blood flow restriction (BFR) training, which uses cuffs to partially restrict blood flow during low-load exercise, has been shown to effectively reduce pain and improve functionality and quality of life in patients with neuromusculoskeletal conditions, based on a systematic review of 14 studies.

While BFR training shows promising short-term benefits within the first six weeks, its effectiveness for medium- and long-term outcomes remains unclear, indicating a need for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Blood Flow Restriction on Functionality, Quality of Life and Pain in Patients with Neuromusculoskeletal Pathologies: A Systematic Review. Reina-Ruiz, ÁJ., Martínez-Cal, J., Molina-Torres, G., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9505400/

Effect of Blood Flow Restriction Technique on Delayed ... The effect of the blood flow restriction technique (BFR) on delayed onset muscular soreness (DOMS) symptoms remains unclear.

2. sciencedirect.com sciencedirect.com/science/article/pii/S266633762500071X

“CLINICAL-BFR”: An exploratory blood flow restriction ... We demonstrated that clinical BFR was 1) less intense, 2) reduced pain-associated discomfort, 3) decreased DOMS, 4) increased affectivity, 5) ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7727422/

EFFECT OF BLOOD FLOW RESTRICTION TRAINING ON ... Blood flow restriction (BFR) training enhances muscular strength and hypertrophy in several populations including older adults and injured athletes.

4. nature.com nature.com/articles/s41598-025-11654-y

Effects of different arterial occlusion pressures during blood ... Blood flow restriction (BFR) training has been shown to induce exercise-induced muscle damage (EIMD) in some cases, although findings are ...

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/abs/10.1111/cpf.12925

Impact of blood flow restriction intensity on pain perception ... Results. The 80% BFR group experienced faster reductions in pain perception compared to the 20% BFR group. Muscle strength recovery was also ...

6. bjsm.bmj.com bjsm.bmj.com/content/57/14/914

an intervention study evaluating acute training responses ... Our study supports the use of AUTO pressure applications during BFR resistance exercise, as it appears to enhance performance with less discomfort, exertion and ...

7. journals.lww.com journals.lww.com/md-journal/fulltext/2021/05070/application_and_side_effects_of_blood_flow.64.aspx

Application and side effects of blood flow restriction... Most professionals observed tingling (71.2%) and delayed onset of muscle soreness (55.8%). Rhabdomyolysis, fainting, and subcutaneous ...