Olympic competition brings out the best in athletes and their trainers! Blood Flow Restriction Training and other Olympic Treatment Trends in 2021.
During my childhood, my house was an Olympics house. The love of sports and fervent nationalism that members of my parent’s generation instilled in their children created a combination of family ‘must-see’ viewing.
We marveled at the athletes’ talent and sat in open-mouthed disbelief each night as we watched together, always seeing something we had never seen before.
Melancholy After the Olympics Are Over
I don’t know if it was the bond that we all shared that I missed or longing for the spectacle of it all, but I must admit. I felt a bit blue when the Olympics were over.
Not like I do when my idols roll onto the Champs-Elysees during the final stage of Le Tour, or even back then on the day after Christmas, but the feeling is there. Perhaps it was because I knew that it would be four years before I would have the chance to see something I had never seen before each night.
Viewing the World Through PT Colored Glasses
I still watch the Olympics, and so do my children. I still see things that I have never seen before, but they are different things. When you have been a physical therapist for as long as I have, you process your environment differently from your non-PT peers.
When I walk through the supermarket, I can’t help but diagnose the musculoskeletal ailment of each of my fellow shoppers by the hitch they have in their gait. Now when I watch the Olympics, I can’t help but fixate on the newest fitness and performing enhancing equipment or trend I have seen for the first time.
Realistic Skepticism Was My Practice
I always tried to shy away from the newest must-have physical therapy treatment equipment in my private practice. I would have needed a warehouse for the unused mattresses made of magnets, tables that vibrated, weights that shook, and the barrels of miracle lotions and creams.
It was hard to resist the ‘Goldilocks of PT equipment salesmen’ when he tried to convince me that I shouldn’t listen to the hot and cold laser guys and that his ‘luke warm’ laser was ‘just right.’
Treatment Trend Temptation Is Hard to Resist
In my view, if it wasn’t substantiated by research and hadn’t passed the test of time, I wasn’t going to stretch my patient’s healthcare dollar in search of the newest breakthrough. In the quest for marginal gains, however, Olympic athletes and the governing bodies that support them are more concerned with getting an edge than what it costs, or so it seems.
In 2012 it was kinesiotape. In 2016, it was cupping, and the thing I noticed this year that I had never seen before was the tourniquet-style contraptions strapped to the limbs of many of the athletes. What was that?
What is That Tape Olympic Athletes are Wearing?
If you live in an Olympics house, then you know what I mean. The brightly colored strips of tape randomly stuck to athletes’ bodies remind me of how my driveway looked after my kids finished creating with those giant sticks of chalk.
Kinesiology tape (KT), or kinesiotape as it is known, is flexible, cloth tape that athletic trainers apply to the muscles and joints of athletes for injury treatment, prevention, and performance. Fitness professionals undergo training in the precise application of KT. I am one of them.
The Theory in Support of Kinesiology Tape
I’m not ashamed to admit that I signed up for the KT course a bit naive and mesmerized by the pretty colors. But mainly because I was under the false assumption that the tape stabilized the joints and helped protect the muscle. I have a feeling you thought that is what it was for also.
In theory, however, the benefits of KT lie in its ability to reduce pain by increasing blood flow and enhancing lymphatic drainage. In addition, the tape mimics the skin’s elasticity, and the stimuli encourage the muscles to fire correctly, thereby preventing compensation. The principle of proprioception, a person’s perception of where a joint or limb is positioned in space, also comes into play.
The Power of Placebo is Strong
The substantiating research and test of time jury are still out on this one. That hasn’t stopped athletes from using KT close to a decade later. Athletes anecdotally report confidence and a greater awareness of the affected body region while wearing the tape. The placebo effect is a powerful one, and its benefit far outweighs the risk in this case.
Coincidentally…The Danish men’s pursuit team may have found another use for KT during this year’s games. All four of them have developed a coincidental contagious case of shin splints. The position of the tape, much like the recently UCI-banned long socks, creates a trip strip, improving aerodynamics by disrupting onrushing airflow.
In my professional opinion, the likelihood that all four members suffered from the same injury is…? I’m not touching that one!
What Are Those Large Round Spots on Olympic Athletes?
If you and your family have sat to watch any of the swimming events, I know you have asked yourself the same. The round spots you see dotting the skin of athletes. As if during training, they were attacked by an enormous amorous octopus.
‘Cupping,’ or ‘dry cupping’ as it is known, is when suction is applied to the skin using cup-like devices for several minutes. The procedure is often combined with other modalities like massage and acupuncture.
The Theory Behind Dry Cupping
Cupping is not anything new. It has been practiced in Egyptian, Chinese, and Middle Eastern cultures for millennia. What is really old is new again, especially for Olympic athletes and celebrities around 2016.
When you apply the cups to the athlete’s skin, the suction draws fluid into the area, promoting blood flow, lymphatic drainage, and healing. The skin markings are due to rupture of the blood vessels, which creates a bruise.
No conclusive research here either, although the test of time has a passing grade. I call this another no-risk and much placebo reward situation.
What Are Those Cuff-Like Straps on the Limbs of Olympians?
The risk-reward question is a solid one in the case of Blood-Flow Restriction (BFR) training. I want to begin by saying, at the surface, this sounds crazy to me too. Now that I am mostly retired, my mind is more wide-open. Let’s see.
The practice involves wearing a blood-pressure cuff-like device to restrict circulation to the muscles of the involved limb. Reduced blood flow limits the oxygen to the vessels supplying the muscles and triggers a muscle-building hormone response. In short, the lack of oxygen causes stress, and the muscle must adapt.
The Theory of Blood Flow Restriction
In theory, muscle-building stress forms through exercising under a lighter load or less resistance, which is easier on the joints and surrounding structures. The benefit is the ability to get the results of lifting heavy weights by training with lighter ones.
In addition, the blood-flow restriction stimulates the muscles to over-compensate and therefore aids in recovery time and quality. With minor damage to the muscle fibers, unlike what occurs with heavy eccentric contractions, as described in this previous post on Strength Training Terminology, there is less delayed-onset muscle soreness (DOMS), and you can train more often.
Few Long-Term Studies Available
The clinical implications for post-surgical and deconditioned patients like those I frequently treated in the clinic are profound. Unfortunately, there is a scarcity of long-term studies on the side effects and potential adverse consequences.
For this reason, I choose not to go further in-depth into the methodology, application, and protocol for BFR training. If you are interested in learning more, this study was published in Frontiers in Physiology in 2019. This study published in the International Journal of Exercise Science in 2017 provides more information.
Worthy of Note
Worthy of note, however, is the disappointment of the inability to enjoy the brightly colored KT and geometric aesthetics of an athlete whose limb is blue due to lack of blood.
In all seriousness, long-term circulatory damage is one of the many risk factors that require further investigation.
Oh yeah, one more thing. I think I have been BFRing for a while. I have this really tight pair of bibs. I am only kidding!
Conclusion - Be Careful!
There is a reason why the first, and often the only, time you see performance-enhancing practices like KT, cupping, and BFR is at elite athletic competitions. The athlete is incentivized to push the envelope and experiment with their bodies to gain a microscopic edge over the competition.
Unfortunately, science moves at a glacial pace in comparison, which puts the athletes in a difficult position. A position they are willing to embrace and a compromise they will make.
Unlike you and me, Elite athletes have resources and fitness and health professionals to monitor them, however. It is a luxury we don’t have, and that can be dangerous to the amateur athlete.
Witnessing something for the first time at the Olympics and equating it with the extraordinary feats of strength, agility, stamina, and power seen in the gifted Olympic athletes makes the ordinary Joe like us a victim of their success.
Just as the success of Michael Phelps in 2016 resulted in a surge of polka-dotted gym rats throughout the world, the success of an athlete who trains using BFR would undoubtedly influence amateurs to replace their current “training technique of the week.” In this case, the consequences would be dire.
However, the unpopular truth is that if you asked any of those athletes if it was the KT, cupping, BFR, or hard work that led to their success, I know you can guess the answer.
What did you see for the first time during the Olympic games?
Comment below! Your fellow virtual cyclists want to know.
Semi-retired as owner and director of his private Orthopedic Physical Therapy practice after over 20 years, Chris is blessed with the freedom to pursue his passion for virtual cycling and writing. On a continual quest to give back to his bike for all the rewarding experiences and relationships it has provided him, he created a non-profit. Chris is committed to helping others with his bike through its work and the pages of his site.
In the summer of 2022, he rode 3,900 miles from San Francisco to New York to support the charity he founded, TheDIRTDadFund. His “Gain Cave” resides on the North Fork of Long Island, where he lives with his beautiful wife and is proud of his two independent children.
You will read him promoting his passion on the pages of Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. Chris is co-host of The Virtual Velo Podcast, too!