Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety

doi:10.3389/fphys.2020.00243

Comment

. 2020 Mar 20:11:243.

doi: 10.3389/fphys.2020.00243. eCollection 2020.

Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety

Mathias Wernbom^{1

2}, Brad J Schoenfeld³, Gøran Paulsen⁴, Thomas Bjørnsen⁵, Kristoffer T Cumming⁶, Per Aagaard⁷, Brian C Clark^{8

9}, Truls Raastad⁴

Affiliations

¹ Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.
² Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Department of Health Sciences, CUNY Lehman College, Bronx, NY, United States.
⁴ Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway.
⁵ Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
⁶ Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Notodden, Norway.
⁷ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁸ Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, United States.
⁹ Department of Biomedical Sciences, Ohio University, Athens, OH, United States.

PMID: 32265737
PMCID: PMC7098946
DOI: 10.3389/fphys.2020.00243

Comment

Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety

Mathias Wernbom et al. Front Physiol. 2020.

. 2020 Mar 20:11:243.

doi: 10.3389/fphys.2020.00243. eCollection 2020.

Authors

Mathias Wernbom^{1

2}, Brad J Schoenfeld³, Gøran Paulsen⁴, Thomas Bjørnsen⁵, Kristoffer T Cumming⁶, Per Aagaard⁷, Brian C Clark^{8

9}, Truls Raastad⁴

Affiliations

¹ Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.
² Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Department of Health Sciences, CUNY Lehman College, Bronx, NY, United States.
⁴ Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway.
⁵ Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
⁶ Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Notodden, Norway.
⁷ Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
⁸ Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, United States.
⁹ Department of Biomedical Sciences, Ohio University, Athens, OH, United States.

PMID: 32265737
PMCID: PMC7098946
DOI: 10.3389/fphys.2020.00243

No abstract available

Keywords: fatigue; hypoxia; ischemia; muscle fiber degeneration; muscle hypertrophy; occlusion.

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Figures

**Figure 1**
Responses in creatine kinase (CK) activity levels in serum before and 1 hour (1h), 1 day (1d), 2 days (2d), 4 days (4d), and 7 days (7d) after a damaging bout of low-load BFR-RE. Figure based on data from individuals in the study of Sieljacks et al. (2016). Note the differences between individuals, and also in the time-course of the responses in the two participants who were “high-responders” (CK > 19,000 U/L). The upper detection limit for the CK essay in this study was 20,000 U/l, and one of these two individuals may have exceeded this limit. Serum myoglobin showed similarly high increases (data not shown).

**Figure 2**
Small moderately strongly to strongly NCAM-positive muscle fibers from a subject in the study of Bjørnsen et al. (2019). The biopsy was taken 3 days after the last training week. Note central/non-peripheral myonuclei in several of the NCAM-positive fibers. The section was re-photographed (due to loss of the original pictures) after several years in the freezer, and the positive staining would likely have been even stronger if the section was new. Red = laminin, green = NCAM, and blue = DAPI. Picture cropped from 10× original. Picture courtesy of Mathias Wernbom.

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Comment in

Response: Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety.
Burr JF, Hughes L, Warmington S, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J, Patterson SD. Burr JF, et al. Front Physiol. 2020 Oct 30;11:574633. doi: 10.3389/fphys.2020.574633. eCollection 2020. Front Physiol. 2020. PMID: 33192577 Free PMC article. No abstract available.

Comment on

Corrigendum: Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety.
Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Patterson SD, et al. Front Physiol. 2019 Oct 22;10:1332. doi: 10.3389/fphys.2019.01332. eCollection 2019. Front Physiol. 2019. PMID: 31695626 Free PMC article.

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Response: Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety.
Burr JF, Hughes L, Warmington S, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J, Patterson SD. Burr JF, et al. Front Physiol. 2020 Oct 30;11:574633. doi: 10.3389/fphys.2020.574633. eCollection 2020. Front Physiol. 2020. PMID: 33192577 Free PMC article. No abstract available.
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References

1. Amato A. A., Greenberg S. A. (2013). Inflammatory myopathies. Continuum (Minneap Minn). 19, 1615–1633. 10.1212/01.CON.0000440662.26427.bd - DOI - PMC - PubMed
1. Ansari R., Katirji B. (2014). “Serum muscle enzymes in neuromuscular disease,” in Neuromuscular Disorders in Clinical Practice (New York, NY: Springer; ), 39–50. 10.1007/978-1-4614-6567-6_3 - DOI
1. Bäcker H. C., Busko M., Krause F. G., Exadaktylos A. K., Klukowska-Roetzler J., Deml M. C. (2019). Exertional rhabdomyolysis and causes of elevation of creatine kinase. Phys. Sportmed. 30, 1–7. 10.1080/00913847.2019.1669410 - DOI - PubMed
1. Bjørnsen T., Wernbom M., Løvstad A., Paulsen G., D'Souza R. F., Cameron-Smith D., et al. . (2019). Delayed myonuclear addition, myofiber hypertrophy, and increases in strength with high-frequency low-load blood flow restricted training to volitional failure. J. Appl. Physiol. 126, 578–592. 10.1152/japplphysiol.00397.2018 - DOI - PubMed
1. Child R., Brown S., Day S., Donnelly A., Roper H., Saxton J. (1999). Changes in indices of antioxidant status, lipid peroxidation and inflammation in human skeletal muscle after eccentric muscle actions. Clin. Sci. (Lond). 96, 105–115. 10.1042/cs0960105 - DOI - PubMed

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[1] Amato A. A., Greenberg S. A. (2013). Inflammatory myopathies. Continuum (Minneap Minn). 19, 1615–1633. 10.1212/01.CON.0000440662.26427.bd - DOI - PMC - PubMed

[2] Amato A. A., Greenberg S. A. (2013). Inflammatory myopathies. Continuum (Minneap Minn). 19, 1615–1633. 10.1212/01.CON.0000440662.26427.bd - DOI - PMC - PubMed

[3] Ansari R., Katirji B. (2014). “Serum muscle enzymes in neuromuscular disease,” in Neuromuscular Disorders in Clinical Practice (New York, NY: Springer; ), 39–50. 10.1007/978-1-4614-6567-6_3 - DOI

[4] Ansari R., Katirji B. (2014). “Serum muscle enzymes in neuromuscular disease,” in Neuromuscular Disorders in Clinical Practice (New York, NY: Springer; ), 39–50. 10.1007/978-1-4614-6567-6_3 - DOI

[5] Bäcker H. C., Busko M., Krause F. G., Exadaktylos A. K., Klukowska-Roetzler J., Deml M. C. (2019). Exertional rhabdomyolysis and causes of elevation of creatine kinase. Phys. Sportmed. 30, 1–7. 10.1080/00913847.2019.1669410 - DOI - PubMed

[6] Bäcker H. C., Busko M., Krause F. G., Exadaktylos A. K., Klukowska-Roetzler J., Deml M. C. (2019). Exertional rhabdomyolysis and causes of elevation of creatine kinase. Phys. Sportmed. 30, 1–7. 10.1080/00913847.2019.1669410 - DOI - PubMed

[7] Bjørnsen T., Wernbom M., Løvstad A., Paulsen G., D'Souza R. F., Cameron-Smith D., et al. . (2019). Delayed myonuclear addition, myofiber hypertrophy, and increases in strength with high-frequency low-load blood flow restricted training to volitional failure. J. Appl. Physiol. 126, 578–592. 10.1152/japplphysiol.00397.2018 - DOI - PubMed

[8] Bjørnsen T., Wernbom M., Løvstad A., Paulsen G., D'Souza R. F., Cameron-Smith D., et al. . (2019). Delayed myonuclear addition, myofiber hypertrophy, and increases in strength with high-frequency low-load blood flow restricted training to volitional failure. J. Appl. Physiol. 126, 578–592. 10.1152/japplphysiol.00397.2018 - DOI - PubMed

[9] Child R., Brown S., Day S., Donnelly A., Roper H., Saxton J. (1999). Changes in indices of antioxidant status, lipid peroxidation and inflammation in human skeletal muscle after eccentric muscle actions. Clin. Sci. (Lond). 96, 105–115. 10.1042/cs0960105 - DOI - PubMed

[10] Child R., Brown S., Day S., Donnelly A., Roper H., Saxton J. (1999). Changes in indices of antioxidant status, lipid peroxidation and inflammation in human skeletal muscle after eccentric muscle actions. Clin. Sci. (Lond). 96, 105–115. 10.1042/cs0960105 - DOI - PubMed

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Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety

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Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety

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