How Your Client Can Get the Benefits of Lifting Heavy without Lifting Heavy with Dr. Susie Lachowski-Glass

You're listening to the PT Profit podcast, episode number 321. Today I'm sitting down with Dr. Susie Lachowski Glass, and we are discussing how to help your clients get the benefits of lifting heavy without lifting heavy. Are you ready? Let's dive in.

Hi, I'm Beverly Simpson, former fitness manager turned online personal training business owner. And this podcast is where smart fitness professionals, professionals including trainers and clinicians, discover how to increase client performance and movement, package and position their products and services and get out of their own way so that they can increase their revenue to live a life that they love without sleazy sales. Welcome to the PT Profit Podcast.

What's up, coach? Thank you so much for pushing play on another episode of the PT Profit Podcast. I'm your host, Beverly Simpson, and I'm really excited. For today's episode, I have a very special super, super smart coach, Dr. Susie Luchowski Glass. We are discussing the benefits of blood flow restriction training. Now, if that word or that modality feels new or scary to you, then you definitely want to stay till the end of this episode because Dr. Susie Luchowski Glass really breaks down the science behind the modal. And she shares with us how she has dedicated her doctorate degree to learning more about the modality, how it's been around for ages. While it seems like a new practice, she also discusses how she can powerfully implement it both in person and online, and how specifically you can learn more about the modality as well as get certified in it in one of her brand new upcoming programs, which we are talking about inside of this episode. So without further ado, let's go ahead and roll that interview. What's up, Susie? Thank you so much for joining me on the show today. How are you?

I'm good. How are you? Thank you for having me.

I am so good. I am so excited about today's show. I cannot wait to dive in. So let's just go ahead and get right into it. So for those of you who are tuning in and have not had the pleasure of being introduced to your work, can you share with us a little bit about who you are, who you serve, and how you got there?

Yeah, absolutely. My name is Susie Luchowski Glass. I am right now, I'm a founding director of the Division of Exercise Science at a college in Massachusetts called American International College. I have my PhD in exercise physiology and I specialize in blood flow restriction training and therapy the last ten plus years or so. I also own Glass Training and Education where I provide CEU courses for professionals, clinicians, coaches on blood flow restriction training. But I also train individuals and basic fitness, specialized fitness, bfr, all those kind of things. So that's kind of me in a quick nutshell.

Okay, I am so excited to dive in because I'll tell you just for context, I have never even heard of BFR training. Blood flow Restrictive restriction training, is that right? I had never heard of that until I was introduced to your work. So would you mind sharing with us a little bit more about what is that exactly, and how does that help clients? And, and you know, what are some of the benefits? Like, how did you get into that? How did you discover that? Give us all the things.

Yeah, sure. So I'll definitely start with how I kind of got into it. When I was in graduate school, I came across an article. It's called Katsu. And actually that's where like BFR specifically kind of originated back in the 60s and 70s with this man called Dr. Sato. I came across this article and ultimately Katsu just means additional pressure in Japanese. And the whole premise behind it was that they had all these huge physiological changes of strength, muscular endurance, health and wellness, all these things. I came across with lifting extremely light loads, like 20 to 30% of someone's like one rep max, ultimately just very low weights, but altering blood flow patterns. And by doing so, they were able to get very similar adaptations to if someone was lifting heavy weights or exercising at a high intensity. So once I read that, I was like, wait a minute, that kind of sounds like some sort of magic. I got to, I got to look into this a little bit more because as an athlete myself, I was like, traditional overload this, that, all those other kind of things, things growing up. And so ultimately I kind of went, you know, head first into all that research that came out of Japan. And then I decided to do my dissertation on a blood flow restriction training dissertation. So from there I kind of fell in love with the modality, played around with it myself. I started guest lecturing everywhere on it as, as well as presenting, you know, my work, and then kind of just took. Took off from there, working with various devices, training clients, doing my own case studies, and then ultimately coming. Coming to, developing my own comprehensive course through, through all of that. But that's kind of how I got into it for the last ten years or so. And what BFR is, is that's typically what someone will hear is blood flow restriction. It kind of sounds scary. I run into this all the time, even with professionals or coaches or, you know, anyone that says oh, what are you gonna. You hear the word blood and restrict and like that can't be good. You know, that's gotta be something like damaging or painful or whatever it is. No one likes really getting their blood taken or all that. So I mean, I'm just gonna throw my little thing in there. If I had to choose, I would have called it like hemodynamic alteration training or something where it sounds scientific and then someone could ask you what it is. And I'm like, oh, we're just altering blood flow patterns to activate big muscle fibers. And people would be like, oh, okay, that sounds way better. So anyway, I think the term can be a little scary for people to, to get into first until you kind of really learn about it. So different. You know, there's different aspects to bfr, blood flow restriction training. And like I said, Katsu is a, is the one that started it all. But they really talk about blood flow modification training because if we get into the nitty gritty kind of sciency aspect of it, they're more so affecting venous outflow and not as much arterial inflow, but different techniques. You can also alter or restrict arterial inflow as well as outflow. So that's kind of what, you know, we go through and teach all of that and the differences with that. But the whole premise is you. That you put some sort of reputable band or cuff that's, you know, been tested and validated and all those things either on the upper extremities or lower extremities, as high as you can go, pretty proximal. And ultimately what you do by applying various pressures to which is specified to the individual, that by restricting or altering blood flow, what ultimately happens is your small muscle fibers kind of poop out or fatigue fairly quick in the exercise regimen, even though you're lifting light weights. So even from there you have to your type 2B's or your really bigger muscle fibers need to be activated in order to keep exercising. And then a whole cascade of physiological processes happen from there, which then enhances muscular strength, endurance, circulating, you know, hormones that help with health or, you know, health, bone growth, you know, fat metabolism, you name it. We could keep keep going on, you know, and on with that. But ultimately some. Some huge benefits to BFR would be minimal, you know, just in general, minimal equipment, you know, so you don't need to lift, you know, you don't have to have a ton of weights around to be using this. But some of the physical benefits are, you know, increased strength, increased muscular endurance, Increased aerobic capacity, increase increased blood flow from the muscles. You also have increased V2 aerobic capacity, functional movement, and then other things such as, you know, secondary effects that it could happen, like systemically enhanced, you know, bone growth and things like that. So the modality has a. A very wide range of benefits. So it can benefit someone all the way from the athlete training all the way up to someone who's like, elderly or de. Deconditioned as well. So. And to the injured and everyone in between. So there's my really quick snapshot for, for you for that.

I mean, it's so amazing and I want to just talk, so I want to just like, really dive into it because you. You talked about some things that like, came up for me too. Right. Like, it seems scary when we hear the words like blood and restriction. And then from knowing you personally, I know that you've worked a lot with physical therapists and clinicians. Is this something also that you've noticed that, you know, coaches and trainers can also practice as long as they're, you know, in a safe environment and certified and so on and so forth. Coaches use this as well?

Yep, absolutely. Yep. There's just, there's different ways you go about the modality, but for sure, like where a physical therapist or clinician is going to be looking at it more from an injured rehabilitation standpoint, but for sure, strength coaches, fitness professionals, I highly think, I highly suggest they put this tool in their toolbox, once educated, know how to apply it and everything for sure can help, kind of just widen their clientele on who they can capture as well, you know, for who they want to help. So absolutely. Fitness and strength and conditioning folks, and they're all that could for sure use it.

So I mean, this is amazing. And I think really what strikes, what really, you know, striked me, I'll say strike, to me, is that whatever piqued my interest, I guess that's a better way to say that was that I, you know, it was that people who are deconditioned and you and you know, the elderly, the elderly demographic as well as potentially the injured demographic, they can get the benefits of being under load without being under load. I mean, that is like magic. That was like, oh, that I want that magic wand. Because that's exactly what we want. It's one of the hardest things to navigate and at least in my experience, because, you know, when I was working at the. In, in a gym and when I was working with the general population or even the athletic population, they've got compens. They've got, they have, you know, performance based injuries or performance based constrictions that I are hard to navigate. It's like, well, I really want to just do this, but I can't because of this circumstance. So I mean, it's super powerful. But one of the things I'm curious about is, you know, what are some of the, you know, because it is scary to hear restriction and blood flow. So what are some of the things that people really need to be paying attention to when they're first learning about this modality and when they're first starting to implement it? What are some of the like cautionary experience things that they need to be keeping up, keeping in mind?

Sure, yeah. So I take the BFR training very similar to how I would take traditional training. And what do I mean? What I mean by that is if I get a new client, I always ease anyone into a program or something or I also kind of of judge based off of the individual or the athlete or the status or however they are, however. So that would be my. One thing is if you're starting with bfr, once you've learned about it, you've applied it on yourself, you've kind of gone through exercise regimens. And I highly suggest that number one is that you do it yourself before you apply it to any sort of client or patient because then you will kind of feel that physiological effects. And even though you're lifting low loads or low intensities, it still it's a high intensity workout. What I mean is you're building up a lot of like metabolic waste. You're gonna feel that metabolic burn within those muscles. So telling individuals that, you know, even though I'm having you lift light loads, you're, you're going to be getting a really good workout in 10 to 15 minutes. And that's another benefit. It can be done in a very quick period of time. So one thing I would say is definitely try it yourself, number one, kind of practice various exercises with it before you apply it to anyone else. Then the other thing is when you are ready to apply it to like, you know, your client or your patient or something, ease into it. I always back off on adjusting either the pressures or the intensity or so forth so they get a feel of the modality because again, we want them to buy into it with all of these benefits. And especially if they're a great candidate for the benefit, you hit them too hard too soon, they're going to be like, don't do that to me again, almost kind of like anything. If someone's just learning to lift and all of a sudden you tell them you're going to go squat, you know, your one rep max under a bar with next to, next to a powerlifting group, they're probably not going to come back to you, you know, I mean, so very similar tact, I take it as, you know, I always ease into it. I'd rather someone come back to me and be like, oh, that felt really good. Let's amp it up next time. Like, all right, let's do it next time. Because you really want them to buy into it with all of these benefits that you can honestly really receive from it. So that would be my first piece of advice, is learn about it, apply it to yourself, and then ease your, your client or patient into it. You know, you do have some of those really intense athletes that you've worked with that are like, no, let's just go, let's just do it. I know, I trust you totally fine. You know, take it a totally different way, you know, But I've had clients too, that were hesitant, so we eased them into it. And now they absolutely just love it and take it, take it everywhere with them or they travel or they do all of that. So that's my first piece of advice is don't, don't crush them right away. Ease them into it. Show that, you know, apply it on yourself first. Kind of show them how it goes. Sometimes I'll even do an exercise regimen with them. I'm like, well, let's do it together, you know, so then they're really good. Hey, I see you do it. You know, all those kind of things. That would be like my first piece of kind of advice, getting into that.

Okay, that's good. So now just out of curiosity, and forgive me if this sounds like a silly question, but I'm going to ask it anyway, which is, you know, when we're talking about the differences between, you know, like strength training and we're talking about training like the central nervous system and kind of maxing out in strength there versus, like hypertrophy. Does the BFR technique help build the muscle or we training the. Just the central nervous system?

That's a good question. I would say both. So it's actually helping activate and recruit more motor units and more muscle fibers. So you're actually training your nervous system to recruit more that you normally typically wouldn't recruit. So let's just use it as an example. Let's just say someone is a little weaker or a little deconditioned let's just say someone who's postmenopausal, maybe is osteopenic, couldn't, you know, so we're going to be a little bit cautionary on loading that person anyway. We need to kind of wake up their central and their peripheral nervous system a little bit to enhance recruitment of the bigger muscle fibers in order for them to enhance balance, quality of life, functional movement tasks, all of those kind of things. So by again, altering those blood flow patterns, our smaller muscle fibers are going to drop out first and then we're going to activate those type 2B's or those bigger muscle fibers and it'll go through this whole, all of these anaerobic cascades, all these other kind of metabolic pathways which typically you would see in heavy lifting. So then when that occurs, you're going to activate very similar hypertrophy mechanism mechanisms as if they were lifting heavy weights. So we're just doing it in a totally different way. You're almost just tricking your body into thinking you're lifting really heavy weights, but you're not. So, but we're still getting to those same muscle fibers we need to get to in order to increase like protein synthesis, muscle hypertrophy, things like that. We're just doing it in a totally different way. Now, I will say that. Is heavy strength training a direct comparison to bfr? No. You know, there's some benefits to, you know, the heavy loading on the mechanical loading that BFR typically wouldn't have. But when we're talking about certain populations as a whole, there's way more benefits to doing BFR than to not because some people can't lift heavy weights or just don't want to either. They're older and they're just like, you know what? I don't, I, I'm done lifting heavy. I don't need to get under the squat bar anymore for my team. Like, I don't, I don't need to do that. I just want to maintain a healthy lifestyle. You know, good resting metabolism, muscular strength and all that. And BFR is a total way to do that for them.

Or they really don't want those ugly calluses that happen on those three fingers. Right. So, like. But you know what's interesting to me to hear you say that too is though, that BFR could really facilitate the experience of getting them to the heavy load faster if they wanted to. Because now you have now conditioned the, the body and built the necessary muscle required. As long as you've got the mobat mobility and movement patterns to get them under a load if they wanted to.

Yep.

Which I think is, you know, traditionally, if they didn't have BFR techniques, they, it would just take a hang of a lot longer, if ever, depending on the population.

Yeah, no abs. You hit the nail on the head because that's where we see in a couple different populations where like with the rehab population, say it's like post surgical or post injury, it takes a lot to get them to be able to lift heavy again or load heavy, so to speak. And sometimes you can't, depending on the surgery. You don't want to compromise the integrity of the surgical site. Like all these other list of things we could go through for that population, we can bridge the gap by starting to decrease the amount of atrophy that's occurring and get them there sooner where they can actually load a little bit sooner. Now, another way we do that is, you know, sometimes I'll get a lot of people, I'll say, okay, well BFR sounds great, but it only sounds really good for like maybe the aging or the deconditioned or the injured population. Someone's like, how would you program that into a traditional strength athlete or a traditional athlete? And I'm like, you know, that's a great question. We, we work, I work with some, some bodybuilders and some power lifters. And I would never tell them, or my linebackers, I would never say, hey, don't ever lift heavy weights again. Because the success of their sport is, you know, stopping someone that's £300, that's, you know, charging them, you know, those kind of things. But how could BFR help? I like to call bfr, you know, in those situations and those like traditional athletes who are healthy, no injury is almost like an icing on the cake situation. So let's say they're lifting, they have a nice regimen, they're doing like a really heavy leg day. Right at the end of that workout, they can do a light load BFR accessory workout to enhance all the systemic benefits that come with it that could help with recovery from that heavy workout they just did. Also on their active recovery days where they're cycling or walking or doing something like that, doing some light again, accessory or BFR work can also help systemically as well as those hypertrophy mechanisms occur without inducing heavy amounts of excess load, because they already did that the day before. So they're already inducing all those micro tears and so forth. So you don't want to put too, too much stress on those muscle fibers. But you can do it with those athletes, like I said, at the end of a workout to get that little extra metabolic benefit or during an active recovery. And that's how we would program it in there.

Yeah, so that's actually a really great question. So remember earlier you were talking about or jogged a really great question for me, which was that you were talking about how you would ease someone into using the BFR modality and you even said that, that this could be like a 10 to 15 minute workout and then you get a really good adaptation within 10 minutes. So if someone has a session that's anywhere from 30 to 45 minutes to how, where would you program it into someone's like a general population example of a strength program. Where would you put it? How would you. How and how would you progressively overload it?

Yep. So with, with bfr it depends on again their, their goal. So if, if they're an athlete where we have to work on either, you know, agility, this other type of training, or traditional strength training too, where we're loading them, I would put it at the end of the workout where they're coming in for the last 10 minutes or so. Also do a full BFR workout typically with 20, 25 minutes. So a half hour session. Some people will do BFR the whole time. So it really is dependent on that client specifically. So again, if I'm talking to someone, if I'm still teaching them how to squat or doing something where they do need to lift heavy, I might do some accessory work, 10 minutes at the end with them with BFR. Got it. Sometimes if I really need to catch up someone with hypertrophy at the beginning, like that's typically where I get a lot of athletes are from. For me specific, I almost call myself a strength therapist and I'm going to have to coin a new term because I get them when they graduate from PT sometimes and depending on how their rehab went or whatever, they're still fairly deconditioned and atrophied. But they're cleared from their surgeon, they're cleared to go back, but we still have a lot of catch up to do before they go back on the field. Because a lot of the times I'll capture those athletes where they, they just weren't ready yet. They said, oh no, you're cleared to go back. And then they're like a deer in the headlights trying to cut back and forth, don't even know how to do, you know, agility. And as well as their muscular endurance is down. So typically I'll hit them With a lot of BFR to regain some muscle, some hypertrophy, some strength and then we'll again do that while we're easing to the heavier lifting. So all depends on a patient or excuse me patient or client's goal. Like I had a mom who has four kids, super busy coach, teacher, all these kind of things and was like I need, I have 15 minutes to myself throughout the day. Susie, she's like I need to get crushed. Like I'm a previous athlete. I want a really good workout, like 10 to 15 minutes where I feel like I'm really doing something. So enter BFR and absolutely loved it and is exactly what she needed just to like maintain like her fitness, her athleticism, the feel that she was like still an athlete and like going, you know, all those kind of things. So again, it really kind of all depends. But you can really get a super workout in and 15 to 20 minutes, 30 minutes even. And it's, it's a huge metabolic workout which typically if you're going to lift a heavy session and really want to adjust skeletal wise, all that, you know, you need at least like two to three minutes in between your sets. Then multi in between your exercise. You need to plan for a minimum of an hour, an hour and a half. Not everyone has all that time either.

Yeah, exactly. So that was actually kind of my next question. As I heard you say 30 minutes. Is that kind of like the max in terms of what you. Where you would program BFR typically?

Typically 20 to 25 or so. 25 minutes or so. Yeah.

That sounds amazing. I'm also curious, how long do people start to see adaptations and start to see improvement in their, you know, body composition and or in their strength capability? Like for that mom, for example.

What.

When did she start to notice that like oh hey, this is, this is working.

I would say for most of. Most of the people who are pretty consistent with it who do BFR at least three times a week, two to three times a week, minimally two. But you would. We typically suggest like three to four because we're not inducing as many micro damage. You can do this type of workout much more frequently. I would say usually after about anecdotally. Anecdotally. I would usually say about after four weeks. I usually get some sort of subjective feedback that's like, wow, I really feel stronger. I start, I'm. I feel really good, I feel better, I feel stronger. I feel like I can do this more typically after about at least four weeks. Now I typ. If I'm working with Someone in person. I always like to do a little pre post premid checkup. You know, we do some stuff. So we usually start seeing changes anywhere from like, you know, six weeks strengthwise, muscular endurance wise, like six weeks on and stuff. So it's fairly quick. The adaptations occur. Body comp takes a little, little while longer to adjust. But that also there's a huge nutritional factor into that. Yeah. And everything else that we could get into all day. But I, but typically the strength, strength phase wise, the muscular endurance, where they feel stronger, they feel better, kind of more in control of their body, decreased risk of falls, all of that typically at least four or five weeks. I usually get a pretty big wow, this is making a big difference type of thing.

Okay, amazing. So now kind of with that said, and I know that I, I know that this is like a really big topic as we're starting to talk about nutrition and body composition and I don't want to segue too much into that, but I am curious in terms of energy intake, like when you are lifting really heavy, you need more energy. You, you oftentimes need more calories. Is the same true with bfr, meaning that we need to put the same amount of energy back into the body.

Yep. So I don't know if it's, you know, calorie for calorie, one for one. But absolutely. So before that's part of the, the tips and tricks and all those kind of things before doing a VFR session, making someone is very adequately hydrated and they've eaten something because you are putting them through a pretty intense metabolic workout and you're altering blood flow patterns. So when you alter blood flow patterns, you're restricting venous return back to the heart. So when you are decreasing blood flow back to the heart in order to maintain cardiac output, your heart rate jacks up. So that's really important for trainers, clinicians, anyone to know is that this isn't just like a heavy lift where I'm trying to lift up six reps, then I put it down and I get a break. You're going to be altering like your central hemodynamic patterns. So your heart rate's going to increase drastically, fairly quickly. Like it'll go up pretty quick. So if you're not hydrated, you're gonna have a much more viscous or thicker blood to pump around. You can start to get a little lightheaded. So it's really important to maintain hydration, make sure you eat and so forth. But I would, I typically say the same thing to all My athletes, unless they're on a very specific body comp journey or something like that. Typical. The protein carbs re. Re. Refuel right after, you know, you know, kind of because you are. You need to feed what's going to go happen. You know, if you want to increase those adaptations with protein synthesis, muscular adaptations, you got to feed it adequate protein and carbohydrates that you just completely used all up. So typically you definitely similar.

So you definitely would not recommend doing BFR fasted.

I wouldn't suggest it. I know some people who do themselves, but it, it's. It's. I wouldn't do it. I wouldn't apply it to a client or a patient for sure. Like, if you want to do it yourself and go ahead and experiment with it because you want to go ahead and do it, I would say go for it. But typically I like. I don't want my clients feeling lightheaded or want to pass out.

Passing out. Let's not let the client pass out. But you pass out. Go right ahead.

Yeah, exactly.

Go.

Go for it all yourself.

Exactly. Okay, so now you mentioned tools. Can you. And. And bands. Are there specific bands? What does it look like to actually, you know, get. When. When you mentioned tools and talked about bands, I just imagined like getting into trapeze thing. So can you tell us a little bit about what it actually looks like to execute and what bands you recommend and what tools you recommend? And hey, by the way, like, I'm just gonna go ahead and put the disclaimer right now. This is for educational purposes. And of course, if you really want to learn more about this modality, Susie has an amazing, amazing certification that's moving online that we're going to make sure that we talk all about and we're going to link it in the show. So I'm just asking for curiosity and for educational purposes, do not do unless you're certified. Okay with that.

All right. Yeah. No, so what it looks like. So the bands or cuffs are. There's a wide variety that are out there. There's some can be a little bit more narrow, which is like an inch and a half to two inches width. And then you have some that are like 3 to 4 inches with, you know, the two places you would just put them on the upper extremities where you would put them right below like your delt insertion. So as high as you could go on your upper arm. Yep, yep. Like kind of as high as you.

Can go where it would still be.

You're right. You're right. There, Right, but like where your delta starts right there. Yep, okay. Exactly. And then on your lower extremities, you would put it as high as you could go, right under your gluteal fold. So you want to go kind of all the way up to your thigh. You wouldn't put it in the middle of your thigh because then it's going to kind of impede actual movement. So you want to go as high as you can. Those are the only two places you need to put a BFR band. You don't need to put them around your, you know, your forearm, your calf or anything like that. You know, it's just four cups. Four cups. You can do an upper butt, you could do one limb. So you can just do, you know, put one cuff on one limb, you could put two on the upper limbs or one on the lower extremity, two on the lower extremity. In some fitness situations and depending on the equipment, I've seen some people do all four, it's not typically as common because you really are altering blood flow patterns a lot. And again, that's really going to depend on the, the band, how you're altering blood flow pattern. So typically it's usually just two on the upper extremities or two on the lower extremities for the most part.

Do you ever do crossbody?

You do one and one. You could do it. We could do whatever you want. One and one. Or you. Yeah, you could do one and one ab. Absolutely. So that's kind of how it would look. Just kind of bands on the upper arms or bands on the upper legs. And there's. That's a big part of. I know you mentioned the course already, but that's a big part of the educational piece to all of this is I felt out there years ago that there wasn't really a full, full comprehensive course in the sense of looking at it from a 30,000 foot view down to the nitty gritty back to a 30,000 foot view of. More and more devices are coming out. So it can get confusing for coaches, clinicians, like, well, what the heck do I use? There's this one, but then there's this one and then there's this one. Well, this one's super expensive. This one's really, really cheap. So does the cheap one mean it's not safe? Like, so we kind of go through all of that to kind of just say, hey, this is what's out there, this is what we know. I've worked with a ton of different devices, I guess I'm, you know, quote unquote certified in a lot of those devices. So then we provide that education of here's what's out there. You pick what's best for your client and your clinician, and then we also consult to talk, talk you through that a little bit. To say, like, okay, you're really working more with fitness clients or these type of clients. I would probably lean towards these two bands or these two cuffs. In a physical therapy aspect, I usually suggest having a couple tools in your tool chest because sometimes, you know, some device might be really good for, you know, passive recovery schema, pre preconditioning or reconditioning, things like that, as well as then also using other devices as well. So we, we can get into all of those, but I guess it would really depend on your clientele and what, what they're looking for. Like, I would never suggest a strength coach who's training a ton of clients all at once to go get one of the machines that's $5,000 that hooks up to one limb one time.

You know that exists?

Yes. Yeah, it's, it's a good device. We have it, we teach it, and you get great results. It's really used in the rehab world a lot, really, mainly for the rehab world, not really so much for fitness. And then there's varying levels. So there's that one that's like, you know, a little over $5,000. But you only are using one limb at one time. And you have to be, it has to be administered, administered by a certified professional on that aspect. And then you have all the way down to, you know, there's things you could go on Amazon and you type in bfr and it's like they almost look like tourniquet ace banded straps that pull on your arms and they're like 20 bucks, 30 bucks. You're like, okay, so what's the difference here? So we wouldn't suggest that. I definitely don't suggest anything that, where you could just tourniquet yourself off. I mean, there's plenty of studies out there where people just tighten and use varying subjective pressures and have gotten results. But if you're going to apply it to a client or a patient, get something that's reputable. You can measure, you know, either the pressure that's being put in the band, you can, you know, still feel a pulse. So, you know, you're manipulating just venous outflow. You don't want to completely occlude the, the limb and things like that. So we could definitely, we navigate that's what we teach a little bit. The varying devices out there, but also the material of those devices and how they affect the limb or the. Or human physiology at that point.

Okay, that's cool. Yeah, that would definitely be something I would want to know because it's always like, well, how do you know what's the best tool to facilitate this? So I would definitely want to know that. And this is. At the risk of sounding like this is a dumb question. Okay, Number two, second time I've said that. But, you know, back in the day when I was in the gym, you would see people working out with these, like, V2 masks to like, reduce their, like, air intake or whatever. Is that similar. Is this. Is that in the same vein as what this would be? And, like, does that. Or is that just, like, pseudo wacko wackadoo science?

Oh, gosh. Oh, my God. My students and I usually have a field day with the V2 mask situation or that. That. That mask situation when we talk about it. No, I would not compare that at all. I think that's a little bit more apples to oranges where this. I get what. I totally understand what you're saying where you're like, oh, this could enhance. Almost like you're enhancing that. But, you know, I'm gonna. I'm gonna say kind of a joke at this point. The BFR actually works.

Okay. So, I mean, I didn't want to be insulting, but, like, we used to make fun. Like, I mean. And I don't do this anymore. Okay. This is my younger days, okay. But back then, I'd be like, okay, so anytime I'd see someone working out with that VO2 mask, I'm like, do they know how to train?

Train?

But that was like, my arrogant, dogmatic years now. Now I'm like, okay, well, let me help that person know how to trade. But I'm like, listen, I'm open. I'm agreeable. I could. You know, I've been wrong before, so I can change my mind. That's why I asked.

Yeah, yeah. No, that's so funny. BFR actually has some really good data out there on it, on their results. I know. I love. That's the best part about being in this industry. You never know what's going to come up next. You never know what you're going to see out there. And it's just. It's fun to navigate. It's fun to see and debunk or see if something like, wow, that. I cannot believe that, you know, actually worked. You know, I Mean like even from 10 years ago. It was 10 years ago I started my dissertation. Yeah, it was. You would think even though this modality or Katsu has been around since like early 70s out in Japan, like I introduced it to my college, not no one has heard heard of it up here. Like I had to go through irb, I had to explain everything, go through absolutely everything, show the researchers out there getting all the research from there. And that was only 10 years ago, but it technically had already been being practiced by Dr. Sato and stuff for decades at that point. And he was perfecting like you know, his device and how he, you know, applied. They, like I said, they call it more blood flow modification training just the way the technique of their devices is used. So it's, it's, it's just funny that you say that because some things are actually seem so novel but they actually have been around forever. But then you know, you get, get those type of devices that pop up out of nowhere and like you said, everyone wants to get results the fastest possible way.

The body's always looking for the path of least resistance. Body and mind always. That's amazing. Okay, so I'm curious, have you seen this? You know now in the time of this recording, 2024, can't believe time just goes places. But you know there's been a huge move towards online training and you know, working out at home for whatever reason. Have you seen this modality work successfully for people and patients to actually do it themselves like with guidance but like do it online? Like have you seen be facilitated? Well, yep.

So as long as they go through. So I actually have a couple, I have a client out in California that I, that I train and I'll be seeing her today. It's a same thing. She, you know, we went through an entire introduction, health history questionnaire, everything to make sure she was healthy enough to work out number one or to do any of those kind of things. So once they're cleared and ready to go, it's really easy to facilitate online coaching with bfr and it's also again and I want to get back to the time aspect, super efficient for the coach. You want to get another 30 minute session in with someone, a 40, 40 minute session in with someone. I mean you can just you know, throw on your computer, take them through exercises and because they only just need a small amount of space, you don't need a ton of other equipment that people who are looking for who don't have access to a gym or don't have transportation to a Gym, you have good reputable bands or cuffs. You can easily work with a coach online or a PT online doing thing using this modality in the comfort of your own home or your small 10 by 10 space or whatever you have with. I mean you could ultimately just be doing body weight stuff with it. You don't even need equipment. But typically you could have like very, very small weights, some exercise bands, you know, things like that that typically most people would have, you know, just at home home. So there's the time aspect there. You just save it. You're at home, you don't have to drive anywhere. You can, you know, turn on your computer, turn off your computer and get a full workout in 30 minutes in a small space. So yeah, absolutely. And it's, it's a lot of fun actually coaching, coaching them online with bfr. Once they know how to do it, they can see you. As long as you have bands you can apply it, you can show them, show video tutorials, send them videos, feedback, all of that. So yeah, absolutely. I think this should be a big, hopefully a growing area is using BFR and in this online space.

Yeah, I'm excited, I'm excited to dive in. I think it's going to be, it's amazing. I think it's going to be amazing. So can you share with us a little bit about, about the online course? Like can you tell us a little bit about how like carry us through the, like the actual like you know, when someone joins and gets certified, what does the curriculum look like and what are some of the, the components that come with it?

Yep, sure. So we have been doing this course now or I've been doing the comprehensive course for about four years now in all in person. It's always been in person or live stream where we're doing this and kind of going back and forth with a clinic or somewhere across the country or something like that and kind of taking them through it. A lot of most, the majority of the courses so far have been in person. So typically the curriculum is very, very similar setup to how we set up the curriculum in an in person course. Of course the main difference being like we are not physically there with you applying it to your limbs and you know, you know, palpating your radial pulse like your pulses, things like that and showing you those things. The curriculum and the educational piece are the same on other than when we get to the practical hands on portion. It's really a lot of obviously the videos, those intricate how to's going through pictures, zooming in, showing them how to apply it and things like that. So obviously that's the main difference is the hands on portion is through video explanations and things like that. But we go for. So our, the modules for the online course we have, we dive into, it's obviously like an intro welcome. Then we go to like kind of just an introduction to what BFR is and history and really kind of where this whole thing came from. Came from. And then from there we dive into muscular physiology review. And a lot of courses don't really have this. And I thought that was a big or I don't say have that but when we're talking about device education or things like that is because I get a lot of questions or I started years ago getting a lot of questions on comparing it traditional strength training, comparing it to this, comparing it to that, when I just went ahead and just talked about blue. But so then I'm like, you know what, I think there needs to be a section in this course where we do a quick muscular physiology hypertrophy review. So then when I get into the BFR section they're like, oh, that's how it connects. So then it kind of, I always tell my students there's like a method to my madness. I tell a story, I, I build up to my story, I build up to the grand finale so they understand kind of. So there's not so many questions along the way. It's kind of like oh yeah, we already went over that. That's how this builds on this. That's how I kind of take any bit of my courses. Anyway, so we go over a muscular kind of just a brief muscular physiology review. And it's usually a really good refresher for anyone who hasn't been in school for like 20 years, 30 years or you know, a few years where like oh, that was good to read. You know, we review like muscle, muscle fiber types, you know, the size order principle, things like hypertrophy mechanisms. And then we'll get into the next module which is BFR physiology. So what happens physiologically when you're applying BFR from a musculoskeletal all the way to a hemodynamic or cardiovascular perspective. So we go over the physiology there, there's a little, little again I'll put my disclaimer in the, the device education piece. And it really is just for education on what's out there. So these are how these work, whatever, you know, kind of thing. So we kind of talk about the varying devices and materials of the, those devices out there. From there we Head into practical applications. So we talk about some, some key studies. I mean there's hundreds and hundreds of studies out there now. So I could bore you with saying like here's a study. This is how this benefited this. In part of the course we have a ton of research studies that we share with everyone for a resource guide afterwards that they can dive into themselves. But we pick and choose some really topical physiological studies that reemphasizes the physiology of what's going on. And then from there we talk about our own clients and people we've worked with or our colleagues have worked with and we'll bring up like specific case studies or groups. So we really talk about that. And then we head into the last few sections are like safety, efficacy, do's and don'ts, you know, contraindications, indications, and then obviously all of the applied aspect of how to put on the bands, how to apply the appropriate pressure and then protocol development. So the last piece is how do we program this? What it, what is, what are the sets, what are the reps, what are the rest breaks, what should the client be feeling, what they shouldn't be feeling? So all those last couple modules are, are really getting into the fun part where you actually now then get to apply it to your clients or your patients and things like that and being like, oh cool, so this is how I'm going to apply it here in this situation and all of those kind of things. So then, then it gets into all of the, the, the actual hands on, so to speak aspect.

That's so cool. And what I'm particularly really excited about specifically with this first round that you're essentially bringing to the world, is that you're also doing these implementation Q and A. So this will be your opportunity to like, you know, because how many times have we taken a certification, we've learned something and then we go and apply it and we're like wait, that's not what the book said it was going to happen.

Right?

It's like that's like trying to, to learn how to swim by reading a book instead of like getting in the actual water. So it'll be great because you and your partner are going to be hosting these Q and A's where you can like bring case studies, you can bring like, well, I tried this, this is what happened. And in real time you're going to be able to answer questions. And I think that that is like powerful and amazing, which won't always be there.

So. Yeah, no, absolutely. We thought that this first go around, we Thought offering those once a week sessions going along with the modules so they can ask questions off the modules and get us one on one was, was the way to do this. Plus for us it's a really good benefit because we're going to get feedback right now on the course, launching it for the first time. So like, okay, what was clear, what wasn't clear, you know, what do we need to fix a little bit more in this online aspect. So I love the constructive feedback we're going to get. So I feel like we're going to get just as much of a benefit as anyone else being on there, being a part of this first group, being able to ask us all these questions. Because my colleague Paul, he's a physical therapist and has worked with. Oh my gosh. I feel like almost every clinical case with BFR the last few years under the sun with from the PT perspective. And I have a lot of the strength, conditioning, fitness, deconditioned perspective. So we bring, we kind of marry them both a lot together, which is really, really nice. So you have both of us there answering these questions, but at the same time it's going to give us feedback on. Oh, maybe that wasn't clear enough or we need to clarify that. So I think it's going to be a fun. Well, I'm excited. It's going to be a fun experience. I think so.

Yeah. I can't wait. When is it starting?

March 25th.

Okay, can't wait. It's coming up. Okay, great. So what we'll do is we'll be sure to link all of those details. So if you want to learn more about bfr, we'll make sure that we put it all in the show notes and then I want to be respectful and mindful of your time. So thank you so much for pouring into me and into the community. I cannot wait. This is going to be so amazing. So for those of you who have more questions or they want to connect deeper with you, what are some of the best places I can send them?

Yep, you can send me. You can send me an. An email directly to. It's all one word Glass training and education gmail.com. that's an easy way to get a hold of me. Instagram, I check fairly often. It's just at Dr. Susie Lachowski. So you can DM me there and ask any sort of questions. Those are the two main ways you can get a hold of me is through email or through Instagram DM for the most part.

Okay, great. So we'll be sure to link all of that up. Thank you so much. I really appreciate it.

All right, Beverly, thanks for having me. Enjoyed our session today.

So good.

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