KAATSU Training: squeezing blood for muscle growth?

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Table of Contents

• Heavy or Light Training for Muscle Mass
• “Kaatsu Training”
• Accelerated Metabolite Formation
• Hormone Production
• Kaatsu Training in Practice
• What Pressure for Kaatsu?
• Safety of Restricting Blood Flow
• Pressure Dependent on Individual and Person
• Too Complicated

“Kaatsu Training,” also known as Blood Flow Restriction training, involves restricting blood circulation to and from the trained muscle as a method to achieve muscle growth with lighter weights. Successful in theory, difficult to implement in practice.

Heavy or Light Training for Muscle Mass

Strength training for muscle mass is traditionally done with relatively heavy weights.

We often recommend using weights of at least 65% of your 1RM (the maximum weight with which you can do one repetition of an exercise), but preferably between 75% and 80% of 1RM [1,2]. There are also studies where lower resistance appears to be sufficient for muscle growth [3,4]. However, these studies focus on the direct influence on protein synthesis (production of protein in the muscles).

This is just one factor for muscle growth (muscle breakdown, for example, is another).

When we look at the actual effect on muscle size, the traditional method of training with about 75% of 1RM as resistance seems to be the best method.

However, there are circumstances in which a relatively large resistance is not desirable.

After all, your muscles are not the only things stressed during training, but also joints and attachments. Think, for example, of the elderly, where the risk of injury is higher, but also of people recovering from an injury.

So it would be great if you could achieve the same results with lighter weights.

“Kaatsu Training”

Various studies have been conducted on a method often called “Kaatsu training,” which originally comes from Japan [5].

Convenient because Japan has the largest population of elderly people worldwide.

The method was developed by Yoshiaki Sato. When he was 18 years old and sat in “seiza” (the traditional way of sitting on the knees in Japan) for too long, he had difficulty and pain when standing up, his legs felt as if he had done strength training. This comparison with the feeling of strength training gave Sato the idea to find out if this could be an actual training method.

Kaatsu is Japanese for “increasing pressure.”

In Kaatsu training, the blood flow to and from the muscles of the legs and arms is restricted by tying them off.

According to a 2010 study, this may even lead to more muscle growth than “traditional” strength training [6]. A 2006 study showed that even simple activities like walking can lead to muscle growth when blood flow to the leg muscles is restricted [7]. In the latter case, muscle growth was actually examined, not just one of its factors. The so-called CSA (Cross Sectional Area) of the muscle was examined, in other words: The surface area of the muscle cross-section.

This was found to have increased by four to seven percent after three weeks of walking with restricted blood flow. Strength increased by eight to ten percent while there was no effect in the control group (walking without restriction of blood flow). Another 2005 study showed that twice-daily Kaatsu training with 20% 1RM leads to muscle growth, while training with 20% 1RM without restricting blood flow was not effective [8].

Accelerated Metabolite Formation

An assumed explanation for the effect of Kaatsu is increased metabolic stress. This refers to the number of “metabolites” that are built up, derivative products released under the influence of training such as lactic acid and hydrogen ions.

These, in turn, could lead to increased cell swelling (muscle pump) and/or promote the production of certain hormones [9].

Hormone Production

We have written various articles on the production and release of anabolic (tissue-building) hormones such as testosterone, growth hormone, and IGF-1 in response to strength training.

These hormones promote protein synthesis resulting in muscle growth. On the other hand, there is the action of cortisol, the stress hormone, which works catabolically (breaking down muscle mass). So, the optimal training method increases anabolic hormones while keeping catabolic hormones low.

In an interesting 2006 study, researchers had their subjects [10] train calves (calf presses) and biceps (bicep curls) in three different ways (or not at all):

• With light weight, 30% (1RM) with occlusion
• At moderate/heavy weight, 70% 1RM without occlusion
• Occlusion without training

It is not surprising that occlusion without training yielded no results. What was remarkable, however, was the fact that training with 30% 1RM with occlusion led to higher growth hormone levels than with 70% 1RM without occlusion.

In conclusion, with similar lactate responses, light exercise combined with partial vascular occlusion elicits a greater GH response than moderate exercise without occlusion but does not affect T, FT, or cortisol.

G.V. Reeves, Southeastern Louisiana University

In the aforementioned 2005 study where muscle mass increased with 20% 1RM Kaatsu, it was also found that under those conditions, IGF-1 gradually increased (which did not happen in the control group performing the same training without occlusion) [8].

Kaatsu training in practice

That all sounds great, but application in practice proves to be difficult.

You can of course use a tourniquet, which is why the term tourniquet training is also used for this (or occlusion training). Another alternative is a simple elastic band. However, both have their problems.

For example, what is the ideal pressure they should provide (to what extent should they restrict blood flow)?

What pressure for Kaatsu?

Some Kaatsu fans argue that Kaatsu is not “occlusion training,” in other words, blood flow is not completely cut off.

A certain pressure is needed, not too low, not too high.

This pressure also needs to be constant during training. If you put an elastic band around your arm and then do bicep curls, the band will tighten and provide more pressure as your biceps contract and enlarge during the exercise. There is special equipment available that regulates the pressure in the bands for this purpose.

So, a simple elastic band or tourniquet is not recommended.

A study using a pressure of 160-240 mmHg resulted in almost 8 percent muscle growth (cross-sectional area) compared to almost 2% without occlusion [11].

In another study, a pressure of 50-100mmHg was sufficient to achieve muscle growth with weights of only 20% 1RM in three weeks.

That probably means nothing to you, which brings me to the biggest problem with Kaatsu:

The complexity.

Safety of occluding blood flow

You can probably imagine that Kaatsu may pose risks.

In virtually all studies, Kaatsu is conducted under controlled conditions. In those cases, Kaatsu was found not to pose risks to vessels and vascular functions [12,13,14,15]. However, problems occur in a small number of cases.

This mostly involves a blood clot in the veins (venous thrombosis) and in a much smaller number, a pulmonary embolism (blood cannot or only partially oxygenate the lungs).

In other cases, rhabdomyolysis occurred. You may still remember that term from the unofficial crossfit mascot, “uncle rhabdo.”

Rhabdomyolysis can occur with excessive muscle breakdown resulting in large amounts of creatine kinase that can damage the kidneys.

As in the case of the Norwegian, 31-year-old ice hockey player [16]. During recovery from a knee operation, physiotherapists suggested Kaatsu.

Two days later, he was admitted to the hospital for three days with severe pain, where the diagnosis of rhabdomyolysis was made based on the amount of creatine kinase.

The physiotherapists later indicated that they probably should have built it up more slowly. They mainly referred to the number of sets.

The developer of Kaatsu also personally experienced that things can go wrong when he was admitted with a pulmonary embolism [17].

Pressure dependent on individual and person

The correct pressure seems to depend not only on the width of the band used and the type of material, but also on the size of the limb being occluded [18-22].

With a narrow band, for example, 5 cm wide, arterial occlusion is achieved very rarely with the same pressure that is adequate for a band of 13.5 cm in most cases [23].

This is not taken into account in all studies, so it is unclear to what extent effectiveness and/or safety are influenced [24]. In addition, the correct pressure for the arm seems to need to be determined differently (based on systolic blood pressure in the brachial artery) than for the legs (based on thigh circumference).

Too complicated

I should be enthusiastic about the possibilities of Kaatsu, but I simply find it too complicated, and that is not meant as a pun.

First, you need to know what to use and how.

In Japan, there are numerous opportunities to train yourself in the methods of Kaatsu, and special equipment is available to regulate the pressure. However, this usually involves an institution with a patent on a method.

This always makes me a little wary of objectivity versus commercialism.

Moreover, it appears to be hardly available in the Netherlands. If you feel like getting it from Japan, keep in mind that prices for a package of bands and pressure regulators start at around $2,000.

This makes it unsuitable for the average gym-goer.

I find the theory very interesting and it’s great that a lot of research is being done on it. However, for the time being, you won’t see me walking into the gym with bound arms and legs sticking out of my torso.

Unless Sato-san sends us a package to try out, of course.

References

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