Passive Blood Flow Restriction Accelerates Muscle Recovery After Exercise-Induced Muscle Damage in Healthy, Recreationally Active Females

Abstract Howard, MA, Lubiak, SM, Schmidt, JT, Stray-Gundersen, S, Hirsch, KR, Trevino, MA, Hammer, SM, Dinyer-McNeely, TK, Bergstrom, HC, Keller, JL, and Hill, EC. Passive blood flow restriction accelerates muscle recovery after exercise-induced muscle damage in healthy, recreationally active females. J Strength Cond Res XX(X): 000–000, 2026—The purpose of this investigation was to examine the effects of passive blood flow restriction (pBFR) on indices of exercise-induced muscle damage (EIMD) following a muscle-damaging protocol. Eighteen females completed 6 visits occurring at the same time of day (±2 hours). Muscle damage was elicited by performing 3 sets of 25 maximal, unilateral, isokinetic (60·s −1 ), concentric-eccentric leg extensions on each leg. Each leg was then randomly assigned to receive pBFR (80% of total arterial occlusion pressure) or sham (20 mmHg) at 0, 24, 48, 72, and 96 hours post-EIMD. Indices of EIMD (muscle soreness 0–10 visual analog scale, limb circumference, range of motion ROM, pain pressure threshold, and maximal voluntary isometric contraction MVIC torque) were assessed before EIMD (baseline) and at 0, 24, 48, 72, and 96 hours. Separate 2 (Condition pBFR and sham) × 6 (Time baseline, 0, 24, 48, 72, and 96 hours), repeated-measures ANOVAs were performed. Collapsed across Condition, muscle soreness increased post-EIMD and partially recovered at 72 and 96 hours (change from baseline Δ; Δ2.3 ± 2.3 au and Δ1.4 ± 1.5 au, respectively). Limb circumference increased in both conditions post-EIMD and recovered by 24 hours (pBFR: Δ0.4 ± 1.8 cm; sham: Δ0.5 ± 2.2 cm). ROM recovered sooner for pBFR (24 hours; Δ−6.1 ± 8.9°) than sham (24 hours; Δ−9.2 ± 9.4°), and ROM was greater for pBFR than sham at 48 hours post-EIMD. Pain pressure threshold was greater, collapsed across Time, for pBFR (4.40 ± 1.62 kgf) than sham (4.12 ± 1.63 kgf). Like ROM, MVIC torque recovered sooner for pBFR (24 hours; Δ−14.9 ± 25.3 Nm) than sham (24 hours; Δ−33.9 ± 22.1 Nm). Applying pBFR after EIMD resulted in a faster rate of return for MVIC and ROM in females, suggesting that pBFR may serve as an effective strategy to facilitate recovery of muscle function.