Some of the athletes I train at times have had compromised joints either due to the nature of the sport they play (i.e. contact sports) or as a result of being in their sport for a long time (e.g. degeneration of joint structures). With respect to their strength training, it is still important to try and attempt to provide a high load stimulus.
However compromised joints prevent this from happening due to associated pain and inability to load. This is where using Blood Flow Restriction (BFR) whilst incorporating the theory of Cross Education (or Contralateral Strength Training) for the contralateral effects of unilateral resistance training can assist with providing a performance-based strength program. Contralateral Strength Training involves the concept where exercises are performed to increase muscle strength on one side of the body and voluntary strength improvements are observed on the contralateral side. Therefore an athlete can continue their high-load strength stimulus essential for maintaining/improving optimal athletic performance. This is performed on the "good" side of the body.
The addition of using BFR on the compromised joint enables the athlete to continue training at lower loads whilst being able to maintain/improve muscular strength and size without the stress on the joint. Furthermore BFR has been shown to decrease joint pain which is invaluable in this situation.
With respect to knee injuries I also find it important to include posterior chain, hamstring and calf specific strengthening exercises in a lower-body gym program. As a side note, I use the BFR on my "good" knee joint (whilst lifting a "heavy" stimulus). I find I can lift up to 80%RM with BFR with no restriction. The addition of BFR just means I don't need to go to my full maximum RM and also ensures that I am maximising the benefits of BFR (e.g. hormone release and muscle activation). And I also enjoy the feeling of BFR lifting high loads also.
This video highlights how I would put together a complete lower body strength training program including warm-up, main strength and ancillary exercises. I also sequence the single leg strength exercise in a particular way to ensure the session flows.
Thanks for watching.