Abstract

Musculoskeletal injuries are prevalent among athletes and often lead to prolonged rehabilitation due to muscle atrophy, strength deficits, and joint dysfunction. Traditional high-load resistance training, while effective for muscle hypertrophy and strength recovery, may be contraindicated during early phases of rehabilitation or in individuals experiencing pain or surgical restrictions. Blood flow restriction (BFR) training has emerged as a novel strategy that enables low-load exercise to elicit similar adaptations to high-load training, making it a valuable adjunct in sports rehabilitation. This narrative review explores current evidence on the effects of BFR training in the rehabilitation of athletes with musculoskeletal injuries, with a focus on its physiological mechanisms, clinical applications, pain modulation effects, safety considerations, and limitations. Relevant peer-reviewed articles from 2018 to 2025 were reviewed based on thematic relevance. Studies involving ACL reconstruction, tendon injuries, patellofemoral pain, upper and lower extremity rehabilitation, and pain-related outcomes were considered. BFR training demonstrates significant benefits in preserving muscle mass and strength, accelerating return to sport after ACL reconstruction, and improving functional outcomes in load-compromised rehabilitation scenarios. It also shows promise in reducing pain through mechanisms such as exercise-induced hypoalgesia. Despite its advantages, clinical protocols vary widely, and safety monitoring remains essential. BFR training is a promising rehabilitation modality that bridges the gap between early and late-stage recovery in athletic populations. While current evidence supports its efficacy, further standardized trials are needed to refine protocols and enhance its safe integration into routine sports rehabilitation.