Blood flow restriction in shoulder rehabilitation: a systematic review of its neuromuscular and functional effects.

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Published: 2026-01-01

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Luis Miguel Fernández-Galván
Universidad Europea de Madrid
Spain
https://orcid.org/0000-0002-8753-6814
René Díaz Cordovez
Universitat de València
Ecuador
Vol. 12 No. 1 (2026), Reviews, pages 1-33

DOI:

https://doi.org/10.17979/sportis.2026.12.1.12478
Submitted: 2025-07-24 Published: 2026-01-01
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Abstract

Blood flow restriction (BFR) training has gained prominence as a method to stimulate muscular adaptations using low loads. This systematic review aimed to evaluate the effects of BFR on the neuromuscular function of the shoulder in healthy individuals. A comprehensive search was conducted in PubMed, Web of Science, Scopus and SPORTDiscus databases, following the PRISMA guidelines. Eight studies were included, comprising a total of 223 participants who underwent BFR protocols using low loads (20–30% of 1RM) or submaximal isometric contractions, combined with moderate occlusion pressures (~50% of arterial occlusion pressure). The results consistently showed improvements in muscular strength, lean mass, and electromyographic activation (EMG) of key muscles such as the trapezius, serratus anterior and pectoralis major, without negatively affecting shoulder biomechanics. Additionally, some studies reported positive effects on posture in individuals with rounded shoulders. Overall, the findings support the use of BFR as a safe and effective strategy to induce neuromuscular adaptations in the shoulder, particularly in non-clinical settings. However, further research with greater methodological rigour, larger sample sizes, and long-term follow-up is needed to establish robust recommendations.

Keywords:

clinical rehabilitation, hypertrophy, occlusion training, resistance training

Article Details

References

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