In this episode of BFR Radio, we begin a new series exploring how blood flow restriction (BFR) training can support rehabilitation following major injuries and surgery. For the first episode in this series we are focusing on the acute phase of ACL reconstruction — the period before and immediately after surgery when exercise is limited. You’ll hear how pre-operative BFR strengthening can help protect quadriceps endurance heading into surgery, how passive BFR can reduce post-operative muscle loss by more than half, and how combining BFR with neuromuscular electrical stimulation (NMES) offers a promising strategy to maintain muscle size during immobilisation. Key studies discussed: Zargi et al. – Pre-operative BFR exercise before ACL reconstruction Takarada et al. – Passive BFR in the first 2 weeks after ACLR Franz et al. – Passive BFR following knee replacement Slysz et al. – Passive BFR with NMES during unloading Whether you’re a clinician, coach, or athlete, this episode provides practical insights into using BFR at the earliest stages of ACL rehabilitation to set the foundation for long-term recovery.   Thanks for listening and remember to keep the pump.   Chris   References (APA 7th edition) Franz, A., Heiß, L., Schlotmann, M., Ji, S., Strauss, A. C., Randau, T., & Fröschen, F. S. (2025). Passive blood-flow-restriction exercise’s impact on muscle atrophy post-total knee replacement: A randomized trial. Journal of Clinical Medicine, 14(15), 5218. Slysz, J. T., Boston, M., King, R., Pignanelli, C., Power, G. A., & Burr, J. F. (2021). Blood flow restriction combined with electrical stimulation attenuates thigh muscle disuse atrophy. Med Sci Sports Exerc, 53(5), 1033-1040. Takarada, Y., Takazawa, H., & Ishii, N. (2000). Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Medicine & Science in Sports & Exercise, 32(12), 2035-2039. Žargi, T., Drobnič, M., Stražar, K., & Kacin, A. (2018). Short–term preconditioning with blood flow restricted exercise preserves quadriceps muscle endurance in patients after anterior cruciate ligament reconstruction. Frontiers in physiology, 9, 1150.