Rehabilitation Utilizing Blood Flow Restriction Following Surgical Repair of a Bankart Lesion with a Buford Complex in an Elite High School Football Player: A Case Report.
Kirsten Parrish, Jace Brown
A 17-year-old football linebacker improved in strength, range of motion, and reported function after Bankart repair and multiple other procedures, with BFR as one part of a broader program (weeks 3–12).
This is a single case with incomplete testing. It cannot show BFR works.
Key findings
1BFR was introduced at postoperative week 3 at 50–60% of a measured limb occlusion pressure of 170 mmHg, with external loads at approximately 40% of estimated one-rep-max, and was discontinued at week 12 in favor of conventional loading.
2The athlete showed progressive improvements in range of motion, strength, and patient-reported outcomes, reported no shoulder pain or instability symptoms at the final documented assessment (weeks 15–17), and received medical clearance at week 19 to continue offseason football participation.
3The athlete underwent Bankart repair, capsulorrhaphy, labral debridement, subacromial decompression, distal clavicle excision, chondroplasty, and biceps tenotomy with tenodesis in the presence of a Buford complex, and the authors state that the single-case design cannot determine cause-and-effect relationships.
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What it does not show
Single patient: the authors state the design cannot determine cause-and-effect relationships, and the athlete received at least seven concurrent interventions (BFR, dry needling, soft-tissue work, joint mobilizations, progressive strengthening, plyometrics, UBE), so no single component's contribution can be separated. Formal physical therapy ended at week 17 due to transportation barriers, so the planned later-stage return-to-sport testing (unilateral power, reactive and neurocognitive measures) was never completed under PT supervision. The authors note that girth and strength changes may reflect overall training adaptations and measurement variability, and explicitly state these findings cannot be attributed directly to BFR. Engagement with auxiliary sessions outside the clinic was variable due to scheduling, and some testing sessions occurred after team activities, which the authors note may have introduced fatigue effects.
Declared interests
The authors declare no conflicts of interest. The BFR equipment (SmartCuffs 1.0 with SD3 Series ultrasonic Doppler, SmartCuffs LLC, San Antonio, TX) is named in the methods, but no funding, sponsorship, or author employment relationship with that company is disclosed.
The easy way to misread this
Do not read this case as evidence that blood flow restriction training improves post-operative shoulder outcomes. The athlete received at least seven different interventions simultaneously (BFR, dry needling, soft-tissue mobilization, joint mobilizations, progressive strengthening, plyometrics, and upper-body ergometer work), the authors themselves state the single-case design cannot determine cause-and-effect and that girth and strength changes cannot be attributed directly to BFR, and the planned later-stage return-to-sport testing was never completed. One athlete's favourable course, with multiple treatments running in parallel, does not isolate BFR as the active ingredient.
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