KAATSU for Orthopedic Recovery: Considerations & Protocols
A clear overview of key considerations and protocols for using KAATSU safely and responsibly in individuals recovering from orthopedic procedures.
The information on this page is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
KAATSU AND ORTHOPEDIC REHABILITATION
Following an orthopedic injury or surgery, one of the most immediate challenges is muscular atrophy—the progressive loss of muscle mass and strength due to immobilization and disuse. While physical therapy and traditional strength training are considered the most effective treatments for rebuilding this lost muscle, these methods often cannot begin until weeks after surgery. This delay can significantly impact the recovery process and prolong an individual's return to a healthy, active life.
KAATSU offers a simple, convenient, and easy-to-use approach to avoiding or minimizing this problem. Because KAATSU has systemic (full-body) effects, it can be used on uninjured limbs to stimulate a robust, body-wide hormonal response that supports healing and tissue regeneration. Furthermore, the patented KAATSU Cycle mode can often be applied much earlier than traditional exercise. Very importantly, KAATSU uses gentle, low pressures to safely enhance circulation in the injured limb without stressing healing joints, tendons, or ligaments. This process also helps mitigate muscle loss during the critical early stages of recovery and prepares the body for a more efficient return to strength.
Additionally, because KAATSU can be performed daily - or even twice daily - during the rehabilitation phase, and can be conveniently performed at home, it is an efficient and effective adjunct to regularly scheduled physical therapy sessions that is often limited by health insurance.
CONTRAINDICATIONS
Patient safety is the highest priority. You must first consult with and get approval from your physician or physical therapist before using KAATSU post-injury or post-surgery, especially if you have any of the following conditions:
- Open fractures or unhealed wounds at the band application site
- History of deep vein thrombosis (DVT), pulmonary embolism, or other clotting disorders
- Significant vascular disease or impairment in the affected limb
- Active infections, tumors, or inflammation in the limb
- Extreme swelling (edema) in the limb
- Uncontrolled hypertension (high blood pressure)
- Pregnancy
- Any other serious or acute medical condition that could be complicated by changes in blood flow
KAATSU PRINCIPLES
KAATSU is a versatile tool that can be adapted to nearly every phase of orthopedic recovery, from immediate post-op to a full return to play.
- Mode: Always use the KAATSU Cycle mode. It is the most effective mode for enhancing circulation and preparing the tissue for rehabilitation.
- Frequency: KAATSU can be done daily, and even twice per day (morning and afternoon/evening), to accelerate recovery. A minimum of 3 sessions per week is recommended.
- Systemic Approach: Always perform KAATSU on your arms first, then move to your legs. This creates a systemic hormonal response beneficial for healing.
- Single-limb KAATSU: If you are nervous about placing KAATSU bands on your injured limb during your recovery, or a cast or sling prevents you from placing bands on your limb, you can always do Single-limb KAATSU on your injured limb and normal KAATSU Cycle sets on your other three non-injured limbs.
- Early Intervention: KAATSU can often begin much earlier than traditional exercise. Simple passive cycles can be done even when a limb is non-weight-bearing.
- Hydration: Always be well hydrated before and during your KAATSU sessions.
KAATSU PRINCIPLES (CONTINUED)
- Band Placement: The bands are only located in two locations on your body, no matter where your injury is. The arm bands are positioned high on your upper arms, above your biceps and triceps, near your armpit, but below your deltoid (shoulder) muscles. The leg bands are positioned high on your upper leg, above your quadriceps and hamstrings, near your groin angled upwards to the outer part of their thigh. The leg bands should follow the line of a pair of men's briefs or women's bikini.
- Band Tightness: When you manually apply the bands to your arms, you should be apply to insert one finger between the bands and your skin. This is called "one-finger tightness". If this feels a little too tight, you can loosen the bands to a two-finger tightness. When you manually apply the bands to your legs, you should be sitting down - and not standing up. Apply the bands to a one-finger tightness. After 1-2 KAATSU Cycle sets, then you are manually retighten the bands slightly tighter.
- Appropriate Pressure: Always start in the Low Pressure setting. It is important to enable your vascular tissue to warm up and get acclimated to higher pressures. It is also very important to understand that a high pressure is not necessarily - and not usually - your optimal pressure. To find your optimal pressure, always check your Capillary Refill Time.
- Capillary Refill Time (CRT): Your CRT is a visual indication that the pressure is appropriate. Your CRT should always remain fast (1-2 seconds) on your arms and legs. You can check your CRT by firmly pressing your finger into the base of your palm when your arm bands are inflated. When you release your finger from your palm, the blood should return within 1-2 seconds. You can check your CRT by firmly pressing your finger into your thigh or calves when your leg bands are inflated. When you release your finger from your leg, the blood should return within 1-3 seconds. If your CRT is longer than 3 seconds, then your bands are too tight and should be loosened.
PROTOCOLS FOR ORTHOPEDIC RECOVERY - ARM & SHOULDER SURGERY
The following are examples of simple protocols for reference purposes only. The exact timing, pressures (SKU), and exercises must be determined by your physical therapist or orthopedic specialist based on your specific surgery and stage of recovery, always based on the KAATSU Principles. The primary goal in the initial weeks is to enhance circulation and promote healing, not to induce inflammation or stress healing tissues.
Phase 1: Initial Post-Op Healing (Approximately Weeks 0-2)
The goal during this phase is primarily passive. Vigorous and intense active exercise should be avoided, although moderate movement and gentle exercises within reason are recommended to improve circulation and generate a robust hormonal response.
Post-Op Arm/Shoulder Surgery (e.g., Rotator Cuff, Labrum, Bicep Tendon Repair):
- Systemic Warm-up: While seated comfortably, perform 2-65 KAATSU Cycle sets on your arms first, always using the Low Pressure setting. If you want to avoid placing the band on your injured arm, you can always do SIngle-limb KAATSU on the uninjured arm.
- Move to Legs: Perform 2-6 KAATSU Cycles on your legs, again using the Low Pressure setting.
- Injured Arm: If and when cleared by your surgeon, perform 2-6 Low Pressure KAATSU Cycle sets on the injured arm. The pressure should be minimal and comfortable, with the goal of gently improving blood flow without causing any discomfort at the surgical site.
PROTOCOLS FOR ORTHOPEDIC RECOVERY - LEG HIP SURGERY
Post-Op Leg/Hip Surgery (e.g., ACL, Meniscus, Hip Replacement, Achilles Repair):
- Systemic Warm-up: While seated or lying down, with your head and chest elevated above the KAATSU bands on your legs, perform 2-6 KAATSU Cycle sets on your leg using the Low Pressure setting.
- Move to Uninjured Leg: Perform 2-6 KAATSU Cycle sets on your uninjured leg, if you choose to do Single-limb KAATSU.
- Injured Leg: If and when cleared by your surgeon, perform 2-6 Low Pressure KAATSU Cycle sets on the injured leg. The limb may be elevated. There should be absolutely no pain. This can often be done while the leg is still in a brace or immobilized.
PROTOCOLS FOR ORTHOPEDIC RECOVERY - 2 WEEKS POST OPERATION
Phase 2: Early Mobilization & Re-conditioning (Approximately Weeks 2+)
As cleared by your healthcare provider, you can begin to incorporate gentle movement.
Post-Op Arm/Shoulder:
- Begin with 2-6 3 KAATSU Cycle sets on the arms.
- Incorporate simple, non-painful movements like Hand Clenches and gentle, therapist-approved range-of-motion exercises (e.g., pendulum swings).
- Follow with a leg session to augment maintain the systemic benefits.
Post-Op Leg/Hip:
- Begin with 2-6 KAATSU Cycle sets on the arms.
- Follow with 2-6 KAATSU Cycle sets on the legs.
- Incorporate simple, non-weight-bearing or partial-weight-bearing isometrics like Quad Sets and Glute Squeezes. Progress to basic KAATSU 3-Point Exercises (Seated Toe Curls + Seated Toe Raises + Heel Raises) as your protocol allows.
LITERATURE AND STUDIES
Numerous studies have demonstrated the effectiveness of KAATSU Blood Flow Restriction (BFR) training for increasing muscle size and strength in older adults.
- Effects of Low-Load, Elastic Band Resistance Training Combined With Blood Flow Restriction on Muscle Size and Arterial Stiffness in Older Adults (Yasuda et al., 2014)
- Effect of 24 weeks of KAATSU resistance training on femoral muscle size and safety in a 84-year-old woman (Yasuda et al., 2019)
- Thigh muscle size and vascular function after blood flow- restricted elastic band training in older women (Yasuda et al., 2016)
- Muscle size and arterial stiffness after blood flow-restricted low-intensity resistance training in older adults (Thiebaud et al., 2013)
COMMITMENT TO SAFE AND STUDIOUS APPLICATION
KAATSU is a powerful modality that can significantly enhance and accelerate the orthopedic rehabilitation process by safely stimulating muscle growth and improving circulation without stressing healing tissues. To ensure the best outcomes, it is essential that KAATSU is applied regularly and appropriately, following the established safety guidelines and under the guidance of a qualified healthcare professional.
