Blood Flow Restriction in Athletic Populations-Part 3: Applications for Cardiovascular Conditioning, Performance...

Background: The application of blood flow restriction (BFR) training extends beyond traditional resistance, with targeted use in cardiovascular conditioning, performance priming, and clinical applications relevant to athletic populations. Part 3, the final paper of this series, focuses on the application of blood flow restriction (BFR) during cardiovascular exercise (BFR-CV), ischemic preconditioning (IPC), and therapeutic applications, including the management of joint pain, tendinopathy, and bone health. Methods: A narrative review of research examining BFR applications for cardiovascular conditioning, performance priming, and clinical management was conducted using structured searches of PubMed/MEDLINE, SPORTDiscus, Scopus, and Web of Science, supplemented by targeted literature searching and reference-list screening through May 2026. Search terms encompassed BFR and occlusion training alongside cardiovascular and aerobic exercise, anaerobic and interval training, sprint and sport-specific conditioning, ischemic preconditioning and intra-conditioning, pain and tendinopathy, and bone health. Evidence from trained and athletic populations was prioritized, with relevant clinical and mechanistic studies included where athlete-specific evidence was limited or unavailable. Findings were synthesized narratively across conditioning, IPC/IIC, pain-management, and bone-health applications. Results: Low-intensity BFR-CV (40-50% VO_2max with 40-80% arterial occlusion pressure) may enhance aerobic capacity and muscular endurance in trained athletes while minimizing mechanical loading. Sport-specific BFR applications during soccer drills, basketball activities, and small-sided games have been associated with improvements in repeated-sprint ability and sport-specific endurance without impairing speed or power. IPC may produce small, context-dependent improvements (1-3%) in short-duration, high-intensity performance and may support recovery between repeated competitive bouts. Low-load BFR training (20-30% 1RM) may reduce joint and tendon pain while maintaining muscle strength and mass during rehabilitation. Evidence for bone health remains preliminary, with BFR showing potential to influence bone-turnover markers and preserve musculoskeletal function during periods of restricted osteogenic loading. Conclusions: BFR represents a versatile modality for conditioning, performance optimization, and athlete care when mechanical load or training time is constrained.