[Transcript] – The Official KAATSU Episode: Everything You Need To Know About How To Use Blood Flow Restriction For Muscle Gain, Injury Recovery, Testosterone, Growth Hormone & Much More!

Affiliate Disclosure


From Podcast: https://bengreenfieldfitness.com/article/fitness-articles/workouts-exercise-articles/kaatsu/

[00:00:00] Introduction

[00:01:43] Podcast Sponsors

[00:04:30] Guests Introduction

[00:11:07] How John And Steven Got Interested In KAATSU Training

[00:15:43] KAATSU Defined And What It Does To The Body

[00:23:03] How KAATSU Affects Mood And Alertness After Using It

[00:26:59] How KAATSU Allows You To Build Muscle Without The Use Of Heavy Weights

[00:36:12] Podcast Sponsors

[00:38:47] Should You Use The Bands On Both Arms And Legs Simultaneously

[00:44:20] How KAATSU Affects Longevity

[00:50:35] Why KAATSU Is Not The Same As BFR Training

[00:58:14] Potential Effects Of KAATSU On The Immune System

[01:09:02] How KAATSU Has Helped Service Members With Severe Injuries

[01:11:44] How KAATSU Is Differentiated From BFR In The Scientific Community

[01:14:24] Closing the Podcast

[01:16:31] End of Podcast

Ben:  On this episode of the Ben Greenfield Fitness Podcast.

John:  He was essentially paralyzed. But because it was a brain injury of something with the autonomic nervous system, we were able to help get things turned on on his left side.

Steven:  And this is what he recommends to people who have lower back issues, people who for whatever reason, they don't want to do a sit-up, but they can walk with a book on their head.

John:  Gone are the days of, “Hey, I'm going to work legs hard today, and I can't do them again for three or four days.” You can do them again same day or next morning, no problem.

Ben:  Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.

Alright, you guys have been asking, so here you go, KAATSU training. I've talked a lot about blood flow restriction training before. It's different than these KAATSU Japanese devices. So, I got a couple of cats on the show who have been immersed with some of these Japanese researchers, badass, former Navy SEAL who uses this a ton in his training. And I've been using the KAATSU that I have now on some of the walks that I go on during swims, during workouts, using it in very similar ways you're going to discover on this podcast. These are incredible, incredible ways to train, this idea of restricting, or not really occluding or restricting, but you'll hear, you'll hear. I should just stop talking and let my guests explain to you.

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Alright, folks. This is it, the official KAATSU training episode. If you don't know what KAATSU is, don't worry, it's not some funky Japanese pop-tart. It's a lot more than that. We're going to get into it on today's show. I have addressed in the past on multiple podcast episodes the concept of what you may know as blood flow restriction training, which is not exactly the same as KAATSU, but we'll get into that. And also occlusion training in other podcast episodes. I've touched on it. I've talked with folks like Dr. Mercola about it. I've mentioned how much I'm using it these days, especially being at home.

At the time this is being recorded, we're on quarantine for this coronavirus, and men, one of my top tools at home right now is KAATSU training with bodyweight, not only because I can maintain muscle and get a mitochondrial and satellite cell response with a little less inflammation, but also because I can't go to the gym where all the heavyweights are, but I can simulate that with this type of training that we're going to talk about in today's show because I've been wanting to do a big deep dive on this for a long time and I finally hunted down two of probably the top experts who exist, or at least they're up there when it comes to KAATSU training.

So, everything that I talk about in today's show you're going to be able to find at BenGreenfieldFitness.com/KAATSUpodcast. And it's spelled, brace yourself, K-A-A-T-S-U. So, it's BenGreenfieldFitness.com/KAATSUpodcast for the shownotes. And I have two guests, like I mentioned, I've got two guests. One guest came to my house about three months ago, brought me through this super fun, mildly brutal KAATSU workout out in my home gym, and he showed me the ropes on this thing, and he has trained all over the globe. He left the unit at my house and I actually have it on right now. So, you guys are getting to hear in real-time how this training goes also.

But his name is John Doolittle. He graduated from the US Air Force Academy back in the '90s. He served in the US Navy for 25 years where he was deployed as an officer in the SEAL teams. That's right, he's a Navy SEAL. So, this guy's a badass. He's been in Kosovo, Bosnia, Iraq, Afghanistan. He retired as a Navy captain after his last assignment, and then went on to become a certified KAATSU master instructor. And it's pretty cool, actually, the type of applications he's found with his background in diving, particularly with using this thing for swimmers, which I think is really cool. And I began to use it for my swim workouts. I recently took the unit to India where I had access to a lot of pools in the hotels I was staying in and I was doing KAATSU pool base workouts every day. Holy cow, amazing, amazing, a huge game-changer for me to strap these bands on and not just do resistance training, but also hit the Aerodyne or hit the pool. Totally, totally epic way to train.

So, my other guest today in addition to John Doolittle–and oh, by the way, John, say hi so people know what your voice sounds like versus Steven's.

John:  Hey, great. Thanks, Ben. This is John. Pleasure to be here, man.

Ben:  Alright. So, that's John's lolling US Air Force Academy voice that you can hear right there. And my other guest is Steven Munatones. Am I pronouncing your last name right, Steven?

Steven:  Close. It's Munatones.

Ben:  Steven Munatones. So, Steven has actually studied with Dr. Sato. And if you don't know who Dr. Sato is, he's the dude who invented KAATSU. Dr. Sato, if you google and you look up a picture of him, he's literally like the ripest, youngest looking old dude you'll ever see. Maybe some of those Japanese genes. I suspect part of it might be the KAATSU training. But Steven has had a chance to train under Dr. Sato and he has actually been involved with KAATSU also in the World Open Water Swimming Association where he's been helping to coach for years and help them achieve some national championships or World Championships. And he's a Harvard graduate. He's introduced KAATSU to collegiate, to professional, to Olympic athletes, to military special operators, and I know many of my listeners may not be a Navy SEAL or an extreme athlete, but Steven has also really done a good job introducing this into the aging baby boomer community because as you'll learn on the show, one of the best ways to maintain muscle as you age and even build muscle is this KAATSU training.

So, we're going to delve into all of that and more. But guys, before we dive in, before we dive in, I actually have a KAATSU unit attached to my body right now. And either you guys can answer me this, but I'm right now pushing the on button on it, and what protocol do you recommend I run? Because what a lot of people don't realize, you can do this while you're at your office and get a ton of the benefits we're about to talk about even if you're not exercising. So, what protocol do you guys advise while we're podcasting?

John:  Hey, Ben, this is John. You got the leg bands on or you got the armbands on?

Ben:  I'm rocking the leg bands right now, maybe halfway through the podcast I'll switch, but leg bands right now.

John:  Okay. Perfect. That's what I'm wearing, too. So, have you done any cycles or did you just put them on? If you haven't done anything, let's go ahead and start at the group low, which is the lowest cycle that you got.

Ben:  Okay. Alright. So, I'll run the pro, press the P button. Pro, run it low, okay. I'm running a PL1 right now. Is that the one I should be running?

John:  Okay. That's good. That should take about five minutes.

Ben:  Okay.

John:  And then when that's done, just go ahead and go to pro-medium, and we'll just progress up. Each cycle will take about five minutes.

Ben:  So, this thing's just like pumping my legs, relaxing, pumping my legs, relaxing. We'll talk about why that's beneficial. So, if you guys hear a little low-level motor in the background, that's this little piece. And should you wonder about how one can throw a motor in a pool, the cool thing about these devices is once you get the pressure on, you can actually untether them, then go exercise without the unit attached. But if you have the unit attached, it'll actually cycle the pressure on and cycle the pressure off, which is really cool. So, anyways, that all being said, if you guys hear me grunting and groaning or you hear the veins in my legs expanding as I'm getting all swole during the podcast, this is why. So, thank you, John. And once this five-minute cycle is over, I'll switch to medium, which will give me even higher pressure, right?

John:  Yup, that's right, exactly.

Ben:  Right. Cool. Well, we'll work our way up. Alright. So, John, let's start with you. How did you discover KAATSU? How'd you get interested in this?

John:  Well, so you hit it already. I was in the Navy for 25 years. And during the career in the teams, in the SEAL teams, I like to say it's not if you get hurt, it's when you get hurt. Everybody gets hurt throughout a career in that line of work, right? I'm an orthopedic mess. I've had 12, 13 ortho surgeries. The way I got introduced to KAATSU was during rehab. So, throughout the US Special Operations Command Enterprise, we have physical therapists, trainers, strength coaches, dietitians. We have these people embedded in the various units, right?

So, my injury that I got introduced to KAATSU was a full-thickness [00:12:06] _____ rotator cuff tears. So, I had some surgery. And the guys asked me, “Hey, do you want to try this?” And I'm like, “Well, I'll try anything if it'll help speed up the rehab.” And it actually is the same injury I had had six years earlier and I was kind of nervous about it because when I had that done, that first rotator cuff, it took me like 10, 11 months to get all the way back into it. I mean, full range of motion, strength, mobility. So, I'm in butterfly all that stuff again. And so yeah, I said, “Yeah, I'll try it.” And they had me at 95% strength agility at the five-month mark. That's when I fell in love with it was the rehab piece. I got better, much faster than I was expecting.

Ben:  So, for you, it was basically your rotator cuff healed up super-fast and that's when you became a fan?

John:  Yeah, yeah, exactly. And I retired two and a half years ago. So, that was like three and a half years ago. So, I've been with the company for last two and a half years.

Ben:  Okay. And we'll get in later on to–or later in this podcast, we'll get into why you would have filled up so much more quickly using KAATSU. But how about you, Steven? How did you discover this thing?

Steven:  I was actually a volunteer coach with the U.S. National Swim Team, and the world championships were in Fukuoka, Japan. And I actually just saw an athlete using these bands around his arms and I said, “What is that?” One thing led to another. At the end of the competition, one of the coaches said, “Oh, I'll introduce you to Dr. Sato, who created KAATSU.” I said, “Great.” After the competition is over, I met Dr. Sato. I was blown away immediately by what I saw, and I asked him, “Dr. Sato, why isn't the rest of the world doing this?” Keep in mind, one of the kids on that team, on the USA National Team was a 15-year-old Michael Phelps. So, we had some studs on that team and nobody —

Ben:  Yeah. I've heard of him before.

Steven:  Yeah. Nobody had, at least not an American side had heard anything about KAATSU Dr. Sato taught me, showed me. And again, we were speaking Japanese because I can speak, read and write Japanese, and I said, “Dr. Sato, why isn't KAATSU known around the world?” And he goes, “Well, I don't speak English and I don't travel outside of Japan.” And I said, “Well, I do both of those things. Can you teach me?” And he says, “Sure. I'd love to teach it. I love to share this with the rest of the world.” And I go, “Great.” I go, “Do you have a book or something? I could just read it and then learn what you're doing.” And he pointed up at his forehead and he goes, “Well, it's all right here.”

So, literally over the next 13 years, he took me under his wing. I spent a lot of time at the University of Tokyo Hospital with Dr. Sato and the cardiologist there that were doing the cutting-edge research at the time. And then in 2014, Dr. Sato said, “Okay. You're ready. I think you understand KAATSU and let's go.”

Ben:  Okay. So, that was your guys' introduction to this thing. But now, I think probably we should hit the rewind button here for folks because we have not yet really laid this down. Define KAATSU for me. What exactly is KAATSU?

John:  Well, it's a Japanese word KA, which means increase, and ATSU, which means pressure. And Dr. Sato, his idea with KAATSU was to increase pressure, thereby, expanding and contracting the vascular system, and all the hormonal and metabolic and metabolite changes that come with expanding and relaxing vascular tissue, but it's a Japanese word.

Ben:  Okay. So, in terms of the actual mechanism of action, we can take as deep a dive as you want, explain to me, as I'm standing here with these two bands on my legs right now–and of course they could be using the arms and I know some real cowboys, myself included, will occasionally, although this is against the recommendations, put them on both the arms and the legs simultaneously, what is going on right now on a deep physiological level to my body as I have this thing running, either while I'm standing here or while I'm exercising.

John:  I think maybe we come back to that four limb until I think a little bit later. But from a mechanism perspective, you have the leg bands on right now, and I think it's important for your listeners to understand these are not tourniquets, right? These are elastic, pneumatic bladders inside these bands.

Ben:  Meaning, to differentiate, sorry to interrupt here, but to differentiate, what you mean by that is I have in the past–and I'm not [00:17:30] _____, I think you should get some value out of them, send people to buy like blood flow restriction bands on Amazon. There's like 40 to 60 bucks. You can get these bands that you can use almost like tourniquets to wrap around the limbs, which actually when I was a bodybuilder, we used to use like big gym towels or the resistance elastic bands at the gym to do this way back in the day. So, like 20 years ago, I was kind of messing around with some of this stuff. But what you're saying is these KAATSU bands are different in a way?

John:  Yeah, exactly. The idea is never to occlude, to fully occlude.

Ben:  And what does that mean to occlude?

John:  So, we don't want this to act as a tourniquet. So, a tourniquet will fully stop blood flow, right? You're on a lake cycle right now. You're on a pro. You're probably around 250 millimeters of mercury, maybe a little higher.

Ben:  Let's see. Right now, I turned it up, actually. I'm at 360 millimeters of mercury now.

John:  Okay. Perfect. So, if you had on a surgical tourniquet right now, and remember, a tourniquet doesn't give it all, and you were at 360 millimeters of mercury, you would be very close. And again, I'm not a researcher or doctor, so I don't know the exact pressure, but I know on me, for example, when I had a total knee, they never got my millimeters of mercury on my leg tourniquet. That never got above 400. I think it was in the 300s and it was full occlusion. So, it was time to do surgery, right? So, that's full occlusion. These bands will actually not occlude at all. They're designed to give. And when the muscle moves, when your quads and your hammies move and expand and relax, the band moves with the muscles, moves with the limb. So, if you're moving and doing any kind of muscular pumping action, the blood's moving in and out. If you're totally passive, you still can't fully occlude or use it as a tourniquet. The bloods always move, and I think that's a key mechanism of action key point, as we dive into this a little bit.

Ben:  Okay. So, the tubing is actually allowing the blood to move in a different manner than something like a full-on tourniquet would, and that's important. Why?

John:  Well, we don't want to stop blood flow. Even if you have the leg bands as tight as they'll go, if you just take your thumb, let's say if you're wearing shorts and just press into the meat above your knee, you'll always see that capillary refill. You'll never see that skin tone stay white. You're always going to have blood flow no matter how tight you make these things.

Ben:  Okay. Alright, got it. So, you want to maintain blood flow so that you're not completely occluding a limb. And is that because you're able to actually achieve a better muscle contraction when venous flow is not completely restricted? I'm still trying to wrap my head around the benefits of this versus a full-on tourniquet.

Steven:  So, what we're trying to do, ultimately, is create as much engorgement in the capillaries and veins as we can. How we do that is we gradually put a tighter and tighter pressure or greater and greater pressure on the tourniquet. As the vascular beds are filling up with blood, most people will see their skin tone going from normal color to pink to a little beefy red to, in your case, probably a purplish color. The capillaries are fully engorged now. And ultimately, when you get to what we call the optimal pressure, all of the arterial flow, so the flow from your torso to your limb, whether that's your legs or your arms, equals the outflow, the venous outflow from your legs. At that point, every muscle, every vascular bed is just engorged in blood. When you do that and you do slight movement, or even contraction, that actually creates lactate in a variety of other waste products, and that actually begins a cascade of events. First of all, the signals are sent from your muscles up to your brain, specifically your pituitary gland, and that actually begins the process of growth hormone and other things being released into your vascular system.

Ben:  Like what else in addition to growth hormone?

Steven:  Everything from IGF-1, insulin growth factor. If you do it vigorously, let's say you do 10 push-ups, or let's say you do a short sprint adrenaline, that's at the systemic level up at your brain. At the local level, you'll have VEGF, vascular endothelial growth factor, which will also lead to nitric oxide. So, there's a variety of things that go on in the body, both locally in the working muscle, so in your case, your quads, your hamstrings, and your calves, and then also it's happening up at your brain with the release of growth hormone adrenaline.

Ben:  Okay. A few questions here. Is this why when I do–so I've talked about on the show before how I have one of these Vaspers, which is–actually, it's like a cardio workout machine, like a full-body cardio workout machine that has blood flow restriction, almost like wrap-around–I don't know if they're tourniquets, I suppose you would define them as that, that circulate cold water through the actual device, or when I use these KAATSU training bands to train. Is this why I feel almost like this really intense pick-me-up in mood and alertness after? Would that be the VEGF or is that the IGF secretion? Is that the growth hormone? Do you guys know why there's almost like a psychological effect of these things?

Steven:  Yes. That's actually endorphins, adrenaline. This is why athletes do this immediately before World Championship race or Olympic final. This is why executive would do this right before a major presentation.

Ben:  Oh, yeah. That's one of my favorite things, by the way. They have this in my hotel room and do like a bodyweight workout before I go down into a conference room and give a talk when I'm at a hotel. It's my go-to work out because I feel like I'm just smarter afterwards. It's like an exercise smart drug.

Steven:  Yes. We've done tests at the University of Tokyo Hospital where we place, actually, people in MRI machines, had them have the KAATSU bands on. Of course, they're there still. And we actually see within their brain the various small capillaries light up. I mean, it's a little too deep for me as to what the metabolites are being produced. We do know that there are, as we've measured, 460 of them being produced as a result of KAATSU. But it's also very similar if you do a weight workout or a bunch of burpees, or go for a run. But in this case, in your case, for example, and many other executives, for example, they will do this in their business suit, so they're not sweating. When they do KAATSU, they can do it in their attire that they're going to present in their hotel room, go walk downstairs, and then give a killer speech.

Ben:  Right. Or you could use them as I've done before when I'm like outside going on a walk talking to people, doing consults, doing podcasts, et cetera. I'll actually, and again we can return to this and your guys' thoughts on it, do arms and legs, and then just go for a walk with the things tethered and just maintain that pressure the whole time I'm walking. And the other thing I wanted to ask you about was you talked about the lactate getting trapped in the muscle tissue. When that occurs, is that what's responsible for the HGH and the IGF-1 response? And kind of a follow-up question to that, I've also heard some people say that you also see an amplified testosterone response post-workout when you have that lactate trap in the muscle tissue. But what exactly is going on from an endocrine standpoint with regards to the response of lactic acid?

John:  Hey, Ben, this is John. I'll let Steven hit the testosterone piece. I actually don't know on that, but I do know–and again, I'd talk about this stuff in total lay terms. To me, you're essentially tricking the brain into thinking that you're working much harder. And we know that when lactate is in the tissue and lactate is being created, the brain responds accordingly, right? So, you got this metabolic stress that's taking place in your legs right now, especially if you're standing, if you're not sitting, your brain is reacting to that as if it's exercise. If you're moving your legs, even if it's just a little bit, then your brain reacts even more so, right? So, it's tricking you, it's tricking your brain into thinking you're working just a hell of a lot harder than you are.

Ben:  Okay. Now, when it comes to the actual idea here of, from what I understand, like an increased satellite cell response, or increased mitochondrial proliferation in response to this restriction of blood while training, or this engorgement of the blood in the limbs, what exactly is going on there that would allow you to build muscle or to maintain muscle without using heavyweights? Can you guys get into the science of what's going on there?

John:  I think a key piece here is the cycle aspect, when you think of what's happening when the bands contract like this, everything distal of the bands is–I look at it as almost like a physical stretching. You're stretching all the way down to the capillaries, you're holding it for 30 seconds, your machine right now is going 30 seconds on, 5 seconds off. And each time it comes up in pressure, arguably, you're stretching capillary tissue, which means you're stretching all that tissue nice and wide open. You're essentially improving blood flow by opening those pipes up some. Does that get to your question?

Ben:  So, my understanding is that you get this stimulation of muscle protein synthesis and satellite cell activity that's somehow occurring when the blood flow is actually restricted because there's a greater mechanical tension in the actual muscle belly itself. And when you combine that with the slight hypoxia, the build-up of lactic acid and kind of that acidotic state, the mitochondria, in addition to the muscle fibers, respond by growing in density. So, essentially, what you're doing is tricking the muscle, so to speak, into a hypertrophic state via hormonal trigger, and also a blood flow trigger without the same type of cytokine-based inflammatory response that would normally occur when you heavily damaged tissue.

So, it's almost like you're sending a signal that would normally be sent during like heavy eccentric training or highly inflammatory training, and instead, getting that signal sent via metabolic stress and hypoxic stress, and some amount of acidic stress without the actual loading, which is why somebody who is, say, injured or elderly or doesn't have access to heavyweights, or even doesn't want to produce like an inflammatory firestorm, which is one reason why I've been using it during this coronavirus thing just because I want as little inflammation as possible while still getting the exercise response, I think that's kind of sort of what's going on here as far as the actual muscle response to this stuff. And when you look at a guy like Dr. Sato, from what I understand, he's actually developed specific routines that maximize that response. So, what would be the best way to actually use something like this if someone's goal were, say, muscle gain? Like, what would an actual workout look like, or how is Dr. Sato implementing these KAATSU cycles in his own training?

John:  So, this is John. We were just in the backyard this morning during this modified lockdown. And we did a Dr. Sato chest and pull workout with KAATSU. And you look at the guy and it looks like he throws around 300 pounds no problem, and he can, but that's not how he works out. So, he'll take the 45-pound bar and he'll do a set of somewhere between 60 and 90. And if he's able to hit those numbers, no problem. He doesn't increase the weight.

Ben:  Wait, he'll do 60 to 90 reps in one set?

John:  Yeah.

Steven:  Yes.

John:  Yeah.

Ben:  Really? Okay.

John:  Which makes 40, 45 pounds. And if he can hit that no problem, he doesn't add weight, and this is kind of his key. He adds pressure. And his reps go immediately down significantly after that first set, but that's how he works. He's very, very low weight. And a lot of times, he does no weight.

Ben:  And that's one single set that he's doing?

John:  Correct.

Ben:  Okay. And what about the tempo? Is he doing like super slow training? Because I talked in a recent podcast about how I found some success combining kind of like the Doug McGuff, “Body by Science” super slow training approach while wearing the BFR bands and found a great deal of efficacy in that. But how exactly is Dr. Sato approaching the tempo piece of things?

Steven:  If he's looking at muscle growth, he'll do three or four sets. We'll just take his arms, for example. He'll do three or four sets over his chest. The first set he calls Priming the Pump, and that's where he'll do a large number of sets. Again, if he's on the bench press, he's just using the bar itself. No, he's not adding any place, just the bar itself. And he'll be up, Ben, right about where you are, 350 to 400 SKU, we call that, or standard KAATSU unit. So, he'll be up there. He'll have 60 to 90 reps. He'll rest only 20 seconds. His second set will probably fall anywhere from 20 to 30 reps. His third set will fall significantly more. He might do anywhere from four to eight. And literally, the last rep, he'll try to squeeze out one.

Ben:  Okay. So, the muscle is getting more and more fatigued, more hypoxic, more lactic acid between each set. So, his reps are going down, but he's doing the same exercise set after set after set until he gets to the point where he literally is having a hard time just doing a few reps?

Steven:  Just doing one. Ideally, he'll go from that high number, above 50, to the fourth set, which is one.

Ben:  And how many sets does it take to get from like a 50 rep set all the way down to a set that would only allow you to do, say, one rep?

Steven:  Four sets.

Ben:  Okay, four sets. And how long a period of rest in between sets?

Steven:  Only 20 seconds.

Ben:  Okay. So, totally go 20-second rest. I think that's kind of similar to the protocol you took me through, John, when you came to my house. We got some pull-ups, we got some roll-outs, we got some squats, and yeah, it's incredible how quickly the muscle becomes fatigued when you're using that approach.

Steven:  In addition, so not only does Dr. Sato do these rapid, let's say, bench press and other movements on every other day, he'll do very slow movements on, let's say, Tuesday, Thursday, Saturday. So, he alternates. He is a very much an advocate of stressing the body in different ways. So, on one day, Monday, Wednesday, Friday, he'll go at the regular pace that you see most people do a bench press or a squat. And on other days, Tuesday, Thursday, Saturday, he'll go very, very slowly. So, the workout time will be different, the workout repetitions will also be different, depending on what he's trying to achieve. If he originally was a powerlifter, then he got interested in his physique. So, he does a variety of exercises who get on the step master, some days and just crank him out. He'll go from, let's say, 4 to500 steps on the first set. He'll go to 50 to 80 on the second set. He'll drop down to like 10 to 15 on the last set. And the fourth set, he'll maybe squeeze out one.

Ben:  Okay.

Steven:  So, that's how he mixes both regular speed and then super slow speed, depending on what he does, but it's very interesting. He always starts off with his smaller muscles. So, he'll do, for example, on his arms, he'll work on his forearms first, then go to his biceps, then go to his triceps, and then shoulder work. On his legs, he'll start off with his calves, then go up to his upper leg. And he'll always finish a workout with his core. And you might ask, how does he work on his core with the bands on his legs? For example, instead of doing a plank or a crunch or a sit-up, he'll sit up straight and contract the core, or he'll stand up and balance on one leg. He'll walk with very, very nice posture with the bands after this hard workout contracting the core. And this is what he recommends to people who have lower back issues, older people, people who, for whatever reason, they don't want to do a crunch, they don't want to do a sit-up, but they can walk with a book on their head or they can balance on one foot.

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What are your thoughts on using the arms and the legs at the same time? Because I've heard some people are concerned about the safety of that. I've found it to be a little bit of a time hack because I'll go back and forth from squats to push-ups, to lunges, to pull-ups, and kind of almost do it circuit style with the bands on the arms and the legs and have swum, like I mentioned, like that, and also going on walks like that. But what are your guys' thoughts on occluding or on using the KAATSU bands on the arms and legs simultaneously?

John:  Well, our primary core market is people who's in their 60s, 70s, 80s. I mean, our oldest client is 104 years old. I mean, you know the deal, Ben. They're not studs like you. We don't want those people putting bands on four limbs at once.

Ben:  Why?

John:  Well, there's a potential for them to pass out.

Ben:  So, it's not a blood clot issue, it's more a matter of just your blood pressure–would it be your blood pressure dropping to the point where you would pass out because the blood is occluded, or is not occluded, but is relatively concentrated in these limbs?

John:  Yeah. I mean, you slow down the venous return enough on two limbs and you definitely feel it, just like you're doing right now at your desk. You do it on all four limbs. While you can handle that, a lot of people can't. So, it's a safety thing.

Ben:  Okay. It's just safety. Gotcha.

Steven:  We definitely don't recommend anybody doing this. However, there are some occasions when you do use it on the arms and legs, but they're very rare. We want to make sure people understand that when we say, “Hey, you can be a professional major league pitcher,” put them on your arms, put them on your legs, and throw three or four fastballs, but that's not your average 40 to 60-year-old executive. You can be NBA power forward. Put them on arms, your legs, take maybe two or three free throws or three-point shots, you are smoked. After you're smoked, then you can take off an arm. That's what we recommend first. Then go to the legs. Next, smoke your legs, and this is the really, really key point of KAATSU for people who are performance athletes.

It's constable, do the KAATSU cycle, then do the KAATSU training, go through your exercise, whether that's a batter, a batting, a golfer, using their golf club or a basketball player shooting some three-point shots. After they've smoked, rest a bit, hydrate a bit, then go back to that same exact exercise. It could be 100-meter dash runner working on his starts, or that power forward working on his jump shot. After KAATSU is over, then repeat that same movement and really hit that free-throw, really hit that drive, really come barging out of the starting blocks really hard because you've got this sort of euphoric feeling of KAATSU. It's a perfect time for an athlete really to get psychologically, as well as physiologically ready to have a great vertical leap, or have a great start-out off the blocks.

And in the swimming world, same thing, working on that stroke. If you're a rower, finishing off the last 500 meters of a race. So, KAATSU is integral into a training program, whether you're a CEO of a Fortune 500 company, going to make a speech, the speech is your product, but that KAATSU helps warm you up in the same way for the athlete once they integrate the KAATSU portion of their workout. Go back to what they are working on, whether it's a gymnast, a runner, a triathlete, et cetera, and then do that same motion in a very euphoric state with your body and your capillary beds fully engorged, and you can really see the performance gains in this case.

Ben:  Yeah. And from what I understand, there are a lot of proteins now utilizing this. Is that correct?

Steven:  Correct. Everybody from NFL quarterbacks to Major League Baseball stars. And actually, one of the first guys that used it that really sort of kicked this off in the pro-sports world was the power forward for the New York Knicks.

John:  Carmelo Anthony?

Steven:  Carmelo Anthony, yeah. So, he was looking at it for rehab because he wanted to go to the Rio Olympics in 2016. We went down there with our first-generation product. We called it KAATSU Nano. And after Olympics, we really didn't follow up too well with him to be honestly speaking, then all of a sudden, about two months after the Olympics, we started getting orders from NBA teams, guys all over the place know pro-sports works, NBA guys know NFL guys, NFL guys know Major League Baseball guys, Major League Baseball guys know NHL guys, and the word spread from there.

Ben:  Yeah, yeah. You guys touched on some things that I wanted to comment on. First of all, the longevity piece. I was speaking with my friend Dr. Mercola, who's huge on KAATSU, he's a huge fan of KAATSU. He actually had mentioned that it may increase circulating NAD levels, which we know decline with age, and which we know are very protective for the mitochondria. So, there might be something going on with NAD from a longevity standpoint. That was one thought I had when I was thinking about Dr. Sato. It'd be interesting to see what his NAD levels are even though testing is kind of iffy as far as accuracy. That's one thought that came to mind.

Another thought that came to mind is it's interesting how he's doing slow, but also explosive training with the KAATSU because–I talked about this in my book, “Boundless.” So, if you look at muscle fiber composition, it's these fast-twitch, particularly these type 2A muscle fibers that respond to explosive training or plyometric training that seems to be more correlated with longevity than just muscle mass overall. So, this idea of incorporating in addition to super slow training more of the explosive bodyweight training I think is a smart idea if you're going to use these BFR or these–and I should actually ask you guys if BFR is synonymous with KAATSU or not. We can maybe address that in a moment. But when you're using different modalities as you guys have described, which is why I'm using it for walking and swimming, I'm using it for these more explosive bodyweight workouts, but then I'm also doing some more super slow training either with light weights or with bodyweight. And I think that's another important component is working in multiple modalities with these.

Another thing that came to mind was I actually sometimes wear this app called the NatureBeat with a heart rate monitor when I'm training to gauge sympathetic stress, because if I can identify the modalities that induce the greatest amounts of sympathetic stress, then that means that those are the things they're going to improve vagal tone and post-exercise HRV the most. And I've talked before in the podcast about how back squats and deadlifts seem to be two things that vastly increase my sympathetic activity and drop my HRV during training. Turns out when I wore my HRV strap when doing the KAATSU training, it actually significantly lowered HRV and increased sympathetic activity, this so-called a low-frequency score on the HRV app. So, I think there's something going on from a nervous system standpoint as well. Have you guys come across anything regarding like vagal nerve tone or HRV in response to KAATSU training?

John:  Ben, we definitely have seen some turning on of the–one of the things we've been dealing with in SOCOM ever since, that's Special Operations Command, ever since 911 is so many guys are getting stuck in this hypervigilance state. They're stuck in that sympathetic mode. And so anything that's out there within the emerging technology world that can help guys get back into their parasympathetic state or engage that vagal nerve–or just help them sleep is valuable. And there's absolutely shown in various research studies, KAATSU can turn on the parasympathetic aspect in the human body. It actually helps people sleep. Dr. Sato and Steven could probably talk to this better than me, but Dr. Sato actually has an insomnia protocol. And if you do this stuff, like arm cycles, which is really, really light stretching, really slow movements in your upper body within an hour of going to sleep, bam, it really helps out.

Ben:  Interesting. And then one last thought, and I want to ask you about the difference between BFR and KAATSU, and that is–this may have been in the–what was the book that you gave me, John, to read about KAATSU when you came to my house? Do you recall the name of that book?

John:  Oh, yeah, the one with our German researcher, Robert Heiduk's book.

Steven:  It's called, “KAATSU: The Pressure Training from Japan.

Ben:  Yeah. Okay. So, I found that book fascinating, but one thing they talked about in that book is this concept of doing multiple workouts per day. I think it was in that book or it was in–looking over Dr. Sato's protocol because the training sessions don't take that long, and I've personally been able to come back day after day without soreness and even do like a leg workout and an arm workout when I was experimenting with just the legs and just the arms in a single day. But is that something Sato does or that you guys have seen incorporated, this idea of like micro workouts where you might have a 15-minute workout in the morning using the KAATSU, 15-minute in the midday, and then another 15 minutes in the evening. Is there something to that idea?

John:  So, the way it was explained to me, and it makes sense–like, I spent a career dealing with DOMS, right? You get this delayed onset muscle soreness. You do a heavy workout. You get this inflammation response, and then you got to lay off that muscle group for two or three days. That's been the way we've done things for a long, long time. When you do KAATSU with very, very low weight or by definition light intensity, when you're working at 80%, 90% one rep max or–and I'm more asking you, Ben, but I understand that you're tearing muscle fibers down, and then you get an inflammation response and your body has to take time to repair it out. When you're doing KAATSU, I don't think you're getting nearly that, if any, because you're only working 10%, 20% one rep max, sometimes even less because you're just doing a lot of bodyweight type movement. So, yeah, I would agree, you absolutely can get after it multiple times. Gone are the days of, “Hey, I'm going to work legs hard today, and I can't do them again for three or four days.” You can do them again the same day or the next morning. No problem.

Ben:  Okay. And then one thing I wanted to mention, it sounds like you wanted to jump in, Steven, but really quickly, and then we can come back to this if we need to. A couple of times during this show, I've said BFR and corrected myself and said KAATSU. Can I use those terms synonymously? Like, if we were to take BFR, KAATSU training, and occlusion training, I think we've established that because there's venous return occurring that this would be different than occlusion training or tourniquet based training, but what about BFR training, can that be used synonymously with KAATSU training?

John:  No. It shouldn't be, because when you're doing BFR training, you're doing, by definition, occlusion training. And Steven will go into the history of how we got there and why that term BFR is even out there. But when somebody takes you through occlusion training or BFR training, they'll bring the limb to a full occlusion, and then they'll back it off a percentage. And our approach is completely different. What Dr. Sato has spent essentially his entire adult life refining is that very, very gradual increase. And if you can handle that, you release and you go a little more, and then a little more, and then a little more. And you're never, as we talked about earlier, you're never ever getting to that full occlusion. BFR goes full occlusion, backs it off. KAATSU starts very, very gradual and never gets to occlusion. So, it's a much safer approach.

Ben:  Okay. Got it. And Steven, it sounds like when we were talking about protocols, are you going to jump in and say something?

Steven:  Yes. Going back to the slow training, slow movement, and explosive movement, this is very critical in anything we do. So, for example, let's take the case of NBA power forward who wants a greater vertical leap, or a volleyball player who wants a greater vertical leap. Well, I actually asked that athlete to put the KAATSU bands on, and then go through the cycle program, which is pressure on, pressure off, pressure on, pressure off, gradually increasing. So, their limb is totally engorged in blood, or as much as possible. Then we'll ask that athlete to go very slowly.

So, for example, some slow quarter squats. Don't lock the knees, just up and down, up and down, quite slowly. When they burn out there, then we'll ask them to move explosively. Okay. Jump high to block that volleyball, or jump high on that jump shot, jump as high as you can. Then we burn that out, and then we ask them to take off the bands and then perform as they normally do in their workout. That kind of change in stress from just sitting, engorging the capillary beds and blood to slow movement, and then to explosive movement, and then back to their normal activity, we see the best and optimal performance gains there. And it doesn't matter. It could be a boxer, MMA fighter, a gymnast, a golfer of any age, teenager to older guys. It could be race walkers, marathon runners. This is what we advocate and this is what Dr. Sato is always seeing.

Ben:  Okay. So, again, this is important, and I want to make sure people get this. You're saying you're doing your movement protocol with the bands and reducing the pressure then coming back and hitting it again?

Steven:  In some cases, you're not reducing the pressure, you're just actually reducing the volume or the intensity. So, for example, a runner would run–well, I'll just put it very simply. A runner would run at a, let's say, one-minute pace per 400 meters the first time. The second time, they won't be able to maintain that pace. They'll actually go slow or they'll maintain the pressure. However, when the athlete can continue to maintain the pressure at a one-minute for 400-meter pace, at that point, then we increase the pressure very slightly. Imagine running at a four-mile per minute pace at sea level, then trying to run at four-minute per mile pace at 500 feet, then at 1,000 feet, then at 1,500 feet, et cetera, because as you mentioned before, the hypoxia part of this is also very, very critical for performance gains.

And why is this important? Dr. Sato initially, when I first met him, again this is the early 2000s, we had been working, or he had been working with the cardiologists with over 10-year period 7,000 cardiac rehab patients. Now, those are people generally between the ages of 50 and 80, and he could not push these people hard. He wasn't asking these people to do a bench press, even a push-up. These were people who just had a heart attack, just had a stroke, and a heart bypass surgery. And as they were being rolled out from the operating room, they were putting bands on them very, very lightly and doing passive movement. So, the nurse or the therapist would actually be moving the limb with very, very light pressure.

And during this period, we learned how the body best responds. And again, we were dealing with people. We're in a very vulnerable state. They just come off of a heart attack. They were 65 years old with diabetes. So, the pressures we're talking about were very, very low, and they were obviously getting tired. Their muscle would start to quiver even if we were moving their arms or their legs. From that point, we learned, well, if we could do this with very, very vulnerable, very, very weakened people, we could obviously do that a lot more with very fit people, and very fit all the way up to Olympians and pros.

So, this is why this change in mechanical stress from slow to fast, from explosive back to regular speed if you will, from a low pressure to high pressure, and then you try to sustain that performance level at a certain very high pressure, and high could mean in your case, in Dr. Sato's case, 400 SKU or —

Ben:  Yeah. I've been using 350 to 400 for most of my workouts.

Steven:  And I would expect that for a person of your fitness, your age, et cetera. What Dr. Sato would like to see someone like you do is to maintain that pressure until you're 60, 70, 80, 90 years old, and that's the goal. We want, just as athletes train their bodies, as writers and speakers practice their own cognitive skills, Dr. Sato, and we want people actually to practice their vascular system or train their vascular system throughout their life, and that's the entire goal of KAATSU. It's more of a vascular training than it is muscular training.

Ben:  Right. Although you're getting a pretty significant muscular effect. And the other thing that I find quite interesting is the potential effect on the immune system here, which is of course again, pretty relevant to the times that we are in with this coronavirus pandemic going on. We know that the nitric oxide release that you guys talked about, production of the vascular endothelial growth factor and the nitric oxide, which allows blood vessels to constrict and relax and regulates inflammatory cells in the blood vessel walls is, of course, great for overall cardiovascular function.

There's some other things released, like some plasmalogens and ceramides, even the growth hormone release that I think may have an impact on immunity. But in particular, the FDA just a couple of days ago, they actually allowed for the granting of this thing called an INOpulse for the treatment of COVID-19, which is essentially a machine that allows for increased production of nitric oxide via inhaled nitric oxide. And the reason for that is because it turns out that nitric oxide has some pretty potent antiviral effects, meaning that there are studies that show that nitric oxide inhibits the replication of SARS-CoV.

And there's a few other studies that show that this increase in what's called flow-mediated dilation can also increase the activity of endothelial nitric oxide synthase in the human body, both of which occur in response to this blood flow restriction training. So, I think there's something going on here from an immunity standpoint, but I'm just curious. For you guys, I know you're probably both on quarantine as well, have you been stepping up your use of these things just so you get that nitric side response? And if so, are you also doing anything else like in combination with your KAATSU training to kind of amplify that nitric oxide response?

John:  So, on our end, we have a family of five. We got three teenagers, 17, 15, 13, and Katie and I, and we all use KAATSU. We primarily use the cycle mode when we're going for walks at the end of the day. So, we'll walk dogs and whatnot. And again, Ben, I don't have the background to talk to a lot of the specifics that you're mentioning, but I am seeing a lot of studies that talk about hypoxia in the tissues, that talk about nitric oxide in the tissues, specifically the endothelial nitric oxide synthase. I guess there's three or four different types of INO, but the eNOS, the endothelial nitric oxide, every time you do a cycle, because right now you're doing cycles on your machine, you're not doing that sustained pressure, every time you do a cycle, all that tissue, it expands, and then you get that rapid complete release, and then it relaxes. Each time the tissue and the vascular walls move like that and create this–it's almost like a shearing movement that's taking place primarily in the veins, in the venous tissue, each time that happens, endothelial nitric oxide synthase is being released in the body. Now, combine that with the hypoxic piece that's taking place in the tissue. And yeah, there's some significant immune response stuff going on. I'm not even going to pretend to talk about it like Dr. Mercola, but it's pretty significant from our understanding.

Ben:  Yeah. How about you, Steven?

Steven:  Yes. Japan actually was hit with this pandemic before the U.S., most people in America were even aware of. And Dr. Sato called immediately and encouraged all of us, all of us who are KAATSU users, to do it at least three times a day, which speaks to your previous comment that you can actually use this multiple times a day easily. So, in my own case, I have four children. They're high schoolers, they're college students, and they're young working adults. They were all either put on a work from home basis or their schools were cancelled for the time being. So, they're all home. So, they're all doing online schooling, or three of them, and the other one is working from home.

As they are literally watching their teacher give them a lecture or doing their homework, they have the bands on their arms or their legs. They're doing KAATSU. And then at 2:30, we set up a program for our local high school. I think we have 24 kids who have KAATSU bands on, and we all get on Zoom, and we all do a workout together. The workout is led by one of the teachers, who's a coach. We do everything from tricep dips to stretches to different kind of isometric holes, et cetera. It's a good way for the kids to release. We are in a shelter-in-place location.

And then in addition to that, my wife and I, and my parents who live nearby, my father's 84, my mother's 82, they do it three times a day. They walk around their complex at their own pace, and we strongly encourage everybody to do KAATSU during this period. Dr. Sato's first warning back in–I think it was the second week in January when Tokyo was first aware of this, was we want as strong an immune system as possible. And KAATSU is a big part of that that anybody could work in in the course of their day, whether they're a student in front of their laptop or a husband and wife going to walk the dog in the evening.

Ben:  Yeah, yeah. And what I found is for me, since I'm visiting the sauna so much, I'm also on the cold pool a lot, I can put these on for my flow yoga that I do in the sauna in the morning, which is going to result in a nitric oxide release anyways. And then I just trudge through the yard with the strap still on. And again, I'm breaking the rules. I got the arms and the legs on at the same time, but I walk through the yard, I jump in the cold pool, I go back and forth in the cold pool a few times. And so I'm using it for that. Again, like I mentioned, I'm doing some training on the Aerodyne with it, and then I'm doing a lot of bodyweight kind of like circuits with it. And then also, a little bit of the super slow stuff either with lightweight or with bodyweight.

Now, I think one of the best studies that I have seen–and from what I understand, this is the one that really induced the Chinese Olympic team to begin using KAATSU pretty extensively with their athletes. I'm going to link to in the shownotes, because it shows a reduction in body weight BMI and body fat percentage, the increase in the vascular endothelial growth factor in nitric oxide, which we talked about, which is fantastic for vascular tone and for improving endothelial function. But even a few other things happen that we didn't even talk about on today's show, like lipid metabolism. They showed an intense rise in lipoprotein lipase and pyruvate dehydrogenase, both of which are crucial for blood lipid metabolism.

So, there was a direct cardiovascular effect from a lipid standpoint, and then that PGC-1alpha is also another thing they found increased, and that's part of the mitochondrial response, as well as the drop in blood and oxygen availability that we already talked about. And then they found an increase in power, which is surprising that you increase explosiveness and power because you wouldn't expect that with this type of training, but they observed that in this study after eight weeks of KAATSU training. And then the very interesting thing, like I mentioned earlier, is all of this occurred without KAATSU causing the surge of inflammatory cytokines and the emergence of muscle injury.

So, basically, the muscles are growing with a completely different mechanism of action or relatively different mechanism of action than what you'd expect under normal circumstances. So, I mean, it almost sounds like cheating when you're using these things, but it really is pretty profound. I first learned about this mildly when I was doing the bodybuilding training and just using tourniquets. And then I think I used my first KAATSU device when I was training with Aubrey Marcus down at Onnit. He and I did a little workout. I think right after he got a device, I'm just blown away at how pumped my muscles were after, my biceps seemed like they were twice the size the rest of the day.

And then since John came up to my house, I've been using this KAATSU device quite a bit, and man, it's nuts, it's extremely cool though what this stuff can do. And if any of you listening in, get a chance to try a KAATSU device. Even if you've used the blood flow restriction bands, the tourniquets off of Amazon, for example, this thing with the handheld unit that cycles the pressure and does exactly what Dr. Sato is doing and what a lot of research are doing with, say, true KAATSO training, it's a totally different effect. And again, like I mentioned, you can take the motor control device off and use it in what's called untethered form. So, you can literally get it up to however many millimeters of mercury you want and then untether and just go off and do your workout, which John showed to me, and which I also thought was pretty dang handy again for things like walks or even just hanging out at your desk working.

Like, literally, this whole time, I've been–so you guys probably heard this, hopefully, it's not driving my listeners nuts, and you could hear this motor going just cycling blood at about–I'm on high, so I think it's cycling between about 330 and 360 just in and out of my legs this whole time. So, it's a very cool device. And I think–do you guys have like a discount code or anything like that for my audience to use?

John:  Yeah, discount code BEN. Just capital B-E-N.

Ben:  And what does that get people? What does that save them?

John:  That's 5%.

Ben:  Okay. So, 5%, which it was actually pretty significant on one of these devices because they are more spendy than like the tourniquet you get off Amazon. But again, this is high-tech stuff out of Japan, these KAATSU devices. So, I'll put that link and that code in the shownotes for you guys.

And then John and Steven, anything else you guys wanted to mention, anything you didn't get a chance to highlight as far as any key research studies or developments in this that you wanted to bring up?

John:  My background is the military in the veteran community of course. Ben, I totally believe on what this can do for athletes, elite athletes, and whatnot. A lot of times, those changes on those type of people are small changes, and small change can be really valuable. But the exponential changes on guys that are dealing with spinal cord injury, guys that are dealing with massive, massive TBI where neuromuscular control has been lost, the anecdotal evidence and findings and outcomes that were seen with our vets are absolutely incredible.

I mean, I'll just take this opportunity to talk about real quick, Joe Lowrey, 7th Special Forces Group guy, shot with a PKM round in the head. Right side of his head, left side completely paralyzed, went through a lot of rehab, but he was essentially paralyzed. But because it was a brain injury, not a spinal cord injury, something with the autonomic nervous system we were able to help get things turned on on his left side. So, he still uses a chair, but he's taking over 3,000 steps with a cane per day. That's life-changing stuff.

Another 7th Special Forces Group guy, Romy Camargo, shot in the neck, shattered his C3. They had to remove his C3 through and through his spinal cord, complete quad, complete severed spinal cord. But Romy is dealing with neuropathic pain in his feet and on all kinds of meds and lower extremity circulation issues. Well, his therapist used KAATSU to help improve circulation in his lower extremities. So, when he does KAATSU cycles before going to bed, the neuropathic pain, something with that autonomic nervous system, I'm not smart enough to understand how, but it's making a difference. It's making that neuropathic pain help go away without drugs, non-drug, non-invasive. Some pretty, pretty incredible stuff for our wounded, ill, and injured.

Ben:  Wow. So, huge, huge application here in physical therapy. I dig it, I dig it.

John:  Exactly.

Ben:  Steven, any last comments or thoughts that you have for folks?

Steven:  Yes. I'd like to address the BFR versus KAATSU and where that actually came about. And right about the time that the initial research was being done, the editors of the scientific journals, which Dr. Sato and his colleagues at the University of Tokyo Hospital were submitting their papers, the word KAATSU was not known. And so in a back-and-forth with the journal editors, they came up with the word vascular occlusion or vascular or blood flow restriction. And so it was actually in the middle of the submission of papers where KAATSU actually transitioned because it was a Japanese word to this English vernacular, which then became the BFR acronym.

And that was late '90s, early 2000s that that occurred. And then concurrently to that, and this is where I entered the picture, the Japanese had started a 22nd-century project, and that was a project started in 1999 to look forward 100 years. And Japan had forecasted, which is occurring right now, that their population would be decreasing and the percentage of older people, older than 65, would just dramatically increase, and they knew they had to do things very dramatically and radically to keep their population healthy and productive throughout the 21st century, again looking toward the 22nd century. And one of those technologies was KAATSU.

And so in the midst of all of this, Dr. Sato and his colleagues and I was part of this team there, we're looking at ways how do you keep the muscularity, the vascularity, and then also the aerobic capacity of this rapidly aging population of Japan to improve. And so all of these things were happening all about the same time, and it has applications for again working adults and high-level athletes. So, I wanted to mention that.

Ben:  Well, I'm certainly sold on. I'm actually putting mine–I've got about a 15-minute break here before my next call. And so I'm putting both my arms and my legs here. Let me press my button on 400. I'm going to go tool around the house, grab a drink. I get this podcast uploaded while I've got 400 on the arms and the legs, and I go untethered mode, and I just get a huge pump on, and then go about my day, all swole. So, I —

John:  Don't pass out, Ben.

Ben:  I dig this thing. Don't worry, dude. So, you guys would kill me for this, but I've actually worked out with both the arms and the legs on 400 for a 60-minute workout before and it's a pain cave workout, but sometimes I like to be extreme and take things to the limit. So, warning to listeners, follow the rules unless you're a masochist like me and proceed at your own risk if you are. But this stuff's pretty cool. And I'm going to link if you go to BenGreenfieldFitness.com/kaatsupodcast, K-A-A-T-S-U Podcast, to everything that we talked about in today's show from the previous podcast I've done on this topic to the KAATSU devices themselves with the discount code that John's given us, to some of the cool studies, the book that I read on this. We'll include some photos of Dr. Sato and everything else that you guys need over at BenGreenfieldFitness.com/kaatsupodcast.

John and Steven, thanks so much for coming on and doing this episode. I've always wanted to kind of geek out on this stuff and it was fun to do so with my legs absolutely pumped. My arms are just jacked right now [01:16:04] _____ for like two minutes. So, I'm going to crank out some quick household chores and get my workout in, fellas.

John:  Hey, thanks, Ben, and honored to be on your show. Thanks for everything you're doing. That's really making an impact for a lot of people.

Ben:  Cool.

Steven:  Yeah. Thank you very much. It was great.

Ben:  Thanks for coming on, fellas. And folks listening in, until next time. I'm Ben Greenfield signing out from BenGreenfieldFitness.com. Have an amazing week.

Ben:  Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormone, sleep, digestion, fat loss, performance, and plenty more. Please, also, know that all the links, all the promo codes, that I mentioned during this and every episode, helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. When you listen in, be sure to use the links in the shownotes, use the promo codes that I generate, because that helps to float this thing and keep it coming to you each and every week.



Alright folks, this is it: The Official KAATSU Training Episode.

I've addressed blood flow restriction (BFR) training, KAATSU training, and occlusion training in other podcast episodes, including:

And in this recent Instagram post, I showed one creative way I've been weaving it into my weekly at-home “quarantine” workout routine:

However, I have yet to do a comprehensive podcast on the origins of this so-called KAATSU training out of Japan, nor have I taken as deep a dive as myself and my guests do on today's show.

My first guest on this episode, John Doolittle, CAPT, USN (Ret), graduated from the U.S. Air Force Academy in 1992 and transferred to the U.S. Navy. During his 25-year career in the Navy, he was deployed around the world as an officer in the SEAL Teams, conducting special operations around the globe, including Kosovo, Bosnia, Iraq, and Afghanistan. John retired as a Navy Captain after his last assignment as Director of the Preservation of the Force and Family (POTFF) Task Force at U.S. Special Operations Command (USSOCOM) Headquarters—supporting 73,000 Navy SEALs, Army Rangers, Green Berets, Night Stalkers, Air Force, and Marine Special Operators. John is a certified KAATSU Master Instructor, an NAUI Dive Instructor, and has an MS in Defense Analysis/Irregular Warfare/Special Operations from the Naval Postgraduate School.

My other guest, Steven Munatones studied under Dr. Sato, the Japanese inventor of KAATSU (pictured right), for 13 years before co-founding KAATSU Global with Dr. Sato. He translated much of the original KAATSU information from Japanese to English. Previously, he licensed high-tech Japanese sanitary ware technology at TOTO Frontier. At RealLiveSports, he designed the ESPN Play by Play, a 2006 Toy of the Year. He founded the World Open Water Swimming Association where he utilized 9 years of national team coaching and a 1982 world championship title to help promote the new Olympic sport of marathon swimming. The Harvard graduate has introduced KAATSU equipment and protocols to collegiate, professional, and Olympic athletes, military special operators, and thousands of aging baby boomers in 47 countries.

So what exactly is KAATSU?

KAATSU is a safe and effective form of exercise, rehabilitation, and recovery invented in Japan in 1966. Patented pneumatic equipment enables your arms and legs to modify venous flow which leads to a cascade of positive physiological effects. KAATSU is supported by decades of extensive research at top academic institutions with specific protocols proven by millions of users in 32 countries and patented procedures in sports, exercise, rehabilitation, and wellness activities—both in the water and on land. KAATSU is a Japanese word and trademarked term where KA (加) means “additional” and ATSU (圧) means “pressure.”

During today's discussion, you'll discover:

-How John and Steven got interested in KAATSU training…11:05

  • John:
    • Introduced to KAATSU while rehabbing an injury
    • A previous rotator cuff injury took ~11 months to fully recover
    • With KAATSU, he was at 95% recovery after 5 months
  • Steven
    • Saw a swimmer using them while coaching the U.S. National Swim Team in Japan
    • He met Dr. Sato, founder of KAATSU, who doesn't speak English nor travel outside Japan
    • Sato took Steven under his wing for 13 years, teaching him KAATSU to share with others

-KAATSU defined and what it does to the body…15:50

  • KA (加) means “additional” and ATSU (圧) means “pressure”
  • Increase pressure, thereby expanding and contracting the vascular system
  • The bands are not tourniquets; they are elastic with a bit of give
  • You never want to “occlude” or stop blood flow completely
  • The bands move with the muscles or limbs
  • The blood is always moving
  • Creating as much engorgement in the capillaries and veins as possible
  • Sends signals to pituitary gland
  • This releases growth hormone, IGF-1, adrenaline into the vascular system

-How KAATSU affects mood and alertness after using it…23:25

  • Endorphins and adrenaline
  • Athletes or executives will use it before a big performance
  • Ben refers to KAATSU as an “exercise smart drug”
  • Can see capillaries light up during brain scans while using KAATSU
  • You're tricking the brain into thinking you're working much harder than you are

-How KAATSU allows you to build muscle without the use of heavy weights…26:55

  • Improving blood flow by opening the capillaries
  • Greater mechanical tension in the muscle
  • Mitochondria respond by growing in density
  • Tricking the muscle into a hypertrophic state
  • Sato's typical KAATSU workout:
    • First set: 60-90 reps with 40 lb. bar (priming the pump)
    • Second set: 20-30 reps
    • Third set: 4-8 reps
    • Rest 20 seconds between reps
    • Continue until exhaustion

-Should you use the bands on both arms and legs simultaneously…38:45

  • Not recommended for most users due to risk of passing out due to blood pressure dropping
  • High performing athletes may use both arms and legs in a very limited way (ex. 2-3 jump shots) then do the same motion sans the bands
  • Many professional athletes are utilizing KAATSU bands, most notably Carmelo Anthony

-How KAATSU affects longevity…44:15

  • Mercolasuggests an increase in NAD levels from using KAATSU
  • Explosive or plyometric training more correlated with longevity
  • Use Nature Beat appwith KAATSU to gauge sympathetic stress
  • Military special ops often get “stuck” in the sympathetic mode (fight or flight)
  • KAATSU has been shown to turn on the parasympathetic aspect of the human body
  • Sato has an “insomnia” protocol with KAATSU
  • Book: KAATSU – The Pressure Training From Japan – New perspectives in sport, therapy and health promotion
  • It's possible to do multiple workouts per day, and work the same muscle set with minimal rest

-Why KAATSU is not the same as BFR training…50:45

  • BFR is by definition occlusion training
  • KAATSU approach is completely different; gradual increase vs. a decrease
  • Much safer approach
  • Hypoxia element is critical; akin to running at sea level, then 500 ft., 1000 ft., etc. above sea level
  • Sato worked with 7,000 cardiology patients
    • Did not work them hard, put bands with light pressure
    • Learned how the body responds in a vulnerable state
    • Indicative of how elite athletes may use the bands
  • Maintain the pressure until one becomes 60-70 years old
  • It's more of a vascular training than a muscular training

-Potential effects of KAATSU on the immune system…58:15

  • John uses cycle mode while walking at night
  • Many studies indicate nitric oxide synthase in the endothelial system
  • Sato encouraged KAATSU users to do it 3x per day because of its efficacy in promoting the immune system

-How KAATSU has helped service members with severe injuries…1:09:00

-How KAATSU is differentiated from BFR in the scientific community…1:11:45

-And much more…

Resources from this episode:

– Podcasts:

– Book: KAATSU – The Pressure Training From Japan – New perspectives in sport, therapy and health promotion

– PDF: Effects of KAATSU Training on Human Mitochondria-related Factors and Comprehensive Effects on Cardiovascular System

– KAATSU device and bands (code BEN to save 5%)

– BFR bands (code BEN10 to save 10%)

– Vasper

– NatureBeat

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