12 Feb 2025

Can’t Run, but Losing Your Running Fitness?

VO2 Max: More Than Running – Exploring New Ways to Boost Fitness

Now that marathon season is over and the well-earned R&R of off-season begins, it’s important to remember that VO2 max drops in just a matter of weeks. This decline is one reason why it can be so hard for many runners to get back on track after the New Year.

Many runners we work with focus on our strength training for runners program during the winter to build a solid foundation for their next base build. Strength training not only enhances longevity but also supports VO2 max—a key metric for optimal fitness and performance.

A higher VO2 max translates to better endurance, improved cardiovascular health, and even increased lifespan.

For runners, maintaining a high VO2 max is non-negotiable. Running is the classic method to train it, but what happens when injury, surgery, or tapering takes running off the table?

The great news is that there are effective alternatives, including the innovative use of Blood Flow Restriction (BFR) Therapy. Let’s explore how you can boost VO2 max, even when running isn’t an option.

Why VO2 Max Matters

VO2 max measures how well your body uses oxygen during exercise, reflecting the synergy between your heart, lungs, and muscles. It’s influenced by two main factors:

  • Cardiac Output: The amount of blood your heart pumps per minute.
  • Oxygen Extraction (a-vO2 Difference): How efficiently your muscles extract oxygen from the blood.

While genetics play a role, VO2 max is highly trainable.  This makes it a flexible and rewarding metric for athletes to improve.

Beyond Running: Effective VO2 Max Alternatives

Running is the classic way to train VO2 max, but these alternatives work wonders—whether you’re cross-training, recovering, or just looking to mix things up. This is particularly important for cross-training or if you’re injured and need another way to keep your VO2 max up.

Cycling

Cycling recruits large muscle groups and allows you to adjust intensity. It’s a joint-friendly option for building aerobic capacity.

Rowing

Rowing offers a full-body workout, engaging both the upper and lower body while boosting oxygen utilization.

Swimming

Swimming is perfect for cardiovascular training with minimal joint strain, especially during recovery phases.

Blood Flow Restriction (BFR) Training

This groundbreaking technique is a game-changer. Blood Flow Restriction (BFR) Training creates a controlled environment where oxygen is limited to the working muscles. 

BFR amplifies the training effect, even at lower intensities. It’s particularly effective for VO2 max improvement without the wear and tear of high-impact activities.

How BFR Training Boosts VO2 Max

BFR Training uses cuffs to partially restrict blood flow during low-intensity exercise, mimicking the effects of high-intensity workouts.  I know, it may sound counterintuitive!

Imagine walking with cuffs on your legs for 15-20 minutes and getting the same VO2 max benefits as a 45-minute run…

It’s a game-changer for runners on days when you need more recovery or can’t run because of that nagging knee or plantar fascia pain.

The method not only enhances cardiovascular fitness but also promotes muscle growth and efficiency. Here's a deeper dive into its optimal application for runners:

  • Frequency: 1-3 times per week for 3+ weeks, or 1-2 times daily for up to 3 weeks.
  • Duration: 5-20 minutes per session.
  • Intensity: ≤50% VO2 max.
  • Pressure: 40-80% arterial occlusion pressure (or 6-7/10 tightness).
  • Protocol: Use during activities like cycling or walking.

A study demonstrated that low-intensity BFR cycling (15 minutes at 40% VO2 max, 3 times per week for 8 weeks) yielded cardiovascular benefits comparable to traditional cycling. Participants also experienced significant gains in thigh muscle volume and VO2 max.

It’s important to note that BFR training should supplement, not replace, traditional high-intensity workouts.

Training Intensity Distribution for VO2 Max

In addition to BFR, balancing training intensity across zones is essential for comprehensive improvement. Here’s how to structure your training:

  • Low Intensity (60-80% HR max): 70% of training. Builds efficiency and supports recovery.
  • Moderate Intensity (80-90% HR max): 25% of training. Develops endurance and aerobic capacity.
  • High Intensity (>90% HR max): 5% of training. Pushes cardiovascular limits for VO2 max gains.

Why Next Level Physio Uses BFR

At Next Level Physio in Cary, NC, we leverage BFR as part of our MEI Method, a three-phase system designed to help athletes recover, excel, and exceed their performance goals. BFR is particularly valuable during the Excel Phase, where rebuilding strength and endurance is key. Its low-impact nature ensures athletes stay active without added strain.

Safety and Effectiveness

Proper BFR application is key to success. Using the right cuff size and pressure ensures safety and maximizes effectiveness. Consulting with a professional—like those at Next Level Physio—helps you start a program tailored to your needs and goals.

Final Thoughts

VO2 max isn’t just about running; it’s about approaching fitness holistically. Whether sidelined by injury or seeking new performance enhancements, incorporating BFR can help you achieve measurable gains without extra wear and tear.Curious how we help runners and hybrid athletes get back to running in less than a month? Click here to schedule a free runner’s assessment today and discover how BFR and our MEI Method can take your fitness to the next level. Let’s keep getting better, together!

Why Runners Are Turning to BFR to Maintain VO2 Max When Injured or to Break Through Running Plateaus