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The Swedish Hypertrophy Protocol

What’s old is often new in the world of strength training and bodybuilding. Methods and techniques gain popularity and then, in time are replaced by the latest and greatest protocols. This process follows a fairly cyclical pattern. One such example, is the recent rise in popularity of blood flow restriction (BFR) training.


BFR has been around since the 1966 when Dr. Yoshiaki Sato attended a Buddhist ceremony in Japan and found the blood circulation to his calves was blocked because of the way he was sitting. This gave him the idea of blood flow moderation training. Sato experimented for several years with different protocols to modify blood flow in his limbs. By 1973 he had developed his training to what we now know as BFR. So, you see BFR has been around a while, but only recently has it gained mainstream coverage for it’s effects on hypertrophy.


BFR has shown some very promising results in numerous studies. The majority of these studies have investigated BFR as a standalone training method. Using it in isolation so that it’s the only training stimulus during a research protocol. While these studies are of interest they aren’t that transferable to the real world. Lifting enthusiasts, like you, enjoy shifting heavy iron and would most likely use BFR in addition to your regular training rather than in its place. As Brad Schoenfeld says, “doing just BFR training alone isn’t going to cut it. Your best results are achieved by integrating the technique into a traditional hypertrophy training program.”


So, the question is, “how to combine regular training with BFR for maximal results?”


Fortunately, recent research has been conducted investigating how best to apply BFR to augment traditional bodybuilding training. An exciting thesis paper titled ‘Optimizing strength training for hypertrophy – A periodization of classic resistance training and blood-flow restriction training’, might have the answer we’ve been looking for.


The stated aim of this paper was…


“…to investigate if a combination of classic resistance training and blood flow restricted resistance exercise (BFRE) training would result in greater increases in quadriceps muscle growth compared with other strength training studies.”

The 10-week study conducted at the Swedish School of Sports Science involved a novel training protocol which combined regular resistance training and BFR. It yielded incredible gains in muscle size. These gains are far superior to what has previously been reported in the scientific literature for normal weight training.


The authors reported that quadriceps thickness increased by 15.1% in 10 weeks. That measure can be translated to a 17.3% increase in muscle size. This led them to conclude that, Our unique training protocol resulted in a superior increase in muscle growth in comparison with most other strength training studies.”


This rate of progress is phenomenal. So, what did they do to elicit such dramatic gains in muscle mass?


The authors outlined what the existing research can tell us about training for size and created the following guidelines:


  • 8-12 repetitions, 70-85% of 1RM and 1-3 sets (traditional resistance training)
  • 5-7 repetitions, 80-90% of 1RM and 1-3 sets (heavy resistance training)
  • 20-30 repetitions, 20-30% of 1RM 2-4 sets (BFR)
  • 2-3 training sessions a week per muscle group
  • Undulating periodization


They observed that although many different resistance training protocols have been tested and evaluated no one has combined the above strategies in an attempt to maximize hypertrophy.” To remedy this the researchers set about creating a protocol which could effectively incorporate elements of each to create a maximally effective 10-week program.

The Protocol:


The study manipulated, intensity, volume and frequency over the course of the 10 weeks. The protocol involved 8 weeks of undulating resistance training plus two weeks of BFR. Weeks 1-3, 5-7, and 9-10 followed an undulating pattern, utilising traditional resistance training. In weeks 4 and 8 only BFR training was performed.


In weeks 1-3, 5-7, and 9-10 participants trained three times a week (Mon, Wed, Fri). In weeks 4 and 8 they trained 5 times (every day from Mon-Fri).

The exercises used in the study were the legpress and leg extension.


Sets and Reps


Weeks 1-3, 5-7


Monday Wednesday Friday
Intensity 70-75% 1RM 90% of Monday 80-85% 1RM
Sets 3 3 3
Reps 10-12 10-12 5-7


Weeks 9 & 10


Monday Wednesday Friday
Intensity 70-75% 1RM 90% of Monday 80-85% 1RM
Sets 2-3* 1 2-3*
Reps 10-12 10-12 5-7


*To achieve a tapering effect, the amount of sets was decreased during week 9 and week 10. Only one set was performed on Wednesday during week 9 and 10. During week 10 subjects only performed two sets on Monday and Friday.


Participants worked to failure on the last 2 sets of Mondays session. Wednesday was not taken to failure. Rest between sets was 1-2 minutes on Monday and Wednesday. Fridays session emphasised a slow lowering phase on all reps, taking the last two sets to failure, with 2-3 mins rest between sets.

Weeks 4 & 8


Only BFR Leg Extensions were done on Mon, Wed, & Fri. Only BFR Leg Presses were performed on Tues & Thurs.


Monday Tuesday Wednesday Thursday Friday
Intensity 30% 1RM 20% 1RM 30% 1RM 20% 1RM 30% 1RM
Sets 4 4 4 4 4
Reps 30, 10, AMRAP, AMRAP 30, 10, AMRAP, AMRAP 30, 10, AMRAP, AMRAP 30, 10, AMRAP, AMRAP 30, 10, AMRAP, AMRAP


30 seconds rest was taken between all BFR sets.


As previously mentioned the results of the 10-week intervention resulted in a significant increase in muscle thickness of the Vastus Lateralis (one of the muscles of the quadriceps). Strength also increased in the leg press by 59.1% and in the leg extension by 19.8 %.


The ratio between vastus lateralis muscle thickness and cross-sectional area (CSA) is estimated as 1:1.15. Applying this ratio to the results gives a mean increase in muscle CSA of 17.3 %. That is an average increase of 0.25 % per day over the 10 weeks.


These findings are significantly superior to the findings of previous studies. In fact, in a review of the literature of training factors affecting quadriceps muscle CSA, an average increase of 0.11 % per day was reported (Wernbom, Augustsson & Thomeé 2007).


The 0.25% per day increase reported from the Swedish School of Sports Science lab sits right at the upper end of the range of previously reported findings (0.03-0.26 %) from 44 other studies with a similar training frequency. Consequently, the Swedish protocol resulted in superior increases in quadriceps muscle hypertrophy compared to almost all earlier studies.


Obviously, this is exciting news for anyone interested in gaining muscle. The Swedish Hypertrophy protocol provides a very effective framework to help you grow as fast as possible.


It Gets Better


Applying these findings to your own training could yield even better results than those reported in the study. The authors were restricted to using leg presses and leg extensions for the duration of the study. While these exercises lend themselves very well to BFR training they are not amongst the best choices of exercise for traditional heavy weight training. This leads us to the exciting possibility of even greater growth if you followed a protocol utilising squats instead of leg extensions in weeks 1-3, 5-7, 9 & 10. If you did, I hypothesise that you would make significantly better gains than the fantastic results achieved in this study.


This protocol can also be utilised for hamstrings, biceps and triceps training. You could set the protocol up as follows for each muscle:




Weeks 1-3, 5-7, 9 & 10

RDLs and Lying Leg Curls

Weeks 4 & 8

Seated & Lying Leg Curls



Weeks 1-3, 5-7, 9 & 10

Incline DB Curls and Preacher Curls

Weeks 4 & 8

Cable Curls and Machine Preacher Curls



Weeks 1-3, 5-7, 9 & 10

Close Grip Bench Press and Dips

Weeks 4 & 8

Rope Pressdowns and Machine Dips

Deloads a Thing of The Past?


Another interesting element of this study is the potential to remove, or at least drastically reduce, the need for deloads. By incorporating a week of BFR training every 4 weeks you change the training stimulus and significantly reduce the load used. This acts as a deload of intensity (as %1RM). However, during the BFR week training volume increases making it a significant muscle building stimulus. This manipulation of training variables helps to keep you fresh, might reduce injury risk, and allows for more productive training weeks per year than if frequent deloads were required.


A Caveat


The participants in this study were not advanced lifters with years of training under their belt. This means it is difficult to extrapolate the findings with certainty to an experienced lifter like you. With that said, I still feel it is an intriguing and potentially extremely useful strategy for seasoned meatheads. The results of this study stack up extremely well compared to other studies on similarly inexperienced trainees. Now we all know novices grow from almost anything. Newbie gains are a real thing. But this paper managed to elicit increases in muscle mass unlike almost any other research. They significantly outperformed the results others have managed in this population. If it can cause growth at such a superior rate in people who are primed to grow from almost anything, imagine the difference it could make for you. It is possible that this protocol might be of even more use to someone who is closer to their genetic potential. This protocol taps into hypertrophy that simply doesn’t occur with standard bodybuiding training. So, if you are someone who has been training a while and found new growth hard to come by give this a go. I have experimented with the Swedish hypertrophy protocol with great success with my clients and urge you to do the same.



Optimizing strength training for hypertrophy-A periodization of classic resistance training and blood-flow restriction training (PDF Download Available). Available from: https://www.researchgate.net/publication/319142595_Optimizing_strength_training_for_hypertrophy-A_periodization_of_classic_resistance_training_and_blood-flow_restriction_training [accessed Nov 03 2017].

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