Post-ACL Surgery KAATSU Protocols

Post-ACL Surgery KAATSU Protocols

For who? Competitive athletes
For what? Mobility, Flexibility, Recovery and Rehabilitation

After anterior cruciate ligament (ACL) surgery, rehabilitation begins in order to help blood circulation, prevent blood clots from forming in your legs, and to prevent muscle atrophy.

Dr. Yoshiaki Sato has long worked with KAATSU Specialists in Japan to develop specific protocols to incorporate KAATSU into post-ACL surgery rehabilitation.

With the approval of your physician and therapist, patients can begin KAATSU soon (72 hours) after the surgery if there are no complications. The patient can also do KAATSU on their other healthy limbs (i.e., healthy leg and both arms). The standard protocol includes the following:

KAATSU Equipment

  •  Use either the KAATSU Master 2.0, the KAATSU Nano, the KAATSU C3, and the KAATSU B1 together with the KAATSU Air Bands.
  • The KAATSU Air Bands may look like a tourniquet or blood pressure cuff, but they are specifically designed and manufactured to allow arterial flow to continue and only moderate the venous flow.
  • Because KAATSU has systemic effects, it is recommended to do KAATSU both on the arms first and then the legs no matter when the injury or surgery is located.

Important Points

  • Be well-hydrated before and during KAATSU the Original BFR.
  • Always follow KAATSU protocols (i.e., always have Capillary Refill Time within 3 seconds with no occlusion).
  • You should experience no lightheadedness, or no numbness or whiteness in your limbs. If so, immediately take off the KAATSU Air Bands.
  • Always start with the KAATSU Cycles on both the arms and legs. For older patients and patients who lead sedentary lives, ONLY do KAATSU Cycles.
  • Proceed with KAATSU 3-point Exercises (first on arms and then on legs) or do KAATSU while conducting physical rehabilitation exercises.
  • KAATSU can be done daily, even twice per day during rehabilitation or recovery from injuries.
  • Use an appropriate Base SKU and Optimal SKU that is safe and falls within the standard KAATSU guidelines. However, it is always best to begin KAATSU sessions with low Optimal SKU on the first few KAATSU Cycles.
  • Never experience pain in the joint, tendon, bone or injured areas while doing KAATSU.
  • Always use the correct form in any movements.
  • Rest between sets and between exercises should be no more than 30 seconds.
  • Always breathe normally throughout the KAATSU Constant and KAATSU Cycle modes.
  • You can do KAATSU Cycle daily, but limit your KAATSU sessions to 15 minutes on your arms and 20 minutes on your legs during each session.
  • Sessions should always start with the KAATSU Cycle (i.e., 20 seconds of pressure on + 5 seconds of pressure off). This will help prepare (“warm-up”) the muscles, veins and capillaries before doing anything more strenuous.
  • In order to avoid atrophy, you can regularly do the KAATSU 3-Point Exercises on your legs.


  • With the KAATSU Air Bands at the appropriate Base SKU pressure (i.e., manual tightening) and Optimal SKU pressure (i.e., the inflated pressure), do 3 sets each of the following depending on how the you feel and your range of mobility:
    • toe curls
    • heel raises (or just rotating the ankles)
    • leg curls
    • repeated quadricep contractions
    • stretching
    • stationary bike riding
    • leg presses
  • You can do the same KAATSU 3-Point Exercises on your healthy leg and the following KAATSU 3-Point Exercises for your arms, performed slowly while contracting your muscles:
    • hand clenches
    • biceps curls
    • triceps extensions
    • stretching
  • As you become more mobile, simple walking (especially in the sand at the beach) with the KAATSU Air Bands on is beneficial. You can even do this at yourr home or office as you walk back and forth in your room. If you regularly do these exercises, you should not see any muscle atrophy.
  • Your skin should turn pink or reddish as your limb should experience an engorgement of pool in the limbs.

This information is for educational purposes only and is not intended to replace the advice of your doctor or therapist.