KAATSU – The Pressure Training from Japan
New perspectives in sport, therapy and health promotion.
His intuition for innovative developments brought early adopter Robert Heiduk with a small international group of like-minded people directly to Japan to the inventor of Japanese pressure training. On the basis of this encounter and extensive research, the sports scientist created this comprehensive standard work, which is aimed at coaches, athletes, physiotherapists, doctors, scientists, and students who would like to gain a deeper insight into the methodology of the original protocols of the KAATSU inventor Yoshiaki Sato.
The original core concepts behind KAATSU were not yet available in this form and have been further developed in theory and practice by Robert Heiduk in a new structured approach. The book arouses curiosity about Japanese pressure training and its new possibilities in sport and therapy, but also especially for older people and in corporate health management. This is the English version of the book.
Robert Heiduk is a German sports scientist and product scout for cutting-edge sports technology. For more than a decade he has been active in the education of coaches and in health consulting for companies like Google or PPG Industries. He has experience as an international lecturer and book author. Robert Heiduk's motto: "Whoever wants to go to the source must swim against the current."
KAATSU is not occlusion training. KAATSU is not tourniquet training. KAATSU is not a type of BFR that you see often marketed on YouTube or promoted online. KAATSU is a modality developed over the last 50 years from Japan that has been tested on thousands of cardiac rehab patients before launching outside of Japan and is currently used safely by people of all ages and abilities in 49 countries around the world – who follow the recommendations below:
- Always hydrate well before, during and after each KAATSU session.
- Always first use the KAATSU Cycle Mode before using the KAATSU Constant (Training) Mode.
- Always breathe throughout your KAATSU exercises. Consciously count your repetitions quietly to yourself or out loud so you do not hold your breath while doing KAATSU.
- Always place the KAATSU Air Bands at the correct location on your upper and lower limbs.
- Always confirm your KAATSU Air Bands are high enough to engorge your limbs in blood and create a pink or red color to your skin in your arms and legs. You can get distended veins, but the band pressure should not be so high to occlude your blood flow to your limbs.
- Always wear your KAATSU Air Bands over clothing (e.g., t-shirts, shirts, tights, pants, shorts).
- Always frequently check your Capillary Refill Time (CRT) throughout the KAATSU session.
- Always confirm your CRT is always less than 3 seconds in duration.
- Always release your KAATSU Air Bands if you feel something is not right or unusually uncomfortable. If you feel lightheaded or if you have an unusual pain on one side or the other, immediately stop and take off your KAATSU Air Bands.
- You can perform different exercises during your KAATSU session while doing KAATSU Cycles as you see fit.
- Use the KAATSU Cycle and the KAATSU 3-point Exercises or stretch to warm-up and to help determine the optimal SKU pressure or as a form of basic exercise for both your arms and legs.
- The veins in your limbs may become distended (i.e., pop out) and you may feel a slight tingling in your fingers or toes during the KAATSU Constant mode.
- If you experience occlusion, numbness, or any kind of lightheadedness with the KAATSU Air Bands, immediately remove the bands from your limbs.
- Always check with your physician before starting a KAATSU regimen.
- Always start slowly and conservatively with KAATSU.
- KAATSU can be prudently and safely incorporated into your training, rehabilitation, and recovery regimens – without performing at maximal pressure levels.
- Do not use when dehydrated or intoxicated or after or while drinking alcohol or taking medications or illegal drugs including any performance enhancing drugs.
- Do not use while driving a vehicle.
- Do not use while underwater or while holding your breath.
- Do not use while using a vibration plate or doing anything (e.g., treadmill, Bosu Balls) that you cause you to lose your balance.
- Do not fall asleep while the KAATSU Air Bands are on your arms or legs.
- Do not use if you feel pain during use.
- Do not ever partly or fully occlude your blood flow. Signs of this occlusion are collapsed veins, no pulse at your wrists, pale palms of your hand, pale or blue skin color, or severely delayed (>6 seconds) capillary refill time.
- Do not train in the KAATSU Constant mode (i.e., sustained pressure with the inflated bands) for more than 10 minutes on either your arms or your legs.
- Do not use more than 6 consecutive KAATSU Cycles in a row; always build up to 6 consecutive KAATSU Cycles and never exceed this number.
- Do not simultaneously use the KAATSU Air Bands on both your arms and legs.
- Do not lift heavy weights or heavy resistance when using the KAATSU Constant mode. Use can use water bottles or very light weights or resistance in order to obtain good outcomes and results.
- Do not use the KAATSU Constant mode if you are older than 50, de-conditioned, overweight, tend to faint, or have White Coat Syndrome.
- Do not use the KAATSU Constant mode if you are training at altitude; only use the KAATSU Cycle mode.
- Stop KAATSU immediately if your limbs become clammy, cold, white, or pale. That physiological response may be due to occlusion of your arterial blood flow, use with heavy weights, or use with sustained vigorous activities – especially at high altitudes.
- Do not place the KAATSU Air Bands on your body other than on your upper arms or upper legs.
- Do not do KAATSU if you are pregnant, under medical treatment, have cancer, hypertension, fractures, muscle ruptures, or any acute diseases without the prior approval of your physician.
- Do not do KAATSU if you are undergoing cardiac rehabilitation or have a pacemaker.
- Do not do KAATSU if you have any of the following conditions: atrial fibrillation, acute myocardial infarction, unstable angina, ventricular tachycardia or severe arrhythmia, serious case of cardiac insufficiency (NYHA class IV), serious aortic stenosis, acute pulmonary embolism or lung infarction, acute myocarditis or pericarditis, acute vena cava dissociation, or macular degeneration.
- If you have peripheral vascular disease, Raynaud’s disease, heart disease or low blood pressure, it is essential to only use very low (conservative) pressure in the KAATSU Cycle mode.
- People with Raynaud’s disease can feel discomfort or even pain if they use high pressures on the KAATSU Air Bands. Because the capillaries are engorged in blood, this impacts the nervous system – which should be avoided for people with Raynaud’s disease.
- Do not use if you are under 14 years old. This recommendation is due to a small number of overly ambitious adults who push children too much or too long with KAATSU.
- Do not open the device and attempt to change or repair the device yourself.
- Do not use maximum pressure levels – even if you believe you are a strong and capable athlete. KAATSU can be prudently and safely incorporated into your training, rehabilitation, and recovery regimens – without performing at maximal pressure levels.
Key Points When Doing KAATSU
- Always remain well hydrated before and during the entire KAATSU session. Good hydration means that your urine should be nearly clear – not bright yellow.
- Always start each KAATSU session with the KAATSU Cycle. The KAATSU Cycle include 8 steps of 30 seconds pressure on followed by 5 seconds of no pressure. Each step has sequentially increasing pressure.
- First, start KAATSU on your arms and then do KAATSU on your legs.
- Never simultaneously put on or use the KAATSU Air Bands on your arms and legs.
- Always and frequently check the Capillary Refill Time on the exercising limb is within 3 seconds. Confirm that the color of the limbs remains either pink or beefy red.
- Your veins may become distended (i.e., pop out) during KAATSU.
- You may feel a slight tingling in your fingers or toes during KAATSU. This feeling is acceptable.
- Always immediately stop KAATSU and remove the KAATSU Air Bands if there is any occlusion, numbness, or paleness (i.e., whiteness, grayness, or blueness) in your limbs.
- Always immediately stop KAATSU and remove the KAATSU Air Bands if you experience any lightheadedness. Lie down with your legs elevated if necessary.
- If undergoing rehabilitation from an injury or surgery, never push your joints or your limbs to or pass the point of pain.
- Do not exceed 15 minutes of KAATSU on your arms or legs.
- Keep your rest short between your sets and between exercises. Rest 20 seconds maximum between sets or 60 seconds maximum between exercises. This can be modified as necessary.
- Select exercises, movements or loads that allow slow and steady performance of a good number of repetitions (e.g., 30-40 in first set, 20-30 in the second set, >15 in the third set).
- Do 3-4 sets of each exercise and then continue with a different exercise. If only one limb is being exercised at a time, first do 3-4 sets on that limb and then proceed with 3-4 sets on the other limb.
- Reach maximum effort (or go to muscular or technical failure) within each set if you want to build muscular strength or increase muscle tone or size.
- KAATSU should be implemented with the understanding of your physician or physical therapist. KAATSU can be incorporated with your physical therapy routine.
- KAATSU can be performed with most kinds of exercise equipment.
- Conduct movements slowly, steadily and with good range of motion unless you are performing a specific athletic movement (e.g., swinging a golf club, swinging a bat, throwing a ball, cycling, swimming, practicing race starts or jumps). In these cases of athletic movements, move at the speed in which you want to perform.
- Try to reach muscular failure or technical failure during each set of each exercise.
- The dual combination of Base SKU pressure and Optimal SKU pressure is a critical element of KAATSU. The Base SKU pressure is the manual tightening of your KAATSU Air Bands. The Optimal SKU is the inflated pressure of your inflated KAATSU Air Bands. If the Base SKU is low, the Optimal SKU will be higher. Conversely, if the Base SKU is high, the Optimal SKU will be lower. The Base SKU (i.e., manually tightened KAATSU Air Bands) in combination with Optimal SKU (i.e., inflated KAATSU Air Bands) is critically important to set the pressures necessary to achieve maximum benefits from KAATSU.
- KAATSU Air Band placement is critically important. The KAATSU Air Bands can only be used in two locations: above your biceps and triceps, but below your deltoids near your armpit on your arms, and above your quadriceps and hamstrings near your groin on your legs.
- Muscle contraction in your limbs temporarily squeezes venous blood past the KAATSU Air Band on your limbs.
- KAATSU is the original BFR (blood flow restriction), but KAATSU is not Occlusion Training or Tourniquet Training.
- Occlusion Training or Tourniquet Training is a type of training where blood is reduced or restricted going from your torso to your limbs. This is not KAATSU.
- The term “occlusion” implies that the blood flow is restricted or stopped from going from your torso to your limbs. In contrast, the interaction of the blood flow both in and out of your limbs during the KAATSU Cycle and KAATSU Constant modes is vitally important to realize the benefits, safety, and efficacy of KAATSU.
- KAATSU is a means to safely moderate blood circulation both in and out of your limbs. KAATSU slows the venous outflow and engorges your limbs in blood. This is the most important physiological fact why the KAATSU Cycle is important; the vascular system must be warmed up first before starting KAATSU Constant (Training).
- If you want to build strength or improve muscular size and tone, do sets of each KAATSU to either muscular or technical failure. If the Optimal SKU is set correctly, the duration (or repetitions) of each set will be reduced. That is, if set #1 is 1 minute in duration (or 30-40 repetitions), then rest for a maximum of 20 seconds and continue with set #2. You should reach your muscular or technical failure before 1 minute or 30-40 repetitions in Set #2. Rest should be no more than 20 seconds before set #3 begins. In set #3, you should reach your muscular or technical failure in a shorter time duration or fewer repetitions in Set #2.
- The veins in your limbs may become distended (i.e., pop out) during the KAATSU Constant mode.
- You may feel a slight tingling in your fingers or toes during the KAATSU Constant mode. This is acceptable, but KAATSU should be immediately stopped if there is any occlusion, lightheadedness, or numbness or whiteness in your limbs.
- KAATSU should be implemented with the understanding of your physician.
- Wait at least 72 hours after a surgery to start KAATSU with the approval of your physician.
KAATSU Cycle Mode versus KAATSU Constant Mode
- We recommend that you limit your use of KAATSU C3 to the KAATSU Cycle mode.
- The KAATSU Cycle mode is the most effective, efficient, gentle, and safest mode to generate a hormonal response for a vast number of individuals.
- If you would like to use the KAATSU Constant mode, limit your use to 10 minutes. While some elite athletes and younger biohackers advocate simultaneously using four KAATSU Air Bands in the KAATSU Constant mode at high pressures, this is not the most effective, efficient, gentle, and safest mode for most individuals, outside the younger elite demographic group.
- If you use the KAATSU Constant mode due to doing specific athletic moves (e.g., swinging a baseball bat or golf club, throwing a baseball or football, swimming, paddle boarding) where the Connector Tubes would get in the way or get tangled, limit to a short period of KAATSU.
- If you would like to maximize muscle hypertrophy, you can do so in the KAATSU Cycle mode. In this case, very slowly move your limbs while contracting your muscles in the eccentric and concentric directions (i.e., up and down directions).
Conservatively Start KAATSU
- Always start slowly and conservatively with KAATSU, especially if you have any adverse medical or physiological conditions, are older than 50 years old, or are sedentary or de-conditioned.
- Always start your KAATSU program by using the KAATSU Cycle mode only.
- In order to build up to 5-6 KAATSU Cycle sets in one session, adhere to the following protocols especially if you have any adverse medical or physiological conditions, are older than 50 years old, or are sedentary or de-conditioned.
- Do only 1 KAATSU Cycle in your 1st session in the first week.
- You can do 2 KAATSU Cycle sets in your 2nd session in the second week.
- You can do 3 KAATSU Cycle sets in your 3rd session in the third week.
- You can do 4 KAATSU Cycle sets in your 4th session in the fourth week.
- You can do 5 KAATSU Cycle sets in your 5th session in the fifth week.
- You can do 6 KAATSU Cycle sets in your 6th session in the sixth week.
Seek Medical Advice Before Starting KAATSU
- It is important to seek advice from your physician before starting KAATSU.
- Do not do KAATSU if you are under 14 years old, under 18 years old without adult supervision, pregnant, under medical treatment, have cancer, hypertension, fractures, muscle ruptures, undergoing cardiac rehabilitation, have a pacemaker, heart disease, atrial fibrillation, acute myocardial infarction, unstable angina, ventricular tachycardia or severe arrhythmia, serious case of cardiac insufficiency (NYHA class IV), serious aortic stenosis, acute pulmonary embolism or lung infarction, acute myocarditis or pericarditis, acute vena cava dissociation, macular degeneration, or any acute diseases without the prior approval of your physician.
- If you have peripheral vascular disease, Raynaud’s disease, multiple sclerosis or low blood pressure, it is essential to only use very low (conservative) pressure in the KAATSU Cycle mode.
- People with Raynaud’s disease or multiple sclerosis can feel discomfort or even pain if they use high pressures on the KAATSU Air Bands.
- These protocols have not been evaluated by Health Canada. This product is not intended to diagnose, treat, cure or prevent any disease and its use should be evaluated by your own physician before use.
This website does not provide medical advice. The information including, but not limited to, text, graphics, images, videos, and other material contained on this website are for information purposes only. Although we strive to provide accurate general information, no material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care or exercise regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
KAATSU protocols have not been evaluated by Health Canada. This product is not intended to diagnose, treat, cure or prevent any disease and its use should be evaluated by your own physician before use.
Mark Kawabe is a Personal Training Specialist (PTS) and a certified KAATSU Specialist, but is not YOUR PTS or KAATSU Specialist. A client relationship with you with respect to training is only formed after we have expressly entered into a written agreement with you that you have signed including our fee structure and other terms to work with you in a specific manner.
KAATSU is considered generally safe, but there are contraindications you should be aware of. You should consult your physician or other health care professional to help you determine whether KAATSU use is right for your unique needs. KAATSU Canada and its directors are not liable for any issues associated with you using or acting upon the information contained on our site, or from using the products available to purchase through our site.
The contraindications to KAATSU use are largely the same as the contraindications to exercise as recommended by the American Heart Association. These are:
- Acute myocardial infarction (MI / “heart attack”), within 2 days
- Ongoing unstable angina
- Uncontrolled cardiac arrhythmia with hemodynamic compromise
- Active endocarditis
- Symptomatic severe aortic stenosis
- Decompensated heart failure
- Acute pulmonary embolism, pulmonary infarction, or deep vein thrombosis
- Acute myocarditis or pericarditis
- Acute aortic dissection
- Physical disability that precludes safe and adequate exercise
In addition, to be safe, people with an acute infection, unclear tumour status, acute vena cava dissociation, macular degeneration, chronic lymphedema, pregnancy, or severe hypertension (Systolic >180 or Diastolic >110) should also avoid using KAATSU. We also recommend that children under age 14 do not use KAATSU.