Dorsalis pedis artery thrombosis after blood flow restriction training in an elite rugby player: a complex and cautionary tale

There has been recent interest in blood flow restriction training (BFRT), a novel training method where a cuff used as a tourniquet restricts arterial inflow and venous return to a target limb during exercise. Research suggests that BFRT confers benefits in muscular strength and hypertrophy at lower loads compared with traditional training and is advantageous during rehabilitation of load-compromised individuals. Although BFRT is considered safe, inherent concerns exist regarding its effect on venous stasis and potential thrombotic events. In this case report, we illustrate a rare finding of dorsalis pedis artery (DPA) thrombosis in an elite rugby player after using BFRT postsurgery. We aim to explore the risk factor accumulation in this case and highlight the need for clinicians to be aware of relative risks and contraindications to BFRT. We also emphasise local policy and risk stratification tools to supplement decision-making processes prior to BFRT implementation.