The Skinny on Compression Garments

Vol. 27 • Issue 9 • Page 13

Sports Performance

 

 

Compression garments are used by a wide range of athletes today. The spectrum of those using them ranges from the recreational weekend warrior to the professional athlete, and all those in between.

Those who don this attire hope to gain enhanced performance and accelerated recovery after activity. Is there proof behind these claims, or is this simply a marketing effort to push the sales of athletic clothing?

 

Long History

Despite the recent popularity of compression garments among athletes, stocking-like compression garments have been used by medical practitioners for nearly 60 years. These devices are typically applied to cover the lower leg from the foot to the knee.

They are used to increase circulation, especially the return of blood from tissue space to the veins (venous return). This improved circulation is accomplished by using different grades of compression throughout the stocking.

The bottom of the stocking (by the foot and toes) typically has the most compression, with a gradient of relatively lower pressure used higher in the stocking (toward the knees). This applies a squeezing effect that helps push blood up proximally to facilitate a return of blood to the heart. This pressure is most typically measured in millimeters of mercury (mm Hg).

Pressure ranges vary depending on desired outcomes, but the dose typically varies from 20-40 mm Hg.1 This is used to prevent post-operative conditions caused by static blood flow, including deep vein thrombosis or embolism pathologies. They are also utilized for other vascular conditions, such as vasculitis, and for the wide range of pathologies that contribute to edema.

While compression stockings have been employed for widespread medical use to minimize clot formation and edema, their use as a performance enhancer is not as well established. The proposed mechanism to enhance athletic performance is similar to that used by medical practitioners. Along with improved circulation, proposed physiological benefits include reduced muscular swelling, reduced blood lactate, higher resting temperature of the limb, reduced muscle oscillation and improved proprioception.2-4

Proponents claim these benefits improve athletic performance during sport activity and enhance recovery after activity. While stockings used for medical purposes are typically worn below the knee, athletic compression garments can be worn as knee-high socks, shorts, pants, arm sleeves or even full-body suits.

 

Do They Improve Function?

How can compression improve function during sport activity? Research shows some small improvements in certain aspects of athletic performance.

Multiple studies have shown improvements in repeated jumping power and vertical jump height.1,3-4 This enhancement is possibly due to increased temperature and circulation, which in turn could improve oxygen delivery and exchange to exercising muscle tissue.

Other studies have shown reduced muscle oscillation upon ground contact with landing from jumping maneuvers.1-3,5 This would essentially result in less mechanical load placed on the muscles by stabilizing and supporting the tissue, thereby reducing discomfort. This in turn could reduce perceptions of muscle pain.sports compression garments

Improvements in sprinting performance have also been noted. Improved short-duration sprinting (10-60 meters), time trial performance in sprinting and sprinted duration until exhaustion have been noted compared to control subjects who did not use compression garments.1,3-5 It’s theorized that this improved sprinting performance relates to improved muscle temperature and reduced muscle oscillation.

Other physiological mechanisms include improvements in blood lactate removal from muscle and surrounding tissues. It’s theorized that enhanced circulatory effects and turnover of lactate from such tissues may allow for improved sprinting performance by allowing for more optimal energy metabolism.

Metabolic byproducts appear to be removed more effectively during short-duration, high-intensity activities while wearing compression garments. As such, sports that require jumping, plyometric/explosive movements and sprinting could benefit from compressive garment use.

Interestingly, the benefits of compression garments do not seem to apply to all types of running. Studies of longer-distance runners have not shown as many benefits.6 While longer-distance runners reported less discomfort during running, little statistical physiological benefit was seen in circulation, tissue temperature, or lactate removal. It is worth considering the intensity and type of running before recommending these garments.

From an injury prevention standpoint, studies have demonstrated enhanced joint positional sense and proprioception while using compressive garments.1,3,5-6 This improved awareness of body position is likely due to the aforementioned processes, including improved temperature and circulation and reduced muscle oscillation.

Regarding treatment application, any patient with proprioceptive deficits can benefit. Patients with ankle instability, dynamic knee alignment issues, post-operative movement impairments or chronic pathologies that result in gait abnormalities may benefit from selective compressive garment use.

 

As a Recovery Aid

Another facet of compression garment use relates to recovery from exercise and sporting activity. How is recovery measured? Studies have used an array of both subjective and objective markers to measure recovery.

One subjective measure relates to the perceived level of pain in muscles following activity, or delayed onset muscle soreness (DOMS). Multiple studies have shown reduction in perceived DOMS following strenuous exercise.1-3,7-8

Studies that objectively quantify DOMS have shown mixed results. Studies measuring blood lactate removal after exercise have shown positive benefits as noted above. Other studies that measure muscular swelling via ultrasound have also shown improved recovery and swelling reduction.

However, other objective measures of DOMS such as creatine kinase levels after strenuous exercise have yielded mixed results. Creatine kinase has been used in some studies as a measure of physiological muscle damage following exercise. The relation between compression garments and reduced kinase levels after exercise is not as well supported.1-4,7-8

An indirect way to measure recovery involves measuring muscle performance immediately after activity and then again after a period of compression garment use. Studies measuring muscle strength, vertical jump height, drop jump height, lower- and upper-extremity ergometry (cycling) performance and various measures of sprinting performance have all shown improved recovery relative to control subjects who did not wear garments.1-3,7-8

Mechanisms that allow for this improved recovery are attributed to the physiological benefits previously noted, including reduced blood lactate, improved oxygen exchange to muscle tissue, enhanced venous return and improved circulation.1-5,7-8 The recommended duration of wear to facilitate recovery has varied based on research designs.

SEE ALSO: A Look at Physical Therapy Modalities

How long should garments be worn to optimize recovery? Studies have shown improvements with as little as 12 hours of use (after activity), while other studies have shown that use over 24-48 hours may be more optimal.1,7-8

As far as treatment application, compression garments have the potential to aid patients prone to movement compensations secondary to soreness experienced after bouts of exercise. With quicker recovery, improved muscular swelling and better oxygen exchange, there is a legitimate potential to reduce the occurrence of tendinitis, myalgia and joint dysfunction that occurs after intense exercise.

 

The Bottom Line

Compression garments appear to improve athletic performance in certain sports — especially those involving short-duration, high-intensity explosive movements. They also appear to reduce the severity of muscle soreness and even physiologically expedite recovery from intense exercise.

However, research has yet to definitively determine the specifics of use. Studies investigating exactly when and how long to wear the garments, optimal size of garment and the most beneficial amount of pressure will allow for more precise use. With more research, the potential use for athletic and rehabilitation purposes may be even more widespread and effective.

 

References are available here.

 

Ben Wiggin is practice manager at Back Bay Rehabilitation, Tamworth, N.H. Contact: ­bwig­gin@hugginshospital.org.

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