Compression wear, in the form of lower leg tights, shorts, socks, and other garments are worn by people for various reasons, but are these reasons fad, fashion or science?

 

Compression wear advertises proposed benefits and in the athletic population there is a notion that these tight fitting garments may:
* hold muscles in place
* improve muscle blood flow and oxygen delivery therefore improving athletic performance
* increase proprioception (the body’s sense of position)
* Increase blood return to the heart
* regulate skin temperature
* improve clearance of metabolic waste and exercise by-products
* reduce the risk of injury
* reduce delayed (exercise induced) onset muscle soreness otherwise known as DOMS

A few studies have shown some interesting results to challenge these theories.

In a 2015 study published in the International Journal of Sports Physiology and Performance, researchers tested men wearing compression sleeves versus not wearing compression sleeves when running on a treadmill. They measured variables such as oxygen uptake, stride, body positioning and other markers throughout the runs. They found no difference in exercise efficiency or biomechanics between compression wear on versus no compression wear. One of the researchers Abigail Stickford concluded that when the advertised benefits or purported perks of these garments used in her study were tested scientifically, the results primarily showed no real performance benefits of compression wear during exercise.

In a literature review done in 2015 published in the Journal of Sports Science Medicine, researchers reviewed 23 studies on lower limb compression wear and its effects during and after exercise. They concluded that:
a) The effects of wearing compression garments during exercise are controversial, as most studies failed to demonstrate a beneficial effect on immediate or performance recovery, or on delayed onset of muscle soreness from having worn compression wear during exercise.
b) There was a small trend towards a beneficial effect of compression garments worn after exercise or during recovery, with performance recovery found to be improved in the five studies in which this was investigated, and delayed-onset muscle soreness was reportedly reduced in three of these five studies.

This was supported in a recent 2017 paper published in the Journal of Strength and Conditioning, where they compared wearing compression garments after rugby for 48 hours to consuming recovery drinks. PMS (perceived muscle soreness) levels were lower and circulating concentrations of Creatine Kinase (a hormone critical in muscle energy production) were better in the compression wearing group compared to the recovery drink group, suggesting improved recovery from muscle-damaging exercise. However like most studies they too showed no significant positive effect on muscle performance 24-48 hours after exercise from use of compression wear post exercise.

Conclusion

So, should you wear compression garments during sport or exercise?
Based upon the results of most of the research, lower-leg compression is unlikely to improve endurance or running performance. However, if you think they could improve your performance, it may be worth a shot. The placebo effect is a very real phenomenon that affects everything from exercise performance to health outcomes. If there is a ‘comfort,’ whether physiological or psychological, for an individual wearing compression garments, then it could certainly affect their performance.
The scientific evidence supporting a positive effect of compression garments on recovery is more convincing than on any performance-enhancing effect. Hence wearing compression garments after exercise may be beneficial for performance recovery and delayed-onset muscle soreness, but the factors explaining this efficacy are unclear.

The proclaimed injury reduction benefits of wearing compression garments needs more clarification as it’s an area that has very little research. Anecdotally we have often recommended a calf sleeve to assist in keeping those chronic calf issues at bay in the running population.

And while there may not be a drastic benefit of compression clothing, there’s really no harm in it either. Unless you’re wearing something that’s cutting off your circulation. But most garments have a mild to moderate level of compression and shouldn’t do anything like that providing they are sized to your body correctly. Both anecdotal and experimental results show no significant harm in wearing the garments.

So………

Wear compression for exercise or sport – MAYBE
Expect improved performance – PROBABLY NOT
Wear compression for recovery for 0-12 hours after sport or exercise – YES
Expect improved recovery – PROBABLY
Wear a calf sleeve for running if you have chronic calf problems – PROBABLY

Neeraj Kochhar – SSPC Physiotherapist

 

Bibligraphy
Int J Sports Physiol Perform. 2015 Jan;10(1):76-83. doi: 10.1123/ijspp.2014-0003. Epub 2014 Jun 6.
Lower-leg compression, running mechanics, and economy in trained distance runners.
Stickford AS1, Chapman RF, Johnston JD, Stager JM.

J Sports Sci Med. 2015 Mar; 14(1): 75–83.
Compression Garments and Exercise: No Influence of Pressure Applied
Samuel Beliard, Michel Chauveau, Timothée Moscatiello, François Cros, Fiona Ecarnot, and François Becker

J Strength Cond Res. 2017 Nov;31(11):2977-2982. doi: 10.1519/JSC.0000000000002145.
Efficacy of Compression Garments on Recovery From a Simulated Rugby Protocol.
Upton CM1, Brown FCW, Hill JA.