Monday, 9 May 2022

Do compression socks actually work?

Do compression socks (clothing) actually work, what are the benefits, what do they do? 

Here are some quick answers...

From reading a research paper which analysed all previous studies about the effects of compression clothing on running performance and recovery and it concluded “that by wearing compression clothing, runners may improve variables related to endurance performance slightly (i.e., time to exhaustion) due to improvements in running economy, biomechanical variables, perception, and muscle temperature. They should also benefit from reduced muscle pain, damage, and inflammation.”

In addition I have read other studies and research and overall the evidence for compression clothing remains inconsistent and the language used is always MAY improve or help or some positive effects but not enough to be conclusive. So there is no resounding YES for compression clothing enhancing performance and recovery but importantly at the same time there are NO known negative effects.

For sporting performance the current commercial believe is that wearing compression garments can enhance performance and improve post-exercise recovery time.

So what does this actually mean for you and I?

First of all, how does compression clothing actually work?

Originally, compression wear was developed for swelling disorders in the limbs, and this led on to compression socks to treat vascular disorders, such as varicose veins, and to help to prevent blood clots in bed-ridden patients after surgery. These are typically knee high socks with the compression highest at the ankle and tapering off towards the knee.

The socks work by creating positive pressure on the one-way valves in the veins and the difference in pressure between the ankle and the knee encourages blood to flow back to the heart, against the forces of gravity (which is why it is advised for frequent flyers to minimise deep vein thrombosis too).

What does this mean for you and your training, perhaps your running, cycling, triathlons, tennis ? How can compression socks/sleeves help you?

First of all, DURING activities, particularly during endurance events (according to studies) the major selling point for compression clothing are:

Improved circulation of blood and other essential fluids. Because compression clothing can enhance the flow and exchange of fluids in the muscles, this means aiding the delivery of oxygenated blood, which is vital for the aerobic energy system, removing waste such as deoxygenated blood and processing lactate (lactic acid) to prevent cramps and muscle fatigue.

Muscle oxygenation - studies have concluded better endurance, specifically noting better mechanical performance (muscles less fatigued) over a distance of 10K.

Joint awareness and stability - compression helps to stabilise the muscles and decrease the amount of muscular vibration.

Muscle (and skin) Temperature – keeping the muscles warmer, means more blood flow and more oxygen is readily released, muscles contract and relax and nerve transmission is better and it feels good. 
For some compression clothing can be too hot during activity, so have a look at the potential benefits of using post-exercise.

Comfort and Perception - the feeling of comfort, support, stability, muscles at a warm happy temperature have a positive perceived effect on fatigue.

Lowers heart rate - this is more of a possible the evidence remains even more inconclusive - this was proven in running to exhaustion over a 5km distance . A lower heart rate is good for sustaining a higher level of effort, good for endurance.

And then POST-EXERCISE the potential benefits are IMPROVED RECOVERY owing to:

Reduced Muscle soreness (DOMS (delayed onset muscle soreness) - a reduction in the perception of muscles soreness and pain post intense exercise. Decreases in DOMS (delayed onset muscle soreness).

Increased Blood flow and removal of waste products - this aids better healing and recovery and lactic acid levels (the by product of anaerobic metabolism) have been found to be notably lower immediately post exercise aiding muscle recovery

Decreases swelling - inflammation is a natural part of the recovery and repair of soft tissues after strenuous exercise and compression garments are thought to apply external pressure upon the body, thus decreasing swelling and hence the experience of pain.

Muscle support - again the feeling of a muscle being support, stable and it lessens muscle vibration

So there are many potential benefits for during and post-exercise however, again the results of all studies to date do not provide overly conclusive results about these benefits, but nonetheless positive marginal ones and no known negative ones.

So are compression socks, sleeves, shorts worth the money?

It seems that they are not a game-changer. The most conclusive evidence suggests they are best used to prevent excessive soreness and muscle damage from hard training sessions and there is some evidence that over longer endurance activities they could improve your performance.

There is of course the “placebo effect” and the positive comfort and perception that compression garments give so I think if this works for you, then why not give them a try!

Training plans for different events are hard so I think anything positive that helps you body and soul. Is worth trying!

What about injuries? Are compression socks good for shin splints, calf cramps, strains and Achilles tendonitis?

YES, for all of the reasons noted above, but they are not going to cure any of the above injuries, You should still follow initial acute injury principals of LOVE and PEACE and get an injury assessed for proper recovery and the cause to be addressed. Note, for recovery from an injury it is better to wear a sock rather than a sleeve so that the foot doesn’t get swollen, as it can’t get past the compression at the ankle!

Buying and how tight should a compression sock feel?

An important point when looking to buy compression socks is they should be rated and sold in millimeters of mercury (mmHg) at the ankle and calf. So a sock labeled 15-20 mmHg is 20 mmHg at the ankle and 15 at the calf, and this is a medium level and is recommend rating for general sporting use.

Normally when you buy compression garments you measure the top of your calf or arm and when trying them out the garments should feel tight yet comfortable to wear and should not cause any additional pain.

NB. The above article is meant to give you an overview of the benefits of compression clothes in a sporting/exercise context. This is my summary of a number of articles and papers I have read. I hope this helps! Any queries let me know!

Nicky Holbrook

May 2022

I had some socks a few years ago, but never really felt I got any benefit but in the last month I have been using a new compression calf sleeve for a calf issue and I feel it has really helped my calves recover post exercise.

I am aware of course of the placebo effect and I like wearing them, not all the time, but as there is no known negative effects to using them, then why not?