Compression Garments - A Worthy Investment ?

Compression garments are parts of clothing such as pants, socks, sleeves, etc., that are designed to pressurize the part of body on which they are worn. They are considered especially useful for people who have poor circulation or people who are standing for long periods, as they compress the ends of the limb that are word to prevent blood pooling. 

Compression garments have gained more popularity in the last years in the field of sports as performance enhancements, or as a recovery method. A possible benefit for performance enhancement is increased venous return, by the compression of superficial veins and improved capillary filtration, to reduce venous poling in the limbs during or after exercise (1,2).

Their pressure function in the limb gradiently increases towards the end of it. For example in the leg, the pressure is highest in the ankle region and lower in the upper thigh. This is thought to result in an increased blood flow that aids in removing exercise induced waste products and to allow a faster return to blood gas homeostasis (3).

There are conflicting results in the role of compression garments (CG) as an enhancer of performance. While exercising in different sports and wearing CG, studies have found lower 24 hour post exercise CK and DOMS values (4), reduced lactic acid values post exercise (5) and lower heart rate and lactic acid during active recovery, but no changes in blood pH (6).

However many studies have reported no change in lactic acid in high intensity treadmill running (7,8), a higher RER (Respiratory Exchange Ratio) during submaximal treadmill run (6). Studies on plyometrics and sprint performance also displayed no significant difference while wearing CG (9).

There seem to be some minor performance enhancements and recovery aids in wearing CG. However, as a coach, it is crucial to consider if such improvements are important for your athletes so you invest on this equipment, spend money to buy it and alter your training routines so you will use it.

Concerning lactic acid, which is the major focus of the studies around CG, we see no changes during exercise, but the effects of CG are visible on active recovery, with the subjects having lower values.

Is this actually good?

Lactic acid has been considered for a long time something that reduces performance. However new studies have shown that actually it may be something beneficial for exercise, another energy substrate, and not connected with lowering blood pH (10). So does it matter to remove it quickly from the body post exercise? And moreover if does matter, we must consider that blood lactate is not the same with muscle lactate. A higher extraction of lactate in the quadriceps by higher blood concentration may also mean a lower extraction in the soleus, because of the passive vasoconstriction. It somehow follows the notion of “There Is No Good without Evil”. 

Summarizing from my point of view as a coach, I would not invest in compression garments to aid the performance or recovery of my athletes. Conflicting results and minor enhancements do not outweigh the cost of the material or risks from the compression that have not been yet found.



References


1. O'Donnell TF, Jr., Rosenthal DA, Callow AD, Ledig BL. Effect of elastic compression on venous hemodynamics in postphlebitic limbs. JAMA : the journal of the American Medical Association. 1979 Dec 21;242(25):2766-8. PubMed PMID: 501883.

2. Partsch H, Mosti G. Thigh compression. Phlebology / Venous Forum of the Royal Society of Medicine. 2008;23(6):252-8. PubMed PMID: 19029006.

3. Davies V, Thompson KG, Cooper SM. The effects of compression garments on recovery. Journal of strength and conditioning research / National Strength & Conditioning Association. 2009 Sep;23(6):1786-94. PubMed PMID: 19675482.

4. Duffield R, Portus M. Comparison of three types of full-body compression garments on throwing and repeat-sprint performance in cricket players. British journal of sports medicine. 2007 Jul;41(7):409-14; discussion 14. PubMed PMID: 17341589. Pubmed Central PMCID: 2465357.

5. Berry MJ, McMurray RG. Effects of graduated compression stockings on blood lactate following an exhaustive bout of exercise. American journal of physical medicine. 1987 Jun;66(3):121-32. PubMed PMID: 3605315.

6. Lovell DI, Mason DG, Delphinus EM, McLellan CP. Do compression garments enhance the active recovery process after high-intensity running? Journal of strength and conditioning research / National Strength & Conditioning Association. 2011 Dec;25(12):3264-8. PubMed PMID: 22082795.

7. Ali A, Creasy RH, Edge JA. Physiological effects of wearing graduated compression stockings during running. European journal of applied physiology. 2010 Aug;109(6):1017-25. PubMed PMID: 20354717.

8. Sperlich B, Haegele M, Achtzehn S, Linville J, Holmberg HC, Mester J. Different types of compression clothing do not increase sub-maximal and maximal endurance performance in well-trained athletes. Journal of sports sciences. 2010 Apr;28(6):609-14. PubMed PMID: 20391083.

9. Duffield R, Cannon J, King M. The effects of compression garments on recovery of muscle performance following high-intensity sprint and plyometric exercise. Journal of science and medicine in sport / Sports Medicine Australia. 2010 Jan;13(1):136-40. PubMed PMID: 19131276.

10. Robergs RA, Ghiasvand F, Parker D. Biochemistry of exercise-induced metabolic acidosis. American journal of physiology Regulatory, integrative and comparative physiology. 2004 Sep;287(3):R502-16. PubMed PMID: 15308499.