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.

Hypertrophy-Specific Training - A quick overview

Hypertrophy training is gaining more and more followers as people not only want to look good, but increased muscle mass offers numerous benefits: increased metabolism, greater protection of injuries, greater strength etc. 

In the last decade a new trend in hypertrophy has risen. Hypertrophy-Specific Training™ (HST), created by Bryan Haycock, has gained more popularity and is practiced by many people in the gyms. The basic idea behind this training method is the fastest muscle growth possible without losing efficacy over an extended period of time, and without the use of anabolic steroids. 

A comparison of a "typical" gym routine (up) with a HST routine (down).

The principles of HST (1) are:

1) Mechanical Load

2) Acute vs. Chronic Stimuli

3) Progressive Load

4) Strategic Deconditioning

HST training relies in the gradual increase of intensity and gradual decrease of repetitions. It recommends reducing the number of repetitions every two weeks, and in every two week block, to execute the number of the repetitions with the maximum load. Many common HST programs start with a 15 repetition, 2 week block that is performed over six workouts with the sixth workout being at the exercisers maximum 15 repetition weight.

For example if a person has 60 kg as a 10 repetition maximum load in bench press, in a 3 training schedule week he should use 45, 48, 51, 54, 57, 60 kilos respectively in every of the 6 training sessions of those 2 weeks. It is generally good to increase progressively the resistance by about 5% of the maximum load of the current repetition number until it is 100% in the 6th training session of the 2 week block (2).

Another guideline by the HST training method is to generally keep the sets of the exercises in each workout session within 1 to 2 (1). The muscle will still work 6 sets per week but an individual will not excessively load the central nervous system on one workout, risking overtraining. Muscle groups should be loaded 3 times per week, following the Frequency Principle. Frequent low-volume and high-intensity stimulus is needed for the muscles to adapt.

Although HTS is not a scientifically proved method of training, it is based on physiological principles of hypertrophy first discovered in the laboratory. More and more people choose HST as their hypertrophy training method, and they indeed report fast and desired results.


References


1. http://www.hypertrophy-specific.com/hst_index.html acessed on 17/11/2012

2. http://www.ridgely.ws/publications/minor-principles.pdf acessed on 17/11/2012

The Overtraining Syndrome - How can we diagnose and prevent it early on ?

The overtraining syndrome (OTS) is a disorder that is still hard to diagnose because of the lack of a golden standard in determining it. Functional overreaching, the short term performance decline, is a basic part of every training, as it’s the natural process of the body, to have reduced incline after a training and after a short period of rest this performance is brought back to normal levels. Moreover an overall performance decrease could be a multi-factor phenomenon not just caused from overtraining. Additionally there has not been extensive research in the OTS field because of the ethical conflict of inducing overtraining in athletes.

Indicators of the Overtraining Syndrome

The physiological markers of the OTS can be summed up in 5 categories and according to my judgement placed from the most reliable to least:

1. Performance testing
Reduced performance
Reduced Maximal Heart Rate

2. Physiology
Increased Resting and Exercising Heart Rate
Heart rate variability
Fat loss

3. Biochemistry
Accumulation of Catecholamines
Reduced Lactate, Urea and Creatine Kinase
Reduced Neuroexcitability

4. Hormones
Higher Cortisol Levels
Reduced sensitivity of the Adrenal Glands in Adrenocorticotrophic Hormone

5. Immune system
Weaker Constitution
Increase in Injuries

Causes of Appearance

The overtraining syndrome is a phenomenon not only concerning high level athleticism but also recreational training. It is the final stage of overtraining and it is accompanied by certain biological symptoms. Although there is not a golden standard to identify OTS yet, the causes of OTS are clearer. The causes of OTS can be summarized into two groups: Inability to rest from the training workload, and psychosocial factors.

- Inability to Rest
This group can be in turn, parted into two subgroups: Increasing workload and decreasing resting capability

Increasing workload: A continuous increase of the training workload (intensity, duration or frequency of training) without adequate resting relating to the workload increase could induce OTS (1). 

Decreasing resting capability: Resting and replenishment of nutrients are vital factors to performance and health in general. Dietary caloric restriction (negative energy balance) and deficiency of nutrients, and in general malnutrition factors can contribute greatly into OTS (1).

Impairment of resting after exercise results in decreased performance in short-term and various biological alterations in long-term.

- Psychosocial Factors: Psychological causes are a big factor in the appearance of OTS. A poor mental state (personal and emotional problems), monotony of training, and increased stress and demands in occupation are considered as determining factors (1). Moreover, in competitive athleticism, the length of the competitive season is another contributing factor in appearance of OTS (2), as prolonged and high competitive stress is accumulating without periods of rest and relaxation and can impair the mental state of the athlete.

Prevention

In an older article it is stated that upon recognizing the first stages of OTS a reduction or an abstain from training should commence to allow adequate recovery from fatigue and ailments such as stress fractures or lingering illnesses (2). They progress to inform that psychological overtraining is more difficult to prevent and treat, although the methods for prevention are not much different; taking time off training, and rescheduling the training program. Additionally it is mentioned that observable signs of overtraining syndrome can be used as guides for a gradual return to the athlete's previous training levels, meaning that the subsidence of the initial symptoms that were diagnosed in the athlete could act as a safety measure in order to return back to training.

In a more recent study (1) is presented that the four methods, most frequently used to monitor training and prevent OT are: retrospective questionnaires, training diaries, physiological screening, and the direct observational method. Also the psychological screening of athletes and the Ratings of Perceived Exertion (RPE) have received more and more attention.

It can be concluded from the two articles that at the time period before 2000 the ways to prevent OTS were as limited as the tools to indicate it. The prevention methods were limited into resting and rescheduling of the training program. Meeusen et al. (1) suggest more methods of preventing OTS, something that reflects the broaden in the knowledge of overtraining syndrome. Questionnaires, training recording and observation and psychological screening of athletes are means of preventing OTS faster and more accurately. Evaluation of performance, training workload and the recovery time should be an established process of training, not only for prevention of OTS.

In my own opinion OTS could be prevented by better planning of training. A correct model of periodization with values of intensity, duration and frequency could be able to maximize the performance and improvement of the athlete without overtraining him/her. Proper design of resting periods is also a part of periodization.Periodization concludes also the concept of personal training. An athlete’s self-esteem is boosted when he feels unique and individual, rather than being part of a team. Having a training plan that is exclusively designed for his needs and assets will give a certain feel of importance to the athlete thus making him more focused in his goal and render the training less monotonous.

Finally, it is clear that the everyday social and psychological environment of the athlete plays an important role in his mental state and thus in the development of OTS syndrome (1). Consequently a certain level of controlling the outer environmental factors of the athlete may contribute greatly into preventing OTS. The trainer is able to give help and support both friendly and professionally to the athlete and meet with his/her relatives to discuss problems and issues is something that could refresh and boost his/her state of mind. 

References

1. Meeusen R, Duclos M, Gleeson M, Rietjens G, Steinacker J, rgen, et al. Prevention, diagnosis and treatment of the Overtraining Syndrome. European Journal of Sport Science. 2006 //;6(1):1-14.

2. Johnson MB, Thiese SM. A review of overtraining syndrome-recognizing the signs and symptoms. Journal of athletic training. 1992;27(4):352-4. PubMed PMID: 16558192. Pubmed Central PMCID: 1317287.