Do Compression Garments Work?
Summary of evidence:
– There is moderate evidence that wearing compression garments reduces muscle soreness and accelerates recovery of strength & power within a few days of performance.
– There is limited evidence that wearing compression garments during performance improves running economy. This may be due to improved proprioception and decreased muscle oscillation.
– Recent research has found wearing compression garments during performance does not change aerobic performance.
– There is no evidence that compression garments cause any negative effects.
– Compression garments are relatively cheap, quick and easy to administer and can therefore be used as a valuable recovery tool for both athletes and recreational exercises.
In recent years wearing compression clothing has become common amongst athletes and the recreational athlete alike. Compression garments refer to any sporting garments that are tight and usually made out of elastin and nylon. A quick look at the SKINS website reveals claims that compression products both improve recovery and performance.
“When you apply compression to specific body parts in a balanced and accurate way, it accelerates blood flow. This gets more oxygen to your working muscles – and boosts your performance.”
“Plus, improved oxygenation reduces the effects of delayed onset muscle soreness and accelerates muscle repair. So engineered gradient compression and dynamic gradient compression play a big part in helping you recover from exercise too.”
How would this work?
Normally, blood is returned to the heart through the ‘muscle-pump’ function – muscles contract and put pressure on veins which helps pump blood back to the heart. It is claimed that compression garments provide an external pressure that assists with this process. And theoretically, the quicker the blood returns to the heart, the quicker it becomes oxygenated and can return to the muscles for performance.
Strenuous exercise may cause small amounts of inflammation that causes soreness after exercise (delayed onset muscle soreness). If compression garments provide external pressure they reduce the space available for swelling, thus reducing the swelling and associated pain.
What does the evidence say?
One 2013 systematic review (Hill et al. 2013) analysed compression garments and their effect on recovery within a few days of performance.
- Creatine kinase (CK) – It has been established that there is an increase in CK in the bloodstream with muscular damage following performance. However, results indicate that 66% of the population will experience reduced CK in their bloodstream after wearing compression garments. It is hypothesised that this may be due to the ‘muscle-pump’ function. If blood flow is accelerated there will be an increase in blood returning to the heart (venous return), facilitating removal of metabolites and lowering CK. (Kraemer et al. 2001)
- Delayed onset of muscle soreness (DOMS) – refers to perceived muscle soreness between 24 to 48 hours after exercise. It is estimated that 66% of the population will experience reduced DOMS. The mechanisms are unclear in the research but it is hypothesised that it is likely due to compressions garments external pressure, as discussed above.
- Strength – 69% of the population will experience accelerated recovery of strength after using a compression garment. This may be due to reduced DOMS.
- Power – 66% of the population will experience accelerated recovery of power after using a compression garment. This may be due to reduced DOMS.
- Aerobic exercise – A RCT (Bringard et al. 2006) tested VO2 max (maximumamount of oxygen the body can utilise during intense exercise) over a 15 minute period and found no difference between the group wearing compression garments and the group wearing normal sport attire.
- Running economy – Compression garments may improve running economy (the amount of oxygen required) by 9%. (Bringard et al. 2006)
- As mentioned, a decrease in DOMS has been shown to improve recovery. Therefore, this is likely to impact an athletes ability to perform maximally on the days following exercise.
Why? Whats happening in the body?
There is some evidence that compression garments improve both performance and recovery following performance. However, the mechanism or ‘why’ remains unclear. The idea that compression garments provide external pressure that accelerates the ‘muscle-pump’ mechanism and reduces inflammation are likely to be the case in terms of recovery.
However, it is less clear how compression garments effect performance. Interestingly, as compression garments have been shown to have no impact on cardiovascular response, it is hypothesised that they improve running economy by increasing proprioception (Bringard et al. 2006). Proprioception refers to the sense of position and movement of parts of the body. Two studies have found that compression bandages (but not garments) improve proprioception (Doan et al. 2003)(Perlau et al. 1995). Research has also demonstrated that compression garments reduce muscle oscillations during exercise, which is thought to reduce muscle fatigue (Doan et al. 2003).
So should I wear compression garments?
Despite the lack of consensus as to why they work, there is some evidence that compression garments positively impact both performance and recovery after performance. Additionally, there is no evidence that compression garments have any negative impacts on performance or recovery. In a practical sense, although pressure garments are not cheap, they may be a feasible and effective alternate or adjunct to other recovery interventions such as ice baths or hot and cold therapy. Additionally, putting on a compression garment is quick and therefore likely to have greater compliance in the everyday user who may be too time poor to partake in other therapies such as stretching, for the duration required for effect. Compression garments can also easily be worn while in transit or throughout everyday activities, thus increasing their effects. It is for these reasons that the Australian Government and large sporting teams in Australia encourage their use, especially for recovery.
Doan, B, Kwon Y, Newton, R, Shim, J, Popper, E, Rogers, R, Bolt, L, Robertson, M and Kraemer, W (2003). ‘Evaluation of a lower-body compression garment’, Journal of Sports Sciences, vol. 21, pp. 601-610.
Perlau, R, Frank, C & Fick, G (1995). ‘The effect of elastic bandages on human knee proprioception in the uninjured population’, Journal of Sports Medicine, Vol. 23(2) pp. 251-5.
Hill, J., Howatson, G., van Someren, K., Leeder, J., and Pedlar, C. (2013). Compression garments and recovery from exercise-induced muscle damage: a meta-analysis. British Journal of Sports Medicine, 0, pp.1-7.
Kraemer WJ, Bush JA, Wickham RB, et al. Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. J Orthop Sport Phys 2001;31:282–90.
Bringard A, Perrey S, Belluye N. Aerobic energy cost and sensation responses during submaximal running exercise positive effects of wearing compression tights. Int J Sports Med 2006; 27 (5): 373-8.
To find out more, make a booking with Courtney our Physiotherapist at our Noarlunga Centre Physio clinic.