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02/28/2011

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BluegillLover

Really great post. Thanks for doing it. I've had so much trouble with my calves/shins for the last 10 years of running that my wife got me compression socks for Christmas as a way to maybe help. Maybe they'll have a placebo effect? Stupid science.

Djdigdoug

Thanks for the info Joe! I appreciate the aggregation of the studies and data here. I've seen individual studies cited here and there (usually to support the writer's beliefs or feelings on compression), but never such a large or objective sample. Through my own experiences and research I came to a similar conclusion as you.

Although I don't think they improve my performance, I like wearing the calf sleeves during races and long workouts (especially in the Winter here in New England) as they keep my legs feeling "comfortable." It has bee my experience that wearing the sleeves for too long post-workout does indeed force fluids down into the feet. I accidentally fell asleep with them on once and woke up with painfully swollen feet. I've invested in a couple of pair of compression stockings (one med and one high according to the study data) and have found them to be indispensable during the first 24 hours post hard workout or race.

Thanks again. This was probably the most helpful information I've found on the subject to date. I'm going to re-blog this on my own blog if that's alright.

Regards,

Doug Welch
(@reallynotarunnr)
http://reallynotarunner.blogspot.com

Collie

Just reading the results I came to a different conclusion. Taking the over all results rather than each one at a time, it appears compression clothing does assist in recovery but not in performance. However as i recently discovered compression clothing is basically what is made for geriatrics, but just sold under sports labels. I think a lot of people have been 'had'. Go to your local medical store you can get compression socks that will do the recovery job.

Joe Friel

Djdigdoug--Thanks. Feel free to repost it to your blog.

David Walker

I agree on the recovery aspect. I've been enjoying my compression socks over the last year. I wear them for recovery in the evening, and when I have to be on my feet for long periods or when driving long distances.

I also have pair of knickers and a pair of shorts. The knickers (from Zoot) are insanely tight — good on the legs, not so nice on the crotch. I've worn them for recovery and also on some winter rides. The shorts (2XU) are not very tight and actually feel almost like a regular pair of bike shorts. I wore them all last year under my bibs during races. Not sure if they helped, but I did like the feeling of the compression.

Bottom line for me is that for a relatively small price I'm getting something that makes me feel a bit fresher and more confident on the bike. The placebo effect is still an effect, right?

Chris

I tend to agree with your conclusions - benefits are marginal at best and probably not worth the cash/time for amateurs.

However I think there are also some interesting new products coming out (Adidas powerweb and Asics inner muscle) which are supposed to provide a postural benefit as well as compression, by pulling the body into a certain shape. Perhaps these provide a more compelling case?

Mark

Joe:
Thanks for a great summary of the literature, as it may dampen the hype that the sales reps make for the compression products they pitch.
In my experience, I have worn them for two reasons that you haven't mentioned, both relating to injury. First, I suffered a Jones fracture in my right foot that was casted, and eventually caused me a deep venous thrombosis. Medical compression socks were recommended to me to lesson further risk (along with 3 months of blood thinners). I continue (rightly or wrongly) to have some feeling of vulnerability in that leg, worrying that I may develop another one as a result of a hard workout, so I wear a compression stocking for a day or so after. I also wear them travelling, even though there is no proof of that value either.
Second, with the aforementioned injury, I developed a recurrent calf strain on the opposite leg, which may have been initially overcompensatory, but nonetheless troublesome, often flaring up after races and harder runs, with swelling and even bruising noted afterward. Because of the recurrent nature of it, I sometimes wear a calf sleeve during a training run on the one leg, in the blind hope that I may be providing stability to the calf, although I my theories remain unproven.
It is well known that those who have a tendency to be on their feet all day will tend to have more swollen feet by the end of the day, and many of these people get some benefit from wearing compression stockings while they are up and around, with less swelling, and less aching. It is that perception that, to me, parallels the hard workout in athletes, justifying their use for especially the post-exercise period, even if that is not readily quantifiable.

Alex

I notice a significant difference when I use compression socks during travel post-race. After a race, it is common to sit in the car, or airplane, for several hours on the way home. By wearing compression socks, my legs feel significantly better both during these long trips and the next day.

Iano

Hi Joe

Thank you for a really interesting article.

I've been wearing compression socks for the past 4 years or so and have believed that I do get some benefit. I cannot comment on performance as I haven't done any specific tests, but certainly in recovery and reduction in soreness I would say I've benefitted. I will only wear my socks on runs longer than 15 km and typically not afterwards. I have found that my calves are less sore (than if I forget to wear my socks).

Last year in training for the 89km Comrades marathon, I did a 3 day event called the Easter 100km. At the end of the event (which I wore compression socks each day) I happened to pop into my tri shop and tried on a pair of Zoot compression tights. The thing that struck me was that with the socks on, all the soreness in my legs disappeared - immediately. As soon as I took the tights off, the soreness came straight back to my glutes and quads, but my calves remained free of muscle soreness.

Yesterday, I completed a 3 day 100km trail run, wearing my socks (and funnily enough for the 1st time a pair for recovery) and today, I'm walking and feeling okay.

Thanks.
Iano

Brent

I've been wearing them for a few months, mostly for running, mtb-forgot my socks one day, and cyclocross. Here's an interesting observation: The Bontrager shoes I wear are a little tight and my wider foot feels pressure and pain at the beginning of a ride. With compression socks, no pain or pressure the day I forgot my "regular" socks. Not real scientific but my feet feel better...

Brent

Jerome Dardel

Thank you Joe for that great post.

David Elsbernd

In designing a proper double-blind medical experiment, one must be careful that the subjects do not know they are receiving special treatment, which is why they receive either the pill under test or a placebo. With compression socks it may be difficult to satisfy this requirement, so positive results may need to be taken with a degree of skepticism.

Linda

Wearing compression gear can be a concrete reminder to yourself that you are in recovery mode and should stay off your feet and take it easy. I wore compression tights last year after day 1 of a couple of multi-day cycling events. Not only did they make my legs feel good, but I was continuously aware that I needed to focus on recovery. Instead of my usual over-activity following a race, I rested and perhaps did better on day 2 (who really knows).

Paul Waite

My own subjective observations support the overall consensus which seems to be emerging that compression aids recovery but not performance.

I usually wear compression tights to recover from long hard rides over a hilly 100km or more, where the legs end up feeling sore and abused when I get off the bike. Every time I have worn the tights (I sleep in 'em as well) the legs feel mint in the morning. Every time I haven't worn them the legs have that heavy, achy tired feeling, especially when called to do something like walk up stairs. The difference is so obvious that, to me, the recovery effects are real, not minor, and definitely not a placebo.

I have used both 2XU tights and the Skins RY400 and both do the job nicely. I found them especially useful for overnight recovery when doing a 7-day tour with 100km+ stage racing each day.

greg Hinrichsen

Thanks for the great article Joe. I consult your book (Bible), articles, and blog frequently! Rest, Ice, Compression, and Elevation or RICE is a well known injury treatment formula. Is Compression (gear) possibly good for recovery for the same reasons it is good for injury treatment? I have always thought it made sense that compression was beneficial for recovery, since recovery is, in part, about healing microscopic tissue damage. I have never use compression during races. I have read accounts of pros using a compression suit which ices as well. Greg

Jerry Nairn

Concerning shin/calf compression post-workout, I would think that unless the compression garment is extremely tight, there would be only a minimal restriction of blood flow to the feet.
Besides, it's the calves that have the large running-related muscles which need to have fluids pumped out.
Sure there are muscles in the feet, but that's not where the greatest post-workout inflammation and build-up of fluid is.

Hui Koon

Great post! I have never worn my compressions for races but I use them for recovery and have found them to be effective, even if worn a few hours. Usually I wear them to sleep especially after a long run. It does appear to make me recover better and faster.

Coach Bags

Thank you for offering these a beneficial & original information. Your blogs are continually appreciated for their vivid presentation. Constantly keep us informed about the updates.

damian knightsbridge

hi joe,

I have been using compression more recently to combat DVT formation in lower limb, a genetic blood disorder makes me hyper coagulant meaning i clot very easily. Mixed with micro tearing of muscles from training loads and dehydration the potential to from clots is very great from varicose veins in lower limb. talking to my long time physio and vascular doc, they have agreed that post training compression be a good thing 1/ to shut down any micro bleeds 2/ stop blood pooling( eg sitting down and inactive) combined with icing of know areas of varicose veins. compression has helped reduce the risk level of clotting, dehydration has also been a critical aspect to all this...i have now decided to wear compression while training as there is a notable difference in how " ugly" the v veins look after training , some external vein wall support.

PS love the info you put up!

Mike Patton

Thanks for the update! This is certainly a trend that appears to have a great deal of marketing dollars behind it, but the science doesn't seem that convincing.

I am concerned with the focus on optimizing recovery because there is the muddying of the line between what is ideal for performance or racing, and what is ideal during training. While there are athletes (both age-group/amateur and pro) who struggle to recover properly before the next workout during hard training blocks, this is not necessarily a major problem for most.

I am particularly concerned that the under-recovery that some amateur athletes experience can often be due to simply not eating/hydrating properly or not going to bed early enough (e.g. recovery techniques that don't require marketing dollars), and compression garments can seem like a way to compensate for it. Also, optimizing recovery strategies without compensating by shortening recovery periods and training more often or at higher intensities could mean that the training effect of individual workouts may actually be diminished.

Obviously, the evidence you present suggests that recovery between days/bouts of COMPETITION, or at least performance, can benefit from strategies that improve blood flow to and from the extremities (e.g. compression garments, cold-water immersion, etc.). I just question the need to have every supplement and training aid at hand for every workout.

I welcome your thoughts on this!

Joe Friel

I accidentally hit 'delete' for the following comment by 'Madeleine':

I may be out on a limb here (no pun intended), but the legs go round ‘n’ round just like wheels do. Wouldn’t the rotational weight issues that influence cyclists to buy lighter wheelsets be relevant to the potential benefit of using compression stockings? Small volume edema (e.g. 200grams of edema fluid in each leg) would be impossible to detect visually or that your doctor would notice on physical exam. Since the cited studies don’t (and can’t) measure the change in weight of one leg at a time in a controlled way (i.e. before and after a race or over the course of an intense block of training, with and without the use of compression stockings), they don’t control for the variable of chronic venous insufficiency. Almost all the studies focus on young athletes, for whom the risk of chronic venous insufficiency is slight. Middle aged and age-group athletes may have acquired a mild degree CVI over the years (there is a nice general medical review of this in Bergan et al N Engl J Med 2006; 355:488-498), and have a greater succeptibility to small volume edema in the legs that their training exacerbates. If, then, an athlete has the propensity to develop small volume edema, it would have a similar effect to wearing cycling/running shoes that, instead of weighing 600gm per pair, weigh 1000gm. Over short tests lasting an hour or less, such a weight change may not have a statistically significant impact on the parameters being analyzed. But carrying around an extra 400gm below the knees for the twenty-five thousand pedal strokes of an 80 mile bike race, or for a triathlon, or in a multi-day stage race might have a measurable impact on outcome. Am I out on a limb here?

Reply: Interesting way of looking at it. So you're suggesting that the studies' work durations probably aren't long and the subjects perhaps not old enough to really measure the most likely changes in performance? Right?

Keith T

I first started wearing the gear in Trans Rockies. just seeing the expression on the face of our competition was worth it as they suspected we had an advantage they didn't.

but if the gains are between 1 and 5% would that not be a significant gain even if it doesn't sound like much?

agree on the age differentiation.
y
from a meta data point of view I didn't see any negatives from all the studies. wouldn't that suggest the answer is somewhere between positive and neutral?

Keith

Joe Friel

Keith--I've heard of bracelets that are supposed to create some sort of invisible aura around you (or some such BS) which makes you perform better. There's no known downside. It may even have a positive placebo effect. Would you therefore buy one? I suspect not. Where do we draw the line and say 'enough'? What standards do we use as athletes for all of the stuff someone is trying to sell us to perform better?

Cat

I'm new to cycling. I just completed my 3rd race ever this past weekend. I did the Boulevard race in CA first and didn't wear the compression tights for recovery and the next day or two my legs felt horrid.

The next race I did was a 3 day stage race in AZ. I wore the rights after each stage and even by the 3rd day I didn't feel nearly as sore as after Boulevard.

Last weekend I did a Vegas stage race and again my legs felt pretty darn good after all 3 stages with the use of the tights.

So, gimmick or not, in my mind they are working for me! :) I got 2nd overall in last weekends race!

Madeleine

Hi Joe,

You read me correctly. I think the studies are valid in their own right – the results support the conclusions. But the usefulness of the results to an individual reader is defined entirely by (a) the degree to which the cohort definition includes the relevant demographic; and (b) the degree to which the study endpoints approximate the individual's events. Particularly with negative results, I think it is unsafe to try to extrapolate to participants in long duration events, or to individuals who fall into a demographic other than what was studied (i.e. individuals who are actually succeptible simply by virtue of age to the condition that the compression stockings were designed to alleviate).

But about that limb I am out on. Do you think that the rotational weight of the foot and lower leg should be thought of as influencing performance in the same mechanical way as the rotational weight of wheelsets? Smaller circles, true. But why do we spend so much on lighter shoes and pedal-cleat systems? I'd have to be able to calculate how much the moment of inertia would change if there were 400 extra grams rotating around the bottom bracket axis, and I'm just not a mathematician ...

Thanks,
Madeleine

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