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02/28/2011

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Lucho

Hey Joe-
Tim Waggoner here (formerly Luchinske), not sure if you remember me? I was sponsored by Skins 2 years ago and found that for traveling long distances to/ from races the socks were solid. The full tights are supposed to increase proprioception and awareness of your leg movement and increase economy due to improved form. Also muscle stability and the prevention of muscle damage due to impact. I think there is a significant placebo effect and I would probably rather spend the money for all the compression gear instead on a good vegetable juicer. And then just elevate my legs as I drank a fresh veg juice.
Tim

Joe Friel

Madeleine--That's an interesting idea. If true it would be the same thing for runners.

kmbgolf

every time I go for a run without comp socks I get calf strains

DS

Swelling: I use calf-compression sleeves or knee-length stockings for recovery after very hard or long runs because I find they reduce soreness. Subjectively, it’s also comforting to have that squeeze. But if I leave the sleeves (not the stockings) on for more than a few hours, my ankles will swell a bit that day if I’m on my feet. More interesting, my ankles will swell again late in the afternoon the next day or two if I’ve worn either stockings or sleeves the day of the hard workout. I have no such swelling when I skip the compression altogether. I’ve looked for research on this and have found none.

To be clear, I’m not talking about swelling from injury, but from fluid pooling in the ankles and feet due to gravity – all physical indications are that this is lymphatic fluid, and not blood as another reader suggested.

Concerning performance, I don’t find any benefit from calf sleeves and stockings. However, compression shorts on my quads definitely help me to run better, in addition to minimizing soreness. My guess is that the compression keeps the thigh mass from moving around too much, making movements and muscle contractions more efficient. With calves having less mass and less jiggle than thighs, there’s less inertia to control. I suspect that compression gives more benefits for more muscular or heavier athletes than for the elite ectomorphs, and that runners would benefit more than cyclists.

Jeff

Joe and Madeleine:
I may be a perfect example of Madeleine's hypothesis since I have Chronic Venous Insufficiency (CVI) in one leg only. I'm 55, have serious CVI in right leg only (from a 1981 femur fracture while skiing that did a lot of damage to my inner veins)and absolutely none in my left leg. Been wearing a compression stocking except when sleeping (30-40mm Hg) on right leg since 1993. If I don't wear the stocking, after about 4-6 hours my lower leg has noticable swelling, and over a few days a lot of swelling. I've never tried to measure bicycling performance after not wearing the stocking, but I can tell you that running performance deteriorates (mainly an increase in RPE, not otherwise measured). I can also say that the left leg never experiences any observable increase in fluid buildup, even after a long biking or running session (that is, if you have CVI you can detect swelling due to "pocking" or indentations that stay on the skin surface after you push in with your finger - but on the good let there is never even a hint of "pocking"). (Also, I generally wear a compression stocking on my left leg, just because, but I can observe absolutely no difference in RPE whether I wear a stocking on that leg or not). So, with my N=1 test individual, I think one must have CVI to some degree to benefit from a compression stocking while exercising. Additionally, I just can't imagine the low compression stockings cited in the studies helping anyway, even for someone with CVI.
Thanks,
Jeff

Cindy

I wear compression socks after long runs to aid in recovery. I broke my ankle ( fibula and talar dome) last spring.) To prevent swelling while in the air cast I wore a compression sock instead of a regular sock, since they are similar to the socks given to patients before surgery my orthopedic surgeon approved of the idea.
For my last two half marathon's I wore the socks after to aid in recovery and had no stiffness even while sitting in the car for 4 hours.
I live in Maine so I wear compression tights as a first layer to run outside in the winter, they are warmer probably because they don't let the frigid wind get under them like traditional tights do.

Phil

Hi Joe

Excellent summary. I was going to do something similar so I was wondering what search terms you used on PubMed?

On a note of sports specificity, this paper http://www.ncbi.nlm.nih.gov/pubmed/16505085 looked at recovery in Rugby players and their Creatine Kinase (CK) clearance rates using compression, water contrast therapy, low intensity exercise and passive recovery and concludes that anything is better than doing nothing recovery wise. Here CK is an indicator of muscle damage and rugby players suffer a high level of damage due to the contact nature of the sport.

Perhaps the difference compression gear makes on muscular recovery is intimately linked to the level of muscle damage and the bodies inherent ability to recover. Thus they would be of most use to those who suffer most damage during exercise - either those exercising at high intensities, playing contact sports, or those with underlying comorbidities/poor technique/existing injury.

In relation to venous problems (as opposed to muscular, although they are obviously linked), for elderly people suffering from venous insufficiency leading to lower limb oedema the standard management is to use graduated compression stockings, elevate the lower limbs and increase mobility. These are all things that will work in a healthy adult too, but the difference is obviously that the healthy adult can compensate physiologically (which is why venous stasis and leg ulcers are more prevalent in the elderly). This may be why there are such small benefits noted in studies on compression garments, and why perhaps as noted previously just sitting with your legs elevated is the cheapest option.

Joe Friel

Phil--Thanks for your input. Good comments. It's been a while since I did that search on PubMed but I believe the terms were 'compression exercise.'

Jeff Martinez

Great Review. I am a vascular surgeon who has dealt with compression stockings for venous disease for many years. One concern I have is that not all compression garments are truly graduated in nature. If you have a constant pressure on your legs then you may get more of a tourniquet effect. I would recommend making sure that stockings have graduated compression. My second concern is that our bodies cool by perspiration. Blood is shunted to the skin surface to be cooled. If compression prevents these small vessels to fill, is there some risk for overheating faster? All this being said, I wear the stockings for events and I feel that may calf muscles are less fatigued during long events such as a half ironman.

Kristina

My personal theory is that your body responds to hard exercise that causes muscle injury with swelling - the same way it responds to most injuries. Most of the damage from an ankle sprain or such is caused by excessive swelling, avoid the swelling and you avoid alot of the long term effects of the injury. If would follow that if you treat your muscles with RICE post-exertion, they wouldn't swell as much, and you wouldn't get DOMS... I've used ice baths ever since my first half marathon ended next to a glacial fed lake - I went up to my shorts, but refused to get them wet and my TFLs & Glutes sure paid the price!

ralph e. schmook

I'm a masters cyclist (60+) with a history of lower leg circulation issues evidenced by sometimes painful vericose vains. The relief afforded by compressions socks simply cannot be ignored. All the vascular websites support the use of compression hosiery for pain management. As a long time user, 30+ years, I have learned to stay with what works and reject what doesn't. Regardless of what is marketed, listen to what your body is telling you and make an informed decision.

Mike Fronsoe

Joe, Thanks for the update. Although, personal preference matter when we train or race (quirky beasts that we are), I like the fact that there is some science. I have had repeated calf strains in the past. I've been fortunate to work through them over the past three months with strength training, massage and cross training. However, I'm doing a road relay in which I'l be running six segments of 5-6 miles through the Blue Ridge Mountains. I am scared to death that my calves won't hold up. So, I invested in some calf sleeves. In your opinion, based on this literature. Would you not wear them during the run segments and slip them on between, or wear them continuously during the 30 hour event?

Thanks,

Mike Fronsoe

Joe Friel

Mike Fronsoe - The literature is not conclusive on dealing with what you are describing. But I doubt if there is any downside either to wearing them while running. Good luck!

Kelvin

Nice Article. Well me personally,I have been wearing compression gear for quite some time and it helps to some extent.During my plyometric workouts it stabilizes my muscles to support against any micro tears caused by the impact.I found out also when wearing it I can perform at longer intervals during my training.As a professional powerlifter
it gives better support to hold the weight because it compresses much better for better lifts for me.So yeah its not going to give you super results but it will give you a helping hand.The only compression suit out now that will increase performance I think is the Generator.We use it in the Marine Corps for our PT and it does give resistance plus compression.

the5krunner

From personal experience I would say your summary is fair.

One additional point is that, for me, there MAY be a slight improvement of the incidence of EAMC on the upper legs with full-length compression gear.

Or there might not of course be an improvement because of the compression gear as I now stretch and brick train more...

However if you are prone to EAMC then a $50 pair of stockings might mean lower the risk of you having to stop (or worse) in a race because of EAMC/cramp. So, not a bad insurance policy.

climbergirl

Thanks for all the information! I love to ride and do triathlons... I just had surgery for breast cancer and the issue of lymphedema is now a major one for me, how to get back to sports and avoid it. So, while there might be debate about how these compression garments affect performance, there is no debate about how they help with avoiding lymphedema, and as mentioned by others, varicose veins etc... So, I am psyched that I can buy compression garments that don't look icky and medical-like - have you seen the medical grade compression stuff? :( not pretty!!) and not cheap!! I was just at a lymphedema workshop and there was an ugly "sleeve" that costs about $150 bucks billed to insurance. I am very happy that there are these more attractive options and I won't feel like I stick out like a sore thumb... so, for an athlete like me, I will gladly shell out money for these compression garments.

Gayle

We are manufacturing a leg sleeve. do you know if there are requirements for calling a sleeve "compression"?

Joe Friel

Gayle--I have never seen anything on this but I expect there is a minimum for mm of Hg in order to qualify, at least in medical circles, as a "compression" garment. This undoubtedly varies with the type of product.

J R

Have there been any updates regarding the literature on compression sleeves or socks? I'm seeing more and more of these being worn during and after events. I think the best test will be just to try them out for myself but I'd like to take a more scientific approach.

Joe Friel

JR--I've not seen any but haven't checked for a few months either. If you run across something please send it my way. Thanks.

Bikehound

I've been wondering if they really work. I just put on my winter cycling tights the night after a hard training session. I feel as though they work, but it could always be a placebo effect!!

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