Compression garments: Do they influence athletic performance and recovery?
Issue: Volume 28 Number 4
As coaches we are continually searching for training aids that can accelerate recovery from training and competition. One training aid that has recently been adopted by a variety of athletes is the compression garment. Manufacturers of these garments have reported that compression garments improve recovery, increase power and enhance athletic performance in a variety of sports. Unfortunately, however, there have been relatively few research studies that have examined the efficacy of these garments as tools for improving athletic performance. This article focuses on the research that has described the development of compression garments and their influence on athletes during exercise and recovery.
Medical compression stockings have been used in the treatment of poor venous blood flow for more than 50 years. These medical compression stockings are usually worn over the leg and foot and are adapted to create a controlled, gradient compressive force on the leg. Typically, the compressive force is greatest at the ankle and diminishes over the length of the stocking to a minimum at the top. Medical applications are practitioner-recommended and usually start with compression ranges from 20 mm Hg to 40 mm Hg. The compressive effects of these garments are used to improve recovery in hospitals by promoting venous blood flow, decreasing venous stasis and preventing thrombosis in post-operative patients (O’Donnell, Rosenthal et al. 1979; Lawrence and Kakkar 1980; Gandhi, Palmar et al. 1984) . In recent years, compression garments have become increasingly popular amongst athletes with suggested benefits including improvements in muscular power, strength, endurance, proprioception and injury management.
Recent research with athletes has shown that compression garments may provide ergogenic benefits for athletes during exercise by enhancing lactate removal, reducing muscle oscillation and positively influencing psychological factors. The early research on compression garments demonstrated a reduction in blood lactate concentration during maximal exercise on a bicycle ergometer (Berry and McMurray 1987) . Later investigations have shown improved repeated jump power (Kraemer, Bush et al. 1996; Kraemer, Newton et al. 1997; Kraemer, Bush et al. 1998) and increased vertical jump height (Doan, Kwon et al. 2003) . The suggested reasons for the improved jumping ability with compression garments include an improved warm-up via increased skin temperature, reduced muscle oscillation upon ground contact and increased torque generated about the hip joint (Doan, Kwon et al. 2003) . Combined, these results show that compression garments may provide both a performance enhancement and an injury reduction role during exercises provoking high blood lactate concentrations or explosive-based movements.
Research has also shown that compression garments may promote blood lactate removal and therefore enhance recovery during periods following strenuous exercise (Berry and McMurray 1987; Chatard, Atlaoui et al. 2004) . For example, Berry and McMurray (1987) observed a significant reduction in blood lactate levels in highly fit males wearing compression stockings following a bicycle ergometer test at 110 per cent VO 2max. These results were recently confirmed by Chatard et al. (2004) who reported a significant reduction in blood lactate concentration and an increased plasma volume in 12 elderly trained cyclists wearing compression garments following five minutes of maximal cycling. Furthermore, wearing compression garments during an 80-minute rest period following the five minutes of maximal cycling, significantly increased (2.1 per cent) performance during a subsequent maximal cycling test. It was suggested that increased removal of the metabolic by-products during intense exercise when wearing compression garments may help improve performance (Chatard, Atlaoui et al. 2004) . These results suggest that wearing compression garments during recovery periods following high intensity exercise may enhance the recovery process both during and following intense exercise and therefore improve exercise performance.
Other investigations have suggested that the use of compression garments during recovery periods may reduce the symptoms associated with delayed onset muscle soreness (Kraemer, Bush et al. 2001; Chatard, Atlaoui et al. 2004) . For example, Kraemer et al. (2001) reported that subjects wearing compression garments for three days following severe eccentric exercise showed a decrease in perception of soreness, reduction in swelling and an improved recovery of force production. Similarly, Chatard et al. (2004) , measured a reduction in perceptions of leg pain in subjects wearing compressive elastic stockings during recovery periods following exhaustive exercise. Furthermore, 10 of the 12 subjects in this study reported that they thought the compressive stockings had positive effects on performance during subsequent exercise. Based on the previous research, it appears compression garments may reduce perceptions of muscle soreness during recovery periods following strenuous exercise.
Although some studies have shown compression garments to provide ergogenic benefits for athletes during recovery, others have been unable to support these findings. For example, Berry et al. (1990) examined the effects of elastic compressive tights on eight healthy males following high-intensity exercise (110 per cent VO 2max) for up to three minutes on a treadmill. Results from this study showed that there were no significant differences in energy expenditure, heart rate and blood lactate concentration between athletes wearing elastic tights and a control group at rest and at five, 15 and 30 minutes post-exercise. However, since it has been shown that compression garments require a minimum pressure of 18 mm Hg at the ankle and 8 mm Hg at the mid thigh to mimic the hemodynamic effect of exercise and to increase venous return (Lawrence and Kakkar 1980) , it is possible that the pressure of the elastic tights used in this study may not have been sufficient.
Although there has been limited investigations linking the influence of compression garments on athletic performance, it appears the use of compression garments may have a positive effect on athletes during exercise and during recovery periods following exercise. As no studies have reported negative effects on exercise performance or perceptions of pain, the use of compression garments may provide a useful training tool for athletes across a wide variety of sports.
Suggested benefits of compression garments
Based on current research findings, listed below are potential areas where a competitive advantage may be gained through the use of compression garments:
- enhancing blood circulation to peripheral limbs
- reducing blood lactate concentration during maximal exercise bouts
- enhancing warm-up via increases in skin temperature
- increasing vertical jump height
- improving repetitive jump power
- reducing muscle oscillation upon ground contact
- increasing torque generated about joints, improving performance and reducing the risk of injury, for example, assisting the eccentric action of the hamstring at the end of the swing phase in running
- enhancing recovery following strenuous exercise by aiding in the removal of blood lactate and improving subsequent exercise performance
- reducing the effects of delayed onset muscle soreness in the days following strenuous exercise
- increasing feelings of positive leg sensations both during and following strenuous exercise.
In conclusion, according to the literature, compression garments may offer several ergogenic benefits for athletes across a multitude of sporting backgrounds. In particular, some studies have reported that compression garments can improve muscular power, strength, enhance recovery following intense exercise and improve proprioception. However, caution should be taken when choosing the correct compression garment for your sport and ensuring the garment provides enough pressure to promote venous return.
Berry, MJ, Bailey, SP et al. 1990, ‘The effects of elastic tights on the post-exercise response’, Canadian Journal of Sports Science, 15, pp. 244–8.
Berry, MJ and McMurray, RG 1987, ‘Effects of graduated compression stockings on blood lactate following an exhaustive bout of exercise’, American Journal of Physical Medicine, 66(3), pp. 121–32.
Chatard, JC, Atlaoui, D. et al. 2004, ‘Elastic stockings, performance and leg pain recovery in 63-year-old sportsmen’, European Journal of Applied Physiology, 93(3), pp. 347–52.
Doan, BK, Kwon, YH et al. 2003, ‘Evaluation of a lower-body compression garment’, Journal of Sports Science, 21(8), pp. 601–10.
Gandhi, DB, Palmar, JR et al. 1984, ‘Clinical comparison of elastic supports for venous diseases of the lower limb’, Postgraduate Medical Journal, 60(703), pp. 349–52.
Kraemer, WJ, Bush, JA et al. 1996, ‘Influence of compression garments on vertical jump performance in NCAA division 1 volleyball players’, Journal of Strength and Conditioning Research, 10(3), pp. 108–83.
Kraemer, WJ, Bush, JA et al. 1998, ‘Influence of compression garment on repetitive power output production before and after different types of muscle fatigue’, Sports Medicine, Training and Rehabilitation, 8, pp. 163–84.
Kraemer, WJ, Bush, JA et al. 2001, ‘Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise’, The Journal of Orthopaedic and Sports Physical Therapy, 31(6), pp. 282–90.
Kraemer, WJ, Newton, RU et al. 1997, ‘Influence of a compressive on muscle function and soreness after maximal eccentric exercise’, abstract, 1997 NSCA Conference.
Lawrence, D and Kakkar, VV 1980, ‘Graduated, static, external compression of the lower limb: a physiological assessment’, The British Journal of Surgery, 67(2), pp. 119–21.
O’Donnell Jr, TF, Rosenthal, DA et al. 1979, ‘Effect of elastic compression on venous hemodynamics in postphlebitic limbs’, The Journal of the American Medical Association, 242(25), pp. 2766–8.