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Graduated Compression Stockings and Delayed Onset Muscle Soreness (P105)

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  • CREPS Montpellier - Font Romeu

Abstract and Figures

Delayed onset muscle soreness (DOMS) is a common experience following unaccustomed eccentric exercise. DOMS and associated force deficits may limit optimal performance in subsequent days. The cause of DOMS remains poorly understood, thus there is no effective treatment. Graduated compression stockings (GCS) are a commonly used intervention believed to diminish DOMS. The purpose of this study was to determine if GCS after eccentric walking exercise minimizes DOMS and associated deficits (e.g. muscle force capacity). Eight healthy subjects (age 26±4 yrs, height 175±8 cm, weight 70±5 kg) volunteered to perform a single bout of backward downhill walking exercise (duration 30 min, velocity 1 m.s−1, negative grade −25%, load 12% of body weight). Following walking exercise, subjects were required to wear 5 hours per day for 3 consecutive days GSC (SupportivTM) on one leg while the second was used as control. Muscle soreness and neuromuscular measures (M-wave, peak twitch, maximal voluntary torque or MVT) were taken pre and postwalk, then 2, 24, 48 and 72 hours post-walking exercise for the two legs. There was a 28% reduction in DOMS 72 h after exercise when wearing GCS (P<0.05) than in the control leg. Immediately after exercise there was a 15% decrease in MVT of the plantar flexors in both legs partly attributable to an alteration in contractile properties (−22% in electrically evoked mechanical twitch). In leg wearing GCS, MVT starts to recover while the contractile properties had significantly recovered within 24 h but not in the control leg. In the current study, GCS might have had the effect of compressing the muscle tissue to such an extent that less structural damage occurred relative to a control condition. GCS accelerated the recovery of the muscle force capacity at 24 hours beyond that achieved by the control condition.
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Topics: Exercise physiology, muscular function, stockings, engineering processes.
Abstract: Delayed onset muscle soreness (DOMS) is a common experience following unac-
customed eccentric exercise. DOMS and associated force deficits may limit optimal perfor-
mance in subsequent days. The cause of DOMS remains poorly understood, thus there is no
effective treatment. Graduated compression stockings (GCS) are a commonly used interven-
tion believed to diminish DOMS. The purpose of this study was to determine if GCS after
eccentric walking exercise minimizes DOMS and associated deficits (e.g. muscle force capa-
city). Eight healthy subjects (age 26±4 yrs, height 175±8 cm, weight 70±5 kg) volunteered to
perform a single bout of backward downhill walking exercise (duration 30 min, velocity
1 m.s-1, negative grade -25%, load 12% of body weight). Following walking exercise, subjects
were required to wear 5 hours per day for 3 consecutive days GSC (SupportivTM) on one
leg while the second was used as control. Muscle soreness and neuromuscular measures (M-
wave, peak twitch, maximal voluntary torque or MVT) were taken pre and postwalk, then 2,
24, 48 and 72 hours post-walking exercise for the two legs. There was a 28% reduction in
DOMS 72 h after exercise when wearing GCS (P<0.05) than in the control leg. Immediately
after exercise there was a 15% decrease in MVT of the plantar flexors in both legs partly attri-
butable to an alteration in contractile properties (-22% in electrically evoked mechanical
twitch).In leg wearing GCS, MVT starts to recover while the contractile properties had signi-
ficantly recovered within 24 h but not in the control leg. In the current study, GCS might
have had the effect of compressing the muscle tissue to such an extent that less structural
damage occurred relative to a control condition. GCS accelerated the recovery of the muscle
force capacity at 24 hours beyond that achieved by the control condition.
Keywords: stockings, tissue management, muscle damage, soreness, textile.
Graduated Compression Stockings and
Delayed Onset Muscle Soreness (P105)
Stéphane Perrey1, Aurélien Bringard1, Sébastien Racinais1, Kostia
Puchaux2, Nicolas Belluye2
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1- Introduction
Both recreational and serious athletes have experienced delayed onset muscle soreness
(DOMS), pain, and stiffness following unaccustomed exercise or increased training
workload. Although research on exerciseinduced muscle soreness dates back to 1902
(Hough), the exact mechanisms of soreness and pain, as well as the accompanying
responses remain unclear. These responses include a prolonged loss in range of motion
and strength, increases in muscle enzymes in the blood, swelling and structural damage.
Several studies have shown that eccentric muscle actions result in greater soreness,
fatigue and damage than isometric or concentric contractions. This explains why some
activities such as hiking that incorporates a large degree of eccentric contractions result
in considerable soreness while others, like cycling, that are not biased towards eccentric
contractions produce little soreness. Exercise models developed to study muscle damage
and soreness are those where eccentric contractions predominate such as downhill
running and backward downhill walking (Nottle and Nosaka 2005). The latter allows the
study of the effects of DOMS on alteration of muscle function of the triceps surae
region.
Compression stockings and tights are considered by many athletes to be beneficial
for recovery treatment and related exercise symptom relief and are now very popular.
One of the most recognized actions of compression tights during recovery relates to
DOMS prevention. The increased microcirculation provided by compressive garments
may prevent post-exercise damage and pain by reducing oedema and helping compen-
sate for impaired venous return (Jonker
e
t
a
l
.
2001). Two studies have shown that
compression garments maintained muscle function and reduced perceived muscle sore-
ness following eccentric exercise (Kraemer
e
t
a
l
.
2001a, Kraemer
e
t
a
l
.
2001b). These
studies also showed that compression garments attenuate CK release from skeletal
muscle into the circulation following eccentric exercise. Although compression is advo-
cated in the recovery from exercise induced muscle damage (Noonan and Garrett 1999),
there is little information on the effect of compression on intracellular metabolic func-
tion. The most convincing evidence comes from magnetic resonance spectroscopy that
showed elevated skeletal muscle metabolites phosphodiester in the thigh 1-h following
eccentric injury caused by 30 minutes of downhill walking compared to the control
thigh (Trenell
e
t
a
l
.
2006) but without changing perceived muscle soreness. Overall,these
data suggest that wearing compression garments in the recovery from eccentric exercise
may alter the inflammatory response to damage and accelerate muscle repair processes.
Bringard
e
t
a
l
.
(2006) recently showed in sportsmen a significantly lower venous pooling
(smaller blood volume changes measured with near infrared spectroscopy) and a higher
calf oxygen saturation level with compression tight in comparison to elastic tight and
shorts when subjects were lying supine and during upright standing. It appears that in
comparison to elastic tights, compression tights have positive effects on muscle oxyge-
nation and venous function at rest, and could be useful to oxygenate damaged muscles
after exercise. In this context, wearing elastic compression stockings in 63-year-old
sportspeople during an 80 min recovery period between two maximal 5 min exercises
led to reduction in hematocrit and lactate concentrations. In this study, a 2.1% perfor-
mance enhancement was found during the second bout of exercise (Chatard
e
t
a
l
.
2004).
548 The Engineering of Sport 7 - Vol. 1
Therefore, the goal of this study was to determine whether the impaired muscle func-
tion and DOMS following a single 30-min bout of backward downhill walking exercise
is attenuated by wearing compression stockings 24 h, 48h and 72h after.
2- Materials and methods
2.1 Subjects
Eight healthy young men participated in this study. Their average age, height, and weight
(means ± SD) were 26 ± 4 years, 175 ± 8 cm, and 70 ± 5 kg, respectively. All subjects
were physically active and exercised 1 – 2 times a week, but they had not used an intense
workload for their own resistance-type exercise for the last 3 years. Subjects were not
allowed all forms of exercise throughout the period of the experiment. There is a well-
known repeated bout effect that performance of first bout of eccentric exercise will cause
an adaptation such that there is less damage in the second bout (for a review, see
McHugh 2003). Subjects gave informed, written consent to participate in this study. The
procedures complied with the Helsinki declaration for human experimentation and
were approved by the local Ethics Committee. None of the subjects suffered from muscle
soreness or ankle injuries. Subjects were asked to avoid caffeine intake within the 8-h
preceding the test and to avoid all vigorous activity during the 24-h preceding the test.
Subjects were also asked to refrain from analgesic intake all along the protocol, which
could have disturbed DOMS perception.
2.2 Experimental procedures
Subjects visited our laboratory on four consecutive days. The first day consisted of a
neuromuscular test session (described subsequently) on both legs followed by a back-
ward walking exercise (description below) followed by further neuromuscular testing.
On the second, third and fourth days, subjects returned to the laboratory at the same
hour of day that they had finished the walking exercise and performed the neuromus-
cular testing for both legs. Immediately following exercise and until the end of the expe-
riment, graduated compression stockings were worn 5 hours per day at 2 h, 24 h, 48h
and 72 h following backward walking exercise. Graduated compression stockings (GCS)
covered the calf on one leg (SupportivTM, France). The leg wearing GCS was randomly
assigned (dominant versus non-dominant as determined by the non-preferred leg to
kick a ball). Subjects exercised by walking on a motorized treadmill (S2500, HEF
Techmachine, France) for 30-min at a constant velocity of 1 m.s-1 with a negative grade
of -25%. To increase the eccentric loading on the plantar flexor muscles, the walk was
performed backwards (Nottle and Nosaka 2005) whilst wearing a vest loaded with an
additional weight equivalent to 12% of body weight.
All the neuromuscular tests began with the determination of the stimulation inten-
sity required to elicit a maximal M-wave amplitude (Mmax). Afterwards, three Mmax
interspaced by 8 s were elicited from the relaxed muscle.
The amplitude of the three twitches evoked at Mmax intensities were averaged for
subsequent analysis.
The Engineering of Sport 7 - Vol. 1 549
Thereafter, subjects were instructed to perform three maximal voluntary torque
(MVT) contractions of the plantar flexor muscles, each for 5-s. Subjects were verbally
encouraged to perform maximally. Finally, a doublet (two electrically evoked twitches,
10 ms apart, Mmax intensity) was evoked during each plateau (superimposed twitch)
and another doublet was evoked 4-s after each MVT (potentiated twitch). The ratio of
the amplitude of the superimposed twitch torque over the amplitude of a twitch evoked
at rest 4 s after the MVT was used to assess the level of voluntary activation (VA) where
VA (%) = (1- Superimposed Twitch/Potentiated Twitch) x 100.
A subjective evaluation of the extent of DOMS in the plantar flexor muscles was
performed before each neuromuscular test by completing two subjective scales for
evaluation of DOMS. The first was a visual scale of 9 cm without any graduation (hori-
zontal line ranging from no pain at the left to extreme pain at the right).
2.3 Measurement and calculations
The MVT of the plantar flexor muscles was recorded by a dynamometric pedal (Captels,
St Mathieu de Treviers, France). Subject position was standardized with hip, knee and
ankle angulations of 90°, and foot securely strapped on the pedal. The tibial nerve was
stimulated with a cathode electrode with a diameter of 9 mm placed in the popliteal
cavity (Contrôle Graphique Medical, Brie-Comte-Robert, France). Subjects were in a
standardized position with motionless head and a standardized environment (i.e., same
time-of-day, silent room, constant lighting). Furthermore, a constant pressure was
applied to the electrode with the use of a strap. This was controlled by an air pressure-
recorder (Kikuhime, TT MediTrade, Soro, Denmark). The anode (10 x 5 cm,
Medicompex, Ecublens, Switzerland) was positioned distal to the patella. Electrical
stimulations (400V, rectangular pulse of 0.2 ms) were delivered by a high-voltage stimu-
lator (Digitimer DS7AH, Digitimer, Hertfordshire, England). The amperage was
adjusted for each subject during the familiarization session. During this first session, the
amperage was increased progressively (10 mA increment) until a plateau in twitch
mechanical response (peak twitch, Pt) and Mmax were observed. Electrophysiological
responses to the evoked action potentials were recorded on the soleus and gastrocnemius
medialis muscles with bipolar Ag/AgCl electrodes (Contrôle Graphique Medical, Brie-
Comte-Robert, France) with a diameter of 9 mm and an interelectrode distance of 25
mm. The reference electrode was placed on the wrist. Low impedance between the two
electrodes (< 5 k!) was obtained by abrading and washing the skin with emery paper
and cleaning with alcohol.
Signals were amplified and filtered (band pass 30 Hz 500 Hz, gain = 1000), and
recorded at high frequency (2000 Hz). The action potentials were recorded using MP30
hardware (Biopac Systems Inc., Santa Barbara, California, USA) and dedicated software
(BSL Pro Version 3.6.7, Biopac Systems Inc., Santa Barbara, California, USA). The same
equipment was also used to drive the stimulator. From the mechanical response
obtained, we calculated Pt considered as an index of the contractile properties while
Mmax amplitude represents an index of sarcolemmal excitability. Statistical analyses
were performed with Systat software (Systat, Evanston, IL, USA). Data are reported as
mean ± SEM and the level of statistical significance was set at P < 0.05.
550 The Engineering of Sport 7 - Vol. 1
3- Results
The MVT significantly changed across the 3 days following the walking test in both legs
(P < 0.02). Post hoc analysis showed a significant decrease in MVT after the walking
exercise and which persisted during the next two days (P < 0.01). A significant recovery
in MVT was observed on the third day (48-h versus 72-h after, P < 0.02). An enhanced
recovery of 6 % in MVT for the leg with GCS was observed early during the recovery
but failed to achieve statistical significance. In line with the evolution observed in MVT,
post hoc analysis showed a significant decrease in VA level after the walking exercise (pre
versus post-exercise: P < 0.02), which failed to recover by 48-h (post-exercise versus 24-
h and 48-h after exercise, NS). However there was a significant recovery by 72-h (post-
exercise versus after 72-h, P < 0.005). There was no difference between the two legs for
the VA level. The electrically evoked Pt also displayed a significant variation following
walking exercise (P < 0.001) and legs. Post hoc analysis revealed a significant decrease in
Pt after the exercise (P < 0.001) followed by a significant recovery thereafter (P < 0.001).
The recovery was better at 24 h for the leg wearing GCS. The walking exercise failed to
induce significant changes in the evoked potentials at rest (Mmax) for any experimental
conditions.
The subjects feeling of DOMS increased significantly in the days following the
walking exercise (P < 0.001). Post hoc analysis displayed significantly higher subjective
DOMS for the three days following exercise compared to the termination of exercise (P
< 0.001). Muscle soreness reached a maximum 48-h after exercise and began to recover
by 72-h (48-h versus 72-h after exercise, P < 0.01). At 72 h, DOMS were significantly
lower with the leg wearing GCS (P < 0.05, Figure 1).
Figure 1 - Mean ± SEM rating of perceived delayed onset muscle soreness following the exerci-
se protocol for graduated compression stockings (GCS) and control conditions. * P < 0.05
significantly different from control.
The Engineering of Sport 7 - Vol. 1 551
4- Discussion
The present experiment was designed to test the hypothesis that the triceps surae, which
acts both concentrically and eccentrically during everyday activities, can become
damaged after an eccentric exercise and that subsequently the muscle is able to show an
adaptation response differently while wearing GCS. Muscles exert an eccentric action
when they are lengthened while generating active tension. This occurred in our experi-
mental setup when plantar flexor muscles acted as brakes to slow the motion of the body
during backward walking (Nottle and Nosaka 2005). As expected the downhill walking
exercise induced a significant decrease in the maximal voluntary torque of the plantar
flexor muscles and of similar magnitude for both legs. Immediately after the walking
exercise, the torque decrement of -15% appeared to be caused partly by an alteration in
muscle contractile properties (i.e., -22% for Pt). Furthermore, this alteration was also
associated to a decrease in voluntary activation (i.e., -5% for both legs) suggesting the
concomitant existence of a “central modulation (for a review, see Gandevia 2001). Drop
in torque due to damage to muscle fibres may be confounded by the effects of fatigue.
In the present study, muscle damage was produced by what subjects considered to be
low-intensity exercise. Subjects did not tire during the exercise and by implication
fatigue remained at very low levels.
Therefore, the post-eccentric changes could not simply be assigned to the effects of
fatigue.
The first relevant finding of this study is that the MVT failed to recover before the
third day, whereas the measure of the (peripheral) contractile properties had recovered
significantly within the first 24 hours after exercise (P < 0.01). This delayed recovery in
maximal voluntary torque appeared to be mainly associated to a decrease in VA. The
time course of change in VA presents similarities with the time course of torque changes.
Second, the previous findings on recovery patterns for MVT and Pt amplitudes were
“speeded-up” while wearing GCS. Although not significant, it is worthy to note that Pt
recovered fully with GCS while a 12% decline in Pt was still observed for the control leg
at 24 h. Meanwhile, MVT tended to be higher (+ 6%) for the leg wearing GCS. As in the
present study, several studies have reported a prolonged loss in the ability of eccentri-
cally exercised muscle to generate force (Nottle and Nosaka, 2005, Newham
e
t
a
l
.
1983).
This change may be due in part to alterations in excitation-contraction coupling and
crossbridge formation/function. In the present study, the contractile properties had
significantly recovered during the first day but not MVT (within the third day). Further,
ultrastructural damage worsens in the 2 to 3 days post-exercise as MVT is being restored,
thus ultrastructural damage is not the only factor explaining force loss. Thus, the delayed
recovery in MVT appeared to be mainly associated with a decrease in voluntary muscle
activation. The latter is presented in the literature as a central protection of the muscle
from further peripheral fatigue and damage (Gandevia 2001).
Overall, these results suggest that contractile properties recovered early during the
recovery but with temporal dissociation in the ability to generate force, and that GCS
was able to modulate positively contractile properties within 24 h.
Post-exercise muscle soreness is usually said to follow an inverted U-shaped curve
over time with soreness low immediately following exercise, highest at 24 and 48 h and
552 The Engineering of Sport 7 - Vol. 1
falling at 72 h (see Figure 1). Subjective reports of muscle soreness showed an increase
from baseline 2-h, 24-h and 48-h following eccentric exercise in both leg conditions (i.e.,
with and without GCS). Interestingly, there was a significant difference between both
legs at 72 h (Figure 1). It should be noted that the perceived muscle soreness was signi-
ficantly lower while wearing GCS, which is in line to previous observations (Kraemer
e
t
a
l
.
2001a, 2001b). Soreness itself is unlikely result in a reduced ability to generate force,
since MVT is already markedly reduced immediately following eccentric exercise before
DOMS is perceived. Bringard
e
t
a
l
.
(2006) demonstrated that compression tights were
effective in mediating a reduction in the amount of venous pooling and an increase in
muscle oxygenation in the lower body. Different constructions of garments may mediate
these overall effects via different physiological mechanisms related to fluid shifts and
muscle tissue damage (Jonker
e
t
a
l
.
2001). In the present study wearing GCS during 5 h
per day may minimize oedema and muscle tissue disruption, thereby increasing comfort
in the leg. Use of lightweight (low compression) gradient compression stockings is very
effective in improving symptoms of discomfort, swelling, aching, as well as leg tightness
when worn regularly (Weiss and Dufy 1999).
Wearing graduated compression stockings after eccentric exercise appears to reduce
delayed-onset muscle soreness but considerably later after exercise. This could have
important implications not only for cross-country runners and trailers, but also for indi-
viduals who wish to embark on exercise regimes with associated pain following exercise.
The ease of use, length of time and perceptual benefits of such a recovery aid may in
itself be of assistance to athletes; however, given minimal differences in neurophysiolo-
gical data, the likelihood of a placebo effect may be apparent. Whatever the explanation
for the significant effect reported here for DOMS with GCS 72 h post-exercise, the
current study has provided a small benefit for GCS in the management of the muscle
function impairment associated with DOMS.
5- Conclusion
In conclusion, GCS did affect differently some temporal measures of muscle function
and perceived muscle soreness during 3-days of passive recovery after an exercise-
induced muscle fatigue on calf. These results suggest that GCS may attenuate soreness
associated with delayed onset muscle soreness. However it may not be beneficial in the
treatment of strength and functional declines. Therefore, as significant benefits were
found when subjects wore GCS, it is recommended that active subjects use this addi-
tional recovery tool provided by a correctly fitted GCS after physical activity integrating
severe muscle damage. However, further research is recommended to investigate the
effects of GCS on other measures of muscle function, such as motor performance during
dynamic exercise, and to know the necessary application time of GCS after some specific
exercise. Such research is warranted to ensure that GCS provide an ergogenic aid so that
subjects can exercise more often and with less pain, without impeding performance
during successive training bouts.
The Engineering of Sport 7 - Vol. 1 553
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554 The Engineering of Sport 7 - Vol. 1
... Compression socks have been reported to provide relief from exercise-induced muscle damage and to promote a faster recovery, 9,10 particularly when the sock is worn during the recovery phase. 30 In addition, several studies 14,17,31,32 have shown the potential for compression garments to either reduce perceived pain or facilitate recovery. The results of the Hike Trial support these findings, namely, that participants wearing compression socks reported significantly lower scores for DOMS compared to participants wearing socks offering no compression (NoCo). ...
... Whether the application of compression socks for shorter periods would have the same effect cannot be discerned from the present study. Several studies 31 have used similar durations of post-exercise application of compression socks as in the present study, but some also used extended periods. 14 Kraemer et al. 14 found that wearing a compressive sleeve for 5 days following eccentric exercise maintained elbow ROM and decreased the participants' subjective rating of pain. ...
... 14 Kraemer et al. 14 found that wearing a compressive sleeve for 5 days following eccentric exercise maintained elbow ROM and decreased the participants' subjective rating of pain. Perrey et al. 31 reported that compression garments worn for 72 h after a 30 min backward downhill walk alleviated DOMS pain in the triceps surae by day 3 compared to the condition where no compression garment was worn. They speculated that there is a local effect of tissue compression and a reduction of structural damage, which allows recovery of force production at a faster rate than without the compression garment. ...
Article
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A series of studies were conducted to test the hypothesis that compression socks (uniform or graduated compression) worn after exercise mitigate exercise-induced pain. Fifty-nine (59) participants took part in three separate exercise protocols to induce a degree of muscle soreness from low to severe. Participants wore either ankle height socks with no compression (NoCo), knee height socks with uniform (UNI) or graduated compression (GRAD) for 8 h/day following exercise. Before, immediately after and during recovery, we measured muscle strength, flexibility and the perception of pain. The three exercise protocols were as follows. (1) Hike: compared the effects of GRAD and NoCo socks following a 10-km treadmill hike with a 1000 m ascent and descent. (2) Trail Run: compared the effect of GRAD and UNI following a 14-km trail run with 250 m ascent and descent. (3) Calf Exercise: compared the effect of GRAD and UNI socks with a predominately eccentric calf exercise. GRAD socks significantly mitigated the perception of calf pain compared to NoCo (Hike). The UNI socks were superior to the GRAD socks in mitigating the perception of pain during recovery in the Trail Run. No statistical difference was noted between UNI and GRAD socks after the Calf Exercise. Compression socks mitigated the perception of calf muscle pain (Hike trial), with UNI providing more benefit compared to GRAD socks (Trail Run trial). No differences between the UNI and GRAD socks were observed in the Calf Exercise trial. Compression socks aid in the perception of recovery following low to moderate pain from delayed onset muscle soreness.
... Associated force deficits may limit optimal performance in subsequent days. It was found that wearing CGs 5 hours post-exercise helped to recover contractile properties of muscles within 24 hours (Perrey et al., 2008). Besides an impact of wear time, the range of delivered pressure is also very high among studies ranging from 1-34 mmHg at the ankle and 8-27 mmHg at the calf (Beliard et al., 2015). ...
... Characteristics of CGs used in our study refer to commercially available products. Based on medical findings, earlier research recommended applying graduated compression clothing, with pressure decreasing continuously from distal to proximal and therefore the majority of studies so far have used such garments (Perrey et al., 2008). This is the first study that evaluated the effect of reverse graduated compression with pressure decreasing continuously from the proximal to the distal part of the calf. ...
... However, there appears to be a high variation in pressure exerted by commercially available CGs (Hill et al., 2015) and we believe that athletes are not aware of the pressure applied with these CGs or even the pressure distribution. We did not include a nogarment condition to control for placebo effects; however, we used different garments that were made to look identical and they were randomly administered before each trial to minimize placebo effects (Perrey et al., 2008). We retrospectively found via a questionnaire that athletes recognized with difficulty the garment they were given. ...
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Limited practical recommendations related to wearing compression garments for athletes can be drawn from the literature at the present time. We aimed to identify the effects of compression garments on physiological and perceptual measures of performance and recovery after uphill running with different pressure and distributions of applied compression. In a random, double blinded study, 10 trained male runners undertook three 8 km treadmill runs at a 6% elevation rate, with the intensity of 75% VO2max while wearing low, medium grade compression garments and high reverse grade compression. In all the trials, compression garments were worn during 4 hours post run. Creatine kinase, measurements of muscle soreness, ankle strength of plantar/dorsal flexors and mean performance time were then measured. The best mean performance time was observed in the medium grade compression garments with the time difference being: medium grade compression garments vs. high reverse grade compression garments. A positive trend in increasing peak torque of plantar flexion (60º·s-1, 120º·s-1) was found in the medium grade compression garments: a difference between 24 and 48 hours post run. The highest pain tolerance shift in the gastrocnemius muscle was the medium grade compression garments, 24 hour post run, with the shift being +11.37% for the lateral head and 6.63% for the medial head. In conclusion, a beneficial trend in the promotion of running performance and decreasing muscle soreness within 24 hour post exercise was apparent in medium grade compression garments.
... A 1-week interval was set for garment wearing conditions 37,57 was because 1 week was considered sufficient time for the effect of the previous experiment garment to disappear as it was reported that the effect of simulative training on the muscle and fascia lasted up to 72 h. 58,59 After walking, a fit evaluation interview was conducted about the experiment garments. In the interview, participants were asked to respond on a Likert 5-point scale (1: Strongly disagree, 5: Strongly agree) about each question. ...
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Based on 3D body scanning, this study developed the corresponding measurement-based patternmaking (CMP) method for leggings that could systematically provide an excellent fit and control tightness for different body parts. The CMP method for leggings was qualitatively validated by comparing the fit suitability of the produced leggings prototypes through a wear test. The results suggest that the CMP method is an option to design leggings with outstanding suitability in terms of appearance satisfaction, size satisfaction, compression satisfaction, usefulness in movement, ease of movement, ease in donning and doffing for different body parts. In particular, the graduated application percentage (GAP) provided an advantage in usefulness in movement, while the fixed application percentage (FAP) showed an advantage in ease in donning and doffing. As such, this study suggests selecting the CMP method of the application percentage (AP) depending on the purpose of use. This study demonstrated that the proposed method ensured validity in directly implementing a leggings pattern with 3D body scanning and body measurement alone.
... Previous studies related to leggings are limited to design and pattern development (Gozde & Sinem, 2019;Hwang & Choi, 2014;Pettys-Baker et al., 2017). In addition, most of the studies of compression bottoms are also related to exercise performance (Bringard et al., 2006;Hill et al., 2014;Liu & Little, 2009;Perrey et al., 2008;Rugg & Sternlicht, 2013) and physical recovery (Duffield and Portus, 2007;Trenell et al., 2006) when wearing shorts pants. There is a lack of research on pressure provided by the clothing in close contact to a body part, especially when considering athleisure leggings that cover the entire lower extremities from the waist to the ankle. ...
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The high-elasticity bottoms applying gradual pressurization to the blood vessels of the lower extremities simultaneously assisting to both prevention and treatment of multiple health conditions such as varicose veins. Medical compression stockings are classified as medical supplies, and there is a clear standard on magnitude and application for gradual pressure. However, in the case of leggings, there are no relevant experimental data or papers supporting these findings. This study was performed in order to analyse the gradual compression values in legging. Eight types of leggings currently available on the market by different brands, were analysed to determine the type of pressure applied. The pressure was measured at five points of the clothed body with leggings pulled across lower extremities. An airpack sensor was attached to a wooden leg model and five consecutive records at each measuring point were taken. Afterwards the average values were calculated. As observed in all eight leggings, the measuring point with the highest pressure applied was the back of the calf (mean 18.25 mmHg) or the below the knee circumference (mean 13.83 mmHg), pointing to deviance in applying gradual pressure as proposed in medical compression stockings. The commercial leggings used in this experiment did not show a gradual increase in pressure from the thigh to the ankle body zone. One can presume that the legs’ fatigue would increase over the time. Since, the gradual pressure should be applied in legging construction as seen in medical compression stockings.
... Data are presented as mean ± standard deviation. EPC external pneumatic compression, SC static compression, CTL control, CMJ countermovement jump, RFD rate of force development shown to reduce muscle soreness following 72 h of muscle damaging exercise (Perrey et al. 2008). The suggested mechanism to explain the causation of muscle soreness is muscle swelling elicited by muscle damaging exercise (French et al. 2008;Howatson and Milak 2009). ...
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Purpose To identify the effects of a single 30 min partial lower leg external pneumatic compression (EPC) treatment compared to a static compression (SC) garment or a no treatment control (CTL) on markers of recovery and performance following a muscle damaging protocol. Methods Thirty healthy, active males (23 ± 3 years; 180.2 ± 9.0 cm; 81.6 ± 11.3 kg) performed 100 drop jumps from a 0.6 m box followed by a randomized, single 30 min treatment of either a partial lower leg EPC device worn below the knee and above the ankle (110 mmHg), SC garment (20–30 mmHg) covering the foot and calf just below the knee, or no treatment CTL, and then returned 24 and 48 h later. Participants were assessed for measures of muscle soreness, fatigue, hemodynamics, blood lactate, muscle thickness, circumferences, and performance assessments. Results The drop jump protocol significantly increased muscle soreness (p < 0.001), fatigue (p < 0.001), blood flow (p < 0.001), hemoglobin (p < 0.001), and muscle oxygen saturation (SMO2; p < 0.001). Countermovement jump and squat jump testing completed after treatment with either EPC, SC, or CTL revealed no differences for jump height between any condition. However, EPC treatment maintained consistent braking force and propulsive power measures across all timepoints for countermovement jump testing. EPC and SC treatment also led to better maintenance of squat jump performance for average relative propulsive force and power variables at 24 and 48 h compared to CTL. Conclusions A single 30 min partial leg EPC treatment may lead to more consistent jump performance following a damaging bout of exercise.
... Further, study outcomes often focus on parameters (e.g., lactate, creatine kinase, [7,8]) at least suboptimum for validating recovery. Additionally, the minority of trials (<20-25%; e.g., [9][10][11][12][13][14]) monitor recovery periods >48 h. Thus, the aim of the study was to determine the effect of compression tights on relevant parameters of recovery applying a conscientious methodological and biometrical approach. ...
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Introduction: Recent meta-analyses on compression garments have reported faster recovery of muscle function particularly after intense eccentric power or resistance exercise. However, due to the complex interaction between cohorts included, exercises involved and compression applied, recovery length and modalities, and outcome parameters selected, only limited practical recommendations can be drawn from these studies. Thus, our aim was to determine the effect of compression tights on recovery from high mechanical and metabolic stress monitored over a longer recovery period. Material and methods: Using a crossover design, 19 resistance-trained 4th/5th Division German handball players (31.3±7.7 years; 24.1±3.8 kg/m2) were randomly assigned at the start of the project to the compression tight (recovery-pro-tights, cep, Bayreuth, Germany) or the control group. Immediately after a combined lower extremity resistance training and electromyostimulation, participants had to wear compression tights. Compression was applied initially for 24 h and then 12 h intermitted by 12 h of nonuse for a total of 96 h. Primary study endpoint was maximum isokinetic hip/leg-extensor strength (MIES) as determined by a leg-press. Secondary endpoint was lower extremity power as assessed by a counter movement jump. Follow-up assessments were conducted 24, 48, 72, and 96 h postexercise. Outcomes were analyzed using a linear mixed effect model with spherical symmetric within-condition correlation. Results: All 19 participants underwent their allocated treatment and passed through the project strictly according to the study protocol. MIES demonstrated significantly (p=0.003) lower overall reductions (155 N) after wearing compression tights. In parallel, lower extremity power significantly (p<0.001) varies between both conditions with lower reductions in favor of the compression condition. Of importance, full recovery for lower extremity muscle strength or power was still not reached 96 h postexercise. Conclusion: Based on our results we recommend athletes wear compression tights for faster recovery, particularly after intense exercise with a pronounced eccentric aspect.
... Compression stockings used before exercise, during exercise and after exercise were showed not to have an effect on blood lactate levels and not to have developed the recovery strength in the first 30 min (Duffield et al., 2008;Duffield et al., 2010;Maton et al., 2006). In the studies evaluating the effects of the use of compression stockings on muscle fatigue and muscle concentric strength, compression stockings were found to alleviate the decrease in concentric strength and muscle fatigue compared to control group (Ali et al., 2007;Duffield and Portus, 2007;Jakeman et al., 2010;Perrey et al., 2008). In our study, we used compression stockings with a pressure capacity of 30 mmHg at the level of ankle, and compression stockings with a pressure capacity of 20 mmHg whose intensity gradually decreases up to the knee, even if we did not observed a significant strength increase in females compared to control group, we found a significant increase in LPF strength parameters of males. ...
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In this study, we explained the effects of compression garment and electrostimulation on athletes’ recovery period by evaluating blood lactate and isokinetic peak torque parameters. Twenty volunteers (15.55± 0.51 yr) were included to study. At recovery period, blood samples was taken for lactate values at 0th, 3rd, 5th, 15th, 30th min. The isokinetic strength test was performed on right ankle at 15th min and on the left ankle at 30th min. The same protocol was performed for compression garment on 2 weeks and for electrostimulation on third weeks and results were compared. There wasn’t any significant difference on blood lactate levels within groups. At women; there was not any significant difference on isokinetic peak torques within two groups. but at electro-stimulation usage we found significant increases on right plantar flexion (P<0.1), right dorsal flexion (RDF) (P<0.1) and left plantar flexion (LPF) (P<0.1) values compared to control measurements. At men; with compression garment usage, there was significant increase on LPF values compared to control measurements. At electrostimulation usage, we found significant increases on RDF (P<0.1) and left dorsal flexion (P<0.1) values compared to control measurements. During recovery, there is not any beneficial effect seen on blood lactate level within two groups. When compared to passive rest, compression garments and electrostimulation interventions effects on force generation capacity at recovery are statically significant. Also in terms of force generation capacity; usage of electrostimulation during 15 min and compression garments during 30 min were statically more significant.
... Compression stockings used before exercise, during exercise and after exercise were showed not to have an effect on blood lactate levels and not to have developed the recovery strength in the first 30 min (Duffield et al., 2008; Duffield et al., 2010; Maton et al., 2006 ). In the studies evaluating the effects of the use of compression stockings on muscle fatigue and muscle concentric strength, compression stockings were found to alleviate the decrease in concentric strength and muscle fatigue compared to control group (Ali et al., 2007; Duffield and Portus, 2007; Jakeman et al., 2010; Perrey et al., 2008). In our study, we used compression stockings with a pressure capacity of 30 mmHg at the level of ankle, and compression stockings with a pressure capacity of 20 mmHg whose intensity gradually decreases up to the knee, even if we did not observed a significant strength increase in females compared to control group, we found a significant increase in LPF strength parameters of males. ...
Article
We explained the effects of compression garment and electrostimulation on athletes’ recovery period by evaluating blood lactate and isokinetic peak torque parameters.Twenty volunteers (15.55 ± 0.51 years) were included to study. At recovery period, blood samples was taken for lactate values at 0, 3, 5, 15, 30 minutes. The isokinetic strength test was performed on right ankle at 15th minute and on the left ankle at 30th minute. The same protocol was performed for compression garment on two weeks and for electrostimulation on 3rd weeks and results were compared. There wasn’t any significant difference on blood lactate levels within groups. At women; there wasn’t any significant difference on isokinetic peak torques within two groups. But at electrostimulation usage we found significant increases on right plantar flexion (RPF) (P<0.1), right dorsal flexion (RDF) (P<0.1) and left plantar flexion (LPF) (P<0.1) values compared to control measurements. At men; with compression garment usage, there was significant increase on left plantar flexion values compared to control measurements. At electrostimulation usage, we found significant increases on RDF (P<0.1) and left dorsal flexion (LDF) (P<0.1) values compared to control measurements. During recovery, there isn’t any beneficial effect seen on blood lactate level within two groups. When compared to passive rest, compression garments and electrostimulation interventions effects on force generation capacity at recovery are statically significant. Also in terms of force generation capacity; usage of electrostimulation during 15 minutes and compression garments during 30 minutes are statically more significant.
... The choice of clothing during sporting activities is largely dependent on the regulations and safety requirements within a sport. Several products have been developed claiming to improve performance in temperate environments such as compression socks [31]; but also in hot environments such as hand cooling devices [15]. However, it is important to understand these claims and make informed decisions regarding clothing choices when exercising in the heat. ...
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Football (i.e., soccer) is played in varied climatic conditions throughout the world to which professionals and recreational players alike must adapt. In the Middle East, ambient temperature can rapidly increase above 40°C and humidity can further enhance the harshness of the environment. In Europe, matches are held throughout the year in conditions that range from warm and humid, to cold and damp. In recent years, the physiological, metabolic and nutritional demands of the game have been thoroughly described, along with the thermoregulatory requirements associated with playing in various environmental conditions. The plethora of literature regarding football has allowed for greater insight as to how match-play may be altered under heat stress. It has also led to the development of interventions to enhance performance in the heat. This brief review will address the most recent football literature regarding the influence of heat stress on football performance. Specifically, the review will describe the alterations that occur during match-play in response to the development of hyperthermia and examine how heat acclimatisation may improve or help maintain performance. Furthermore, insight into how heat stress impacts match-play characteristics will be discussed.
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Background Compression garments are regularly worn during exercise to improve physical performance, mitigate fatigue responses, and enhance recovery. However, evidence for their efficacy is varied and the methodological approaches and outcome measures used within the scientific literature are diverse. Objectives The aim of this scoping review is to provide a comprehensive overview of the effects of compression garments on commonly assessed outcome measures in response to exercise, including: performance, biomechanical, neuromuscular, cardiovascular, cardiorespiratory, muscle damage, thermoregulatory, and perceptual responses. Methods A systematic search of electronic databases (PubMed, SPORTDiscus, Web of Science and CINAHL Complete) was performed from the earliest record to 27 December, 2020. Results In total, 183 studies were identified for qualitative analysis with the following breakdown: performance and muscle function outcomes: 115 studies (63%), biomechanical and neuromuscular: 59 (32%), blood and saliva markers: 85 (46%), cardiovascular: 76 (42%), cardiorespiratory: 39 (21%), thermoregulatory: 19 (10%) and perceptual: 98 (54%). Approximately 85% ( n = 156) of studies were published between 2010 and 2020. Conclusions Evidence is equivocal as to whether garments improve physical performance, with little evidence supporting improvements in kinetic or kinematic outcomes. Compression likely reduces muscle oscillatory properties and has a positive effect on sensorimotor systems. Findings suggest potential increases in arterial blood flow; however, it is unlikely that compression garments meaningfully change metabolic responses, blood pressure, heart rate, and cardiorespiratory measures. Compression garments increase localised skin temperature and may reduce perceptions of muscle soreness and pain following exercise; however, rating of perceived exertion during exercise is likely unchanged. It is unlikely that compression garments negatively influence exercise-related outcomes. Future research should assess wearer belief in compression garments, report pressure ranges at multiple sites as well as garment material, and finally examine individual responses and varying compression coverage areas.
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The low oxidative demand and muscular adaptations accompanying eccentric exercise hold benefits for both healthy and clinical populations. Compression garments have been suggested to reduce muscle damage and maintain muscle function. This study investigated whether compression garments could benefit metabolic recovery from eccentric exercise. Following 30-min of downhill walking participants wore compression garments on one leg (COMP), the other leg was used as an internal, untreated control (CONT). The muscle metabolites phosphomonoester (PME), phosphodiester (PDE), phosphocreatine (PCr), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were evaluated at baseline, 1-h and 48-h after eccentric exercise using 31P-magnetic resonance spectroscopy. Subjective reports of muscle soreness were recorded at all time points. The pressure of the garment against the thigh was assessed at 1-h and 48-h following exercise. There was a significant increase in perceived muscle soreness from baseline in both the control (CONT) and compression (COMP) leg at 1-h and 48-h following eccentric exercise (p < 0.05). Relative to baseline, both CONT and COMP showed reduced pH at 1-h (p < 0.05). There was no difference between CONT and COMP pH at 1-h. COMP legs exhibited significantly (p < 0.05) elevated skeletal muscle PDE 1-h following exercise. There was no significant change in PCr/Pi, Mg2+ or PME at any time point or between CONT and COMP legs. Eccentric exercise causes disruption of pH control in skeletal muscle but does not cause disruption to cellular control of free energy. Compression garments may alter potential indices of the repair processes accompanying structural damage to the skeletal muscle following eccentric exercise allowing a faster cellular repair.
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1. Normal subjects performed a step test in which the quadriceps of one leg contracted concentrically while the contralateral muscle contracted eccentrically. 2. Maximal voluntary force and the force:frequency relationship were altered bilaterally as a result of the exercise, the changes being greater in the muscle which had contracted eccentrically. Recovery occurred over 24 h. 3. Electromyographic studies using three sites on each muscle showed an increase in electrical activation during the exercise only in the muscle which was contracting eccentrically. Recovery followed a time course similar to that of the contractile properties. 4. Pain and tenderness developed only in the muscle which had contracted eccentrically. Pain was first noted approximately 8 h after exercise and was maximal at approximately 48 h after exercise, at which time force generation and electrical activation had returned to pre-exercise values. 5. Eccentric contractions cause more profound changes in some aspects of muscle function than concentric contractions. These changes cannot be explained in simple metabolic terms, and it is suggested that they are the result of mechanical trauma caused by the high tension generated in relatively few active fibres during eccentric contractions.
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A between groups design was used to compare recovery following eccentric muscle damage under 2 experimental conditions. To determine if a compression sleeve donned immediately after maximal eccentric exercise would enhance recovery of physical function and decrease symptoms of soreness. Prior investigations using ice, intermittent compression, or exercise have not shown efficacy in relieving symptoms of delayed onset muscle soreness (DOMS). To date, no study has shown the effect of continuous compression on DOMS, yet this would offer a low cost intervention for patients suffering with the symptoms of DOMS. Twenty nonimpaired non-strength-trained women participated in the study. Subjects were matched for age, anthropometric data, and one repetition maximum concentric arm curl strength and then randomly placed into a control group (n = 10) or an experimental compression sleeve group (n = 10). Subjects were instructed to avoid pain-relieving modalities (eg, analgesic medications, ice) throughout the study. The experimental group wore a compressive sleeve garment for 5 days following eccentric exercise. Subjects performed 2 sets of 50 passive arm curls with the dominant arm on an isokinetic dynamometer with a maximal eccentric muscle action superimposed every fourth passive repetition. One repetition maximum elbow flexion, upper arm circumference, relaxed elbow angle, blood serum cortisol, creatine kinase, lactate dehydrogenase, and perception of soreness questionnaires were collected prior to the exercise bout and daily thereafter for 5 days. Creatine kinase was significantly elevated from the baseline value in both groups, although the experimental compression test group showed decreased magnitude of creatine kinase elevation following the eccentric exercise. Compression sleeve use prevented loss of elbow motion, decreased perceived soreness, reduced swelling, and promoted recovery of force production. Results from this study underline the importance of compression in soft tissue injury management.
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Muscle fatigue is an exercise-induced reduction in maximal voluntary muscle force. It may arise not only because of peripheral changes at the level of the muscle, but also because the central nervous system fails to drive the motoneurons adequately. Evidence for "central" fatigue and the neural mechanisms underlying it are reviewed, together with its terminology and the methods used to reveal it. Much data suggest that voluntary activation of human motoneurons and muscle fibers is suboptimal and thus maximal voluntary force is commonly less than true maximal force. Hence, maximal voluntary strength can often be below true maximal muscle force. The technique of twitch interpolation has helped to reveal the changes in drive to motoneurons during fatigue. Voluntary activation usually diminishes during maximal voluntary isometric tasks, that is central fatigue develops, and motor unit firing rates decline. Transcranial magnetic stimulation over the motor cortex during fatiguing exercise has revealed focal changes in cortical excitability and inhibitability based on electromyographic (EMG) recordings, and a decline in supraspinal "drive" based on force recordings. Some of the changes in motor cortical behavior can be dissociated from the development of this "supraspinal" fatigue. Central changes also occur at a spinal level due to the altered input from muscle spindle, tendon organ, and group III and IV muscle afferents innervating the fatiguing muscle. Some intrinsic adaptive properties of the motoneurons help to minimize fatigue. A number of other central changes occur during fatigue and affect, for example, proprioception, tremor, and postural control. Human muscle fatigue does not simply reside in the muscle.
Article
Background: Medical-grade compression of class I (20-30 mmHg) and class II (30-40 mmHg) have been shown to be beneficial against venous hypertension or congestion. Relatively few studies address the effects of ready-to-wear (RTW) lightweight gradient compression pantyhose on venous symptoms. Objective: To perform a study comparing the effects of two different compression RTW lightweight gradient compression stockings (8-15 mmHg and 15-20 mmHg) on the venous symptoms of flight attendants. Method: A prospective crossover trial of symptom evaluation in 19 flight attendants was performed in which participants rated their symptoms on a visual analog scale. During the initial phase, participants wore no compression for 2 weeks. They then wore 8-15 mmHg and 15-20 mmHg gradient compression support hose while flying over a 4-week period. Symptoms before and after wearing the gradient compression stockings were compared and statistically analyzed. Results: Wearing of 8-15 mmHg gradient hose resulted in statistically significant improvement of discomfort (P < 0.01). Swelling, fatigue, aching, and tightness of the leg were all improved to a statistically significant degree (P < 0.01). For 15-20 mmHg gradient hosiery, symptoms were improved to a statistically significant or almost significant level. The difference between the 8-15 mmHg and 15-20 mmHg compression was not statistically significant. Conclusions: Use of lightweight (low compression) RTW gradient compression hosiery is very effective in improving symptoms of discomfort (P < 0.01), swelling (almost P < 0. 05), fatigue (P < 0.05), aching (P < 0.01), as well as leg tightness. Improvement of symptoms is statistically significant compared to no compression when hosiery was worn regularly during waking hours for 4 weeks.
Article
Context Prior investigations using ice, massage, or exercise have not shown efficacy in relieving delayed-onset muscle soreness. Objectives To determine whether a compression sleeve worn immediately after maximal eccentric exercise enhances recovery. Design Randomized, controlled clinical study. Setting University sports medicine laboratory. Participants Fifteen healthy, non-strength-trained men, matched for physical criteria, randomly placed in a control group or a continuous compression-sleeve group (CS). Methods and Measures Subjects performed 2 sets of 50 arm curls. 1RM elbow flexion at 60°/s, upper-arm circumference, resting-elbow angle, serum creatine kinase (CK), and perception-of-soreness data were collected before exercise and for 3 days. Results CK was significantly ( P < .05) elevated from the baseline value in both groups, although the elevation in the CS group was less. CS prevented loss of elbow extension, decreased subjects’ perception of soreness, reduced swelling, and promoted recovery of force production. Conclusions Compression is important in soft-tissue-injury management.
Article
Muscle strain is a very common injury. Muscles that are frequently involved cross two joints, act mainly in an eccentric fashion, and contain a high percentage of fast-twitch fibers. Muscle strain usually causes acute pain and occurs during strenuous activity. In most cases, the diagnosis can be made on the basis of the history and physical examination. Magnetic resonance imaging is recommended only when radiologic evaluation is necessary for diagnosis. Initial treatment consists of rest, ice, compression, and nonsteroidal anti-inflammatory drug therapy. As pain and swelling subside, physical therapy should be initiated to restore flexibility and strength. Avoiding excessive fatigue and performing adequate warm-up before intense exercise may help to prevent muscle strain injury. The long-term outcome after muscle strain injury is usually excellent, and complications are few.