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Background Runners at various levels of performance and specializing in different events (from 800 m to marathons) wear compression socks, sleeves, shorts, and/or tights in attempt to improve their performance and facilitate recovery. Recently, a number of publications reporting contradictory results with regard to the influence of compression garments in this context have appeared. Objectives To assess original research on the effects of compression clothing (socks, calf sleeves, shorts, and tights) on running performance and recovery. Method A computerized research of the electronic databases PubMed, MEDLINE, SPORTDiscus, and Web of Science was performed in September of 2015, and the relevant articles published in peer-reviewed journals were thus identified rated using the Physiotherapy Evidence Database (PEDro) Scale. Studies examining effects on physiological, psychological, and/or biomechanical parameters during or after running were included, and means and measures of variability for the outcome employed to calculate Hedges’g effect size and associated 95 % confidence intervals for comparison of experimental (compression) and control (non-compression) trials. Results Compression garments exerted no statistically significant mean effects on running performance (times for a (half) marathon, 15-km trail running, 5- and 10-km runs, and 400-m sprint), maximal and submaximal oxygen uptake, blood lactate concentrations, blood gas kinetics, cardiac parameters (including heart rate, cardiac output, cardiac index, and stroke volume), body and perceived temperature, or the performance of strength-related tasks after running. Small positive effect sizes were calculated for the time to exhaustion (in incremental or step tests), running economy (including biomechanical variables), clearance of blood lactate, perceived exertion, maximal voluntary isometric contraction and peak leg muscle power immediately after running, and markers of muscle damage and inflammation. The body core temperature was moderately affected by compression, while the effect size values for post-exercise leg soreness and the delay in onset of muscle fatigue indicated large positive effects. Conclusion Our present findings suggest that by wearing compression clothing, runners may improve variables related to endurance performance (i.e., time to exhaustion) slightly, due to improvements in running economy, biomechanical variables, perception, and muscle temperature. They should also benefit from reduced muscle pain, damage, and inflammation.
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SYSTEMATIC REVIEW
Is There Evidence that Runners can Benefit from Wearing
Compression Clothing?
Florian Azad Engel
1
Hans-Christer Holmberg
2
Billy Sperlich
3
ÓSpringer International Publishing Switzerland 2016
Abstract
Background Runners at various levels of performance
and specializing in different events (from 800 m to mara-
thons) wear compression socks, sleeves, shorts, and/or
tights in attempt to improve their performance and facili-
tate recovery. Recently, a number of publications reporting
contradictory results with regard to the influence of com-
pression garments in this context have appeared.
Objectives To assess original research on the effects of
compression clothing (socks, calf sleeves, shorts, and
tights) on running performance and recovery.
Method A computerized research of the electronic data-
bases PubMed, MEDLINE, SPORTDiscus, and Web of
Science was performed in September of 2015, and the
relevant articles published in peer-reviewed journals were
thus identified rated using the Physiotherapy Evidence
Database (PEDro) Scale. Studies examining effects on
physiological, psychological, and/or biomechanical
parameters during or after running were included, and
means and measures of variability for the outcome
employed to calculate Hedges’g effect size and associated
95 % confidence intervals for comparison of experimental
(compression) and control (non-compression) trials.
Results Compression garments exerted no statistically
significant mean effects on running performance (times for
a (half) marathon, 15-km trail running, 5- and 10-km runs,
and 400-m sprint), maximal and submaximal oxygen
uptake, blood lactate concentrations, blood gas kinetics,
cardiac parameters (including heart rate, cardiac output,
cardiac index, and stroke volume), body and perceived
temperature, or the performance of strength-related tasks
after running. Small positive effect sizes were calculated
for the time to exhaustion (in incremental or step tests),
running economy (including biomechanical variables),
clearance of blood lactate, perceived exertion, maximal
voluntary isometric contraction and peak leg muscle power
immediately after running, and markers of muscle damage
and inflammation. The body core temperature was mod-
erately affected by compression, while the effect size val-
ues for post-exercise leg soreness and the delay in onset of
muscle fatigue indicated large positive effects.
Conclusion Our present findings suggest that by wearing
compression clothing, runners may improve variables
related to endurance performance (i.e., time to exhaustion)
slightly, due to improvements in running economy,
biomechanical variables, perception, and muscle tempera-
ture. They should also benefit from reduced muscle pain,
damage, and inflammation.
&Florian Azad Engel
florian.engel3@kit.edu
1
Research Centre for School Sports and the Physical
Education of Children and Young Adults, Karlsruhe Institute
of Technology, Kaiserstrasse 12, 76131 Karlsruhe, Germany
2
Department of Health Sciences, Swedish Winter Sports
Research Centre, Mid Sweden University, O
¨stersund,
Sweden
3
Integrative and Experimental Training Science, Department
of Sport Science, University of Wu
¨rzburg, Wu
¨rzburg,
Germany
123
Sports Med
DOI 10.1007/s40279-016-0546-5
Author's personal copy
Key Points
Runners with varying levels of performance wear
compression clothing to improve this performance
and facilitate recovery, and the present systematic
review summarizes relevant findings published to
date.
The effect size values indicate that application of
compression garments during running and/or
recovery exerts no beneficial effect on racing
performance (400-m sprint—marathon), various
physiological parameters or the performance of
strength-related tasks during recovery from running.
Small positive effects were observed with respect to
the time to exhaustion (in connection with
incremental or step tests), running economy,
biomechanical variables, clearance of blood lactate,
perceived exertion, maximal voluntary isometric
contraction, and peak leg muscle power immediately
after running, as well as markers of muscle damage
and inflammation.
The effect size values for post-exercise pain,
damage, and inflammation in muscles indicated large
positive effects of compression.
1 Introduction
Runners at various levels of performance and specializing
in different events (from 800 m to marathons) wear socks,
sleeves, shorts, and/or tights with compression to improve
their performance [13] and facilitate recovery [4,5]. To
date, the effects of compression clothing have been
examined with a variety of running protocols, including
short-term submaximal treadmill running [611], incre-
mental treadmill tests to exhaustion [1217], 10-km races
[1], time to exhaustion at the pace used during a 10-km
race [18], and 10-km submaximal running [14]. Few such
investigations have involved real-life or simulated running
competitions exceeding 1 hour in duration and conducted
outdoors [2,3,19,20], while others have applied com-
pression garments only during recovery from running for
12 [21], 48 [4,22], or 72 [5]h.
Recently, a number of publications concerning the
influence of compression garments on running performance
and perception of different intensities and durations of
running have reported contradictory findings. In some
cases, time-trial performance improved [23], but not in
others [1,3,25]. Time to exhaustion was either unchanged
[12,18,24], increased [16], or reduced [13]. In certain
studies physiological parameters such as blood concentra-
tions of lactate during [8,15] and after [13] running and
oxygen uptake [13,18] were influenced to a considerable
extent by compression clothing, whereas in others blood
levels of lactate [1,2] and oxygen uptake [12,16,26] were
not altered.
Reviews of statistical findings in this field have sum-
marized the multiple effects of compression clothing on
exercise and recovery in various disciplines [2730]. As
pointed out earlier [29], assessment of effectiveness based
on traditional deductive statistics may be prejudiced, since
significance can be achieved either by increasing the
number of participants and/or decreasing the variance of
data comparing control and treatment conditions [31,32].
Accordingly, as sometimes done [29,3335], calculation
of effect sizes (ES; [36]) allows effectiveness to be com-
pared and the practical relevance of the application of
compression clothing assessed.
The aims of the present systematic review were as fol-
lows: (1) to review the available literature concerning
compression garments and running, (2) to calculate the
effect sizes associated with various markers related to
performance and recovery; (3) to identify evidence-based
application of compression in connection with distance
running; and (4) to develop recommendations concerning
the use of compression for distance runners.
2 Methods
2.1 Data Sources and Literature Searching
A comprehensive computerized search of the electronic
databases PubMed, MEDLINE, SPORTDiscus, and Web
of Science was performed during September of 2015
employing the following keywords: athlete, endurance,
endurance running, blood flow, blood lactate, compression,
compression clothing, compression garment, compression
stockings, running, long distance running, exercise, fatigue,
garments, heart rate, muscle damage, pain, swelling,
oscillation, oxygenation, oxygen uptake, performance,
perceived exertion, power, recovery, strength, stroke vol-
ume, textiles, thermoregulation, time to exhaustion, and
time trial. In addition, the reference lists of the articles thus
identified and from other relevant articles of which we
were aware were examined for additional relevant titles.
2.2 Study Selection and Quality Assessment
Original research articles in peer-reviewed journals that
investigated any kind of lower-limb compression garment
(i.e., knee-high socks, sleeves, shorts, or tights) or whole-
F. A. Engel et al.
123
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body compression garments during and/or after long dis-
tance running were included. These studies assessed
physiological (VO
2max
(maximal oxygen uptake), VO
2peak
(peak oxygen uptake), submaximal VO
2
, blood lactate,
post-exercise clearance of blood lactate, blood gases, car-
diac parameters, inflammatory markers), biomechanical
(ground contact time, step frequency, step length, swing
time), psychological (rates of perceived exertion, perceived
temperature, leg soreness), and/or performance parameters
(running time, time to exhaustion, jump performance,
maximal voluntary isometric contraction, peak leg muscle
power). In the present analysis, we have only included data
from investigations where (1) absolute values (means and
measures of variability) were published or could be
obtained from the authors and (2) both an experimental
(compression) and a control group (non-compression) of
runners at any level of performance (from untrained to
elite) were included. Finally, only data concerning partic-
ipants without any cardiovascular, metabolic, or muscu-
loskeletal disorders were considered (Fig. 1).
Each study meeting our inclusion criteria was also
evaluated by two independent reviewers according to the
Physiotherapy Evidence Database (PEDro) Scale [37],
where a ‘‘yes’’ answer adds 1 point, and ‘‘no’’ 0 points, and
the maximal score is 10 points. This approach has been
applied previously in connection with systematic reviews
to assess methodological quality [3840].
2.3 Statistical Analyses
To compare and quantify each parameter of performance
and recovery, the ES (Hedges’ g) and associated 95 %
confidence interval were calculated as proposed by Glass
[41]. Hedges’ g was computed as the difference between
the means of experimental (compression) and control (no
compression) values divided by the average standard
deviation for the population concerned [41]. To optimize
the calculation of ES and estimate the standard deviation
for Hedges’ g, the standard deviations of the experimental
and control groups at baseline were pooled [36]. In
accordance with standard practice, the ES values obtained
were then defined as trivial (\0.10), small (0.10–0.30),
moderate (0.30–0.50), or large ([0.50) [32]. All statistical
analyses were carried out in version 11.5.1.0 of the Med-
Calc software (MedCalc, Mariakerke, Belgium).
3 Results
3.1 Characteristics of the Studies Analyzed
Of the 643 studies initially identified, 32 (published
between 1987 and 2015) were examined in detail (Fig. 1).
Their average PEDro score was 6.5 (range 5–9). The par-
ticipants and compression clothing, parameters measured,
and protocols in each study are summarized in Table 1.
Thirty-two of these studies involved performance of
different running protocols by a total of 494 participants
(458 men and approximately 36 women (in one case, the
number of women was not reported [1])). Twenty-four
included only male participants, one only women, and the
remaining seven included both. The mean sample size was
15.0 ±7.7 (mean ±SD; range 6–36) and age 29.0 ±7.2
(19–48) years.
Fig. 1 Pathway of identified
and subsequent excluded or
reviewed articles. PEDro
physiotherapy evidence
database
Benefits of Compression Clothing for Runners
123
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Table 1 Summary of studies included in a systematic review of investigations into the effect of compression clothing on long-distance running performance and subsequent recovery
References
(year)
Subjects (n),
sex, age (y)
[mean ±SD]
Characteristics of
participants
a
Characteristics of compression clothing Study protocol
(occasion when
compression
was applied)
Effects of compression clothing
Study population Type of
compression
clothing
Pressure applied
(mmHg)
Measure
Areces et al.
[2]
30 M, 41 ±9
4F,41±9
Experienced marathon runners
(marathon PB: 03:20 ±0:23
[h:min], VO
2max
: n.i.)
Socks (G) 20–25
(manufacturer’s
information)
P, R Marathon P: Run time $,La$, RPE $
R: CMJ $, leg muscle power $,
serum myoglobin $,CK$, leg
soreness 24 h post-race :
Vercruyssen
et al. [3]
11 M, 34 ±10 Well-trained runners (VO
2max
:
60.1 ±6.5 mlkg
-1
min
-1
)
Socks 18 P, R 15.6-km trail run P: Run time $,La$,HR$,
RPE $,
R: oxygenation profile VL $,
MVC $, CMJ $
Bieuzen et al.
(2014) [19]
11 M, 35 ±10 Well-trained runners (VO
2max
:
60.1 ±6.5 mlkg
-1
min
-1
)
Calf compression
sleeves (G)
P: 25/R: 20 P, R 15.6-km trail run P: Run time $,HR$, RPE $
R: MVC :, CMJ :, perceived
muscle soreness :,CK$, IL-6
$
Del Coso et al.
[20]
36 M, 35 ±5 Experienced triathletes (half
Ironman PB: 303 ±33 [min],
VO
2max
: n.i.)
Calf compression
sleeves (G)
n.i. P, R Half Ironman
triathlon (1.9 km
swimming/75 km
cycling/21.1 km
running)
P: Race time $, velocity running
$, RPE $,
R: CMJ $, leg muscle power $,
blood myoglobin $,CK$,
serum LDH $, perceived
muscle soreness $, temp $
Ali et al. [1]12M?F,
33 ±10
Competitive runners (VO
2max
:
68.7 ±6.2 mlkg
-1
min
-1
)
Socks (G) 15, 21, 32 P, R 10 km TT P: TT $,La$,CP$, RPE :;,
HR $
R: CMJ :;
Barwood et al.
(2013) [25]
8M,21±2 Recreationally active individuals
(VO
2max
: n.i.)
(1) Correctly sized
shorts (G)
(2) Over-sized
shorts (G)
(1) 11–20
(2) 10–17
P 15 min treadmill
running at 35 °C and
10–12 kmh
-1
, 5 min
rest followed by a
5-km TT at 35 °C
P: TT $, split time $, pacing
profile $, RPE $, thermal
responses $, perceptual thermal
responses $, sweat production
$, volume of water intake $
Ali et al. [23]14M,22±1 Amateur runners (1) VO
2max
:
56.1 ±0.4 mlkg
-1
min
-1
, (2)
VO
2max
:
55.0 ±0.9 mlkg
-1
min
-1
Socks (G) 18–22 P, R 2 920 m shuttle-runs
(separated by 1 h)
and 10-km TT
P: TT $, RPE $,HR$
R: DOMS :
Vencku
¯nas
et al. [42]
13 F, 25 ±4 Recreationally physically active
individuals (VO
2max
: n.i.)
Tights 17–18 P, R 30-min (4-km)
submaximal running
followed by a
400-m sprint
P: 400-m sprint time $,HR$,
RPE $, perceived sweating $,
perceived thermal sensation $,
skin temp :(higher), body core
temp$
R: orthoclinostatic test $,BF$,
tissue SO
2
$, leg BF during
regeneration :
F. A. Engel et al.
123
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Table 1 continued
References
(year)
Subjects (n),
sex, age (y)
[mean ±SD]
Characteristics of
participants
a
Characteristics of compression clothing Study protocol
(occasion when
compression
was applied)
Effects of compression clothing
Study population Type of
compression
clothing
Pressure applied
(mmHg)
Measure
Varela-Sanz
et al. [18]
13 M, 35 ±7
3F,32±5
Well-trained runners (VO
2max
M:
65.9 ±8.8; F:
59.5 ±2.1 mlkg
-1
min
-1
;
10 km PB M: 37:14 ±04:04; F:
43:09 ±00:25 [min])
Socks (G) 15–22 P TTE test: treadmill
running at 105 % of a
recent 10 km pace
Running economy test:
four consecutive trials
of 6 min at recent
half-marathon pace
P: TTE test: RE $, TTE $,La
$, RPE $,VO
2
$,HR
peak
$, %HR
max
:,
Kinematics $
Running economy test: TTE $,
HR $,La$, RPE $,VO
2
$
Sperlich et al.
[26]
15 M, 27 ±5 Well-trained runners and
triathletes (VO
2max
:
63.7 ±4.9 mlkg
-1
min
-1
)
Socks, tights,
WBC
20 P 15 min treadmill
running at 70 %
VO
2max
followed by
running to exhaustion
at v
max
of previous
incremental test
P: VO
2max
:, TTE $,VO
2
:;,La
$,pO
2
$,SO
2
$, RPE :
Dascombe
et al. [15]
11 M, 28 ±10 Well-trained runners and
triathletes (VO
2max
:
59.0 ±6.7 mlkg
-1
min
-1
)
Tights (G) 16–22, 14–19 P Steptest and TTE test at
90 % VO
2max
,
temp
amb
:22°C±2°C
P: VO
2max
$, TTE $,VO
2
:;,La
$,HR$,RE$
Goh et al. [43]10M,29±10 Recreational runners (VO
2max
:
58.7 ±2.7 mlkg
-1
min
-1
)
Tights (G) 9–14 P 20 min at 1st ventilatory
threshold followed by
run to exhaustion at
VO
2max
at 10 °C and
32 °C
P: TTE $
Me
´ne
´trier et al.
[24]
11 M, 22 ±1 Recreational endurance athletes
(3.1 ±0.3 h training per week,
VO
2max
: n.i.)
Calf compression
sleeves (G)
15–27 P, R Treadmill running:
15 min rest, 30 min at
60 % maximal aerobic
velocity, 15 min
passive recovery,
running to exhaustion
at 100 % maximal
aerobic velocity and
30 min passive
recovery
P: TTE $,HR$, RPE $
R: SO
2
calf during rest and
recovery :
Kemmler et al.
[16]
21 M, 39 ±11 Moderately trained runners
(VO
2max
:
52.0 ±6.1 mlkg
-1
min
-1
)
Socks (G) 24 P Incremental treadmill
running test
P: TTE :,VO
2max
$,La$,HR
$
Benefits of Compression Clothing for Runners
123
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Table 1 continued
References
(year)
Subjects (n),
sex, age (y)
[mean ±SD]
Characteristics of
participants
a
Characteristics of compression clothing Study protocol
(occasion when
compression
was applied)
Effects of compression clothing
Study population Type of
compression
clothing
Pressure applied
(mmHg)
Measure
Rider et al.
[13]
7M,21±1, 3
F, 19 ±1
Well-trained cross-country runners
(VO
2max
: 63.1-
64.9 ±7.0 mlkg
-1
min
-1
;M
8 km PB: 26:37 ±00:56; F
5 km PB: 19:04 ±00:39
[min:s])
Socks (G) 15–20
(manufacturer’s
information)
P Ramped treadmill test
(stage 1 at
160 mmin
-1
, stage 2
at 160 mmin
-1
and a
5 % grade; each
subsequent stage
increased by
26.8 mmin
-1
and
1 % grademin
-1
until
exhaustion)
P: HR $,La$, La threshold $,
VO
2
$, RER $, RPE $, TTE ;
R: La :
Wahl et al.
[12]
9M,22±1 Well-trained endurance athletes
(VO
2peak
:
57.7 ±4.5 mlkg
-1
min
-1
)
Three different
types of socks (G)
(1) 11–21
(2) 20–31
(3) 36–45
P Treadmill test: 30 min
at 70 % of VO
2peak
followed by a ramp
test (1 % increase in
grademin
-1
) until
exhaustion while
wearing compression
P: TTE $, erythrocyte
deformability $,La$,HR$,
pO2 $,VO
2
$,
Berry et al.
[17]
6M,23±5 Well-trained runners (1) VO
2max
:
52.8 ±8.0 mlkg
-1
min
-1
, (2)
VO
2max
:
59.9 ±6.8 mlkg
-1
min
-1
Socks (G) 8–18 P Incremental treadmill
test until exhaustion
P: VO
2max
$, TTE $
Bringard et al.
[45]
6M,31±5 Well-trained runners (VO
2max
:
60.9 ±4.4 mlkg
-1
min
-1
)
Tights n.i. P Energy cost at 10, 12,
14, 16 kmh
-1
(temp
amb
31 °C) and
15 min treadmill
running at 80 %
VO
2max
. temp
amb
23.6
°C
P: VO
2max
;, RPE $, temp $,
metabolic efficiency :
Stickford et al.
[6]
16 M, 22 ±3 Highly trained runners
(10,000 m PB: 29:22 ±0:35;
5,000 m PB: 14:47 ±1:02
[min:s], VO
2max
: n.i.)
Calf compression
sleeves (G)
15–20
(manufacturer’s
information)
P394 min submaximal
treadmill running at 3
constant speeds (233,
268, 300 m/min)
P: RE $, running mechanics $
Miyamoto
et al. (2014)
(I) [46]
11 M, 26 ±4 Healthy young individuals
(VO
2max
: n.i.)
(1) Shorts (G)
(2) Shorts (G)
(1) 7–9
(2) 14–15
P Submaximal treadmill
running for 34.5 min
at 6–12 kmh
-1
. Prior
to and following the
running exercise
magnetic resonance
images from the right
thigh
(1) P: RPE :,R:T2$
(2) P: RPE :,R:T2:
F. A. Engel et al.
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Table 1 continued
References
(year)
Subjects (n),
sex, age (y)
[mean ±SD]
Characteristics of
participants
a
Characteristics of compression clothing Study protocol
(occasion when
compression
was applied)
Effects of compression clothing
Study population Type of
compression
clothing
Pressure applied
(mmHg)
Measure
Miyamoto
et al. (II) [46]
11 M, 27 ±2 Healthy young individuals
(VO
2max
: n.i.)
(1) Shorts (G)
(2) Shorts (G)
(1) 18–22
(2) 23–28
P Submaximal treadmill
running for 34.5 min
at 6–12 kmh
-1
. Prior
to and following the
running exercise
magnetic resonance
images from the right
thigh
(1) P: RPE $,R:T2:
(2) P: RPE $,R:T2:
Sperlich et al.
[9]
15 M, 22 ±1 Well-trained runners and
triathletes (VO
2max
:
57.2 ±4.0 mlkg
-1
min
-1
)
Socks (G) 10, 20, 30, 40 P 45 min treadmill
running at 70 % of
VO
2max
P: VO
2
$,La$,CP$,SO
2
$,
HR $
Lovell et al.
[8]
25 M, 22 ±2 Semi-professional Rugby league
players (3–5 training sessions per
week, VO
2max
: n.i.)
Tights (G) 15–20 P 30 min treadmill
running (5 min stages
at 6 kmh
-1
,
10 kmh
-1
,85%
VO
2max
,6kmh
-1
,
85 % VO
2max
,
6kmh
-1)
P: Physiological parameters $,
except:
La :, RER higher at 10 kmh
-1
;
RER higher at 85 % VO
2max
;
La :,HRat6kmh
-1
;
RER higher at 85 % VO
2max
;
La :,HR:at 6 kmh
-1
Rugg et al. [7] 8 M, 6 F,
28 ±14
Competitive runners (VO
2max
: n.i.) Tights (G) 7–18
(manufacturer’s
information)
P, R Three CMJ, 15 min
continuous
submaximal treadmill
running (5 min at
50 %, 5 min at 70 %,
5 min at 85 % of HR
reserve), three CMJ
P: RPE :, comfort level :R: Post-
run CMJ :
Ali et al. [44]10M,36±10 Highly trained runners and
triathletes (VO
2max
:
70.4 ±6.1 mlkg
-1
min
-1
)
Socks (G) 12–15, 23–32 P, R 40 min treadmill
running at 80 %
VO
2max
P: VO
2
$,La$,HR$, RPE $
R: CMJ $,
Cabri et al.
[10]
6M,31±7 Trained runners (5,000 m PB
1445 ±233 s, VO
2max
: n.i.)
Socks n.i. P, R Submaximal running
(5000 m) at a velocity
of 85 % of
5,000 m PB
P: La $,HR:;
R: La removal $
Valle et al.
[47]
15 M, 25 (SD n.
i.)
Amateur soccer players (VO
2max
:
44.0 ±7.6 mlkg
-1
min
-1
)
Shorts n.i. R 40 min submaximal
treadmill running with
10% decline
R: DOMS :, damage marker :
Benefits of Compression Clothing for Runners
123
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Table 1 continued
References
(year)
Subjects (n),
sex, age (y)
[mean ±SD]
Characteristics of
participants
a
Characteristics of compression clothing Study protocol
(occasion when
compression
was applied)
Effects of compression clothing
Study population Type of
compression
clothing
Pressure applied
(mmHg)
Measure
Miyamoto
et al. [11]
15 M, 26 ±3 Healthy young individuals
(VO
2max
: n.i.)
(1) Socks (G, low
pressure)
(2) Socks (G, high
pressure)
(3) Socks (uniform
pressure
distribution)
(4) Socks (localized
pressure)
(1) 14–18
(2) 21–27
(3) 21
(4) 10–21
R 30 min submaximal
treadmill running
R: (2, 3, 4) T2 :
Bovenschen
et al. [14]
13 M, 40 ±16 Moderately trained runners
(VO
2max
: n.i.)
Socks (G) 25–35 R 10,000 m submaximal
running
Treadmill steptest until
exhaustion
R: Lower leg volume after
10,000 m and treadmill run :,
leg volume 10 min and 30 min
after 10,000 m and treadmill run
$, leg soreness $
Ferguson et al.
[21]
21 M, 21 ±1 Recreational active in intermittent
sports (predicted VO
2max
:
54 ±5mlkg
-1
min
-1
)
Socks (G) 20–40
(manufacturer’s
information)
P, R 90-min intermittent
shuttle run test
(3 920 m walking,
1920 m sprint, 4 s
recovery, 3 920 m at
75 % VO
2max
,
3920 m at 100 %
VO
2max
), subsequently
wearing compression
socks for 12 h
P: HR during exercise $
R: PMS :(24 h post exercise),
MVIC $,CK$, LDH$, IL-6
$, CRP $
Armstrong
et al. [4]
23 M, 10 F,
38 ±7
Experienced marathon runners
(marathon time: 03:58 ±0:23
[h:min], VO
2max
: n.i.)
Socks (G) 30–40
(manufacturer’s
information)
R, P Wearing compression
socks for 48 h after a
marathon, TTE
treadmill test 14 days
after marathon
P: TTE :,HR
max
$, RPE $
Hill et al. [5]17M,7F,
48 ±11
Marathon runners (VO
2max
:
53.8 ±10.2 mlkg
-1
min
-1
;
finish time: 03:46:45 ±00:22:30
[h:min:s])
Tights 9.3–9.9 R Wearing compression
tights for 72 h after a
marathon
R: PMS (24 h post) :, MVIC $,
CK $, C-reactive protein $
F. A. Engel et al.
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The compression garments employed included knee-
high socks (n=17), tights (n=10), knee-high calf
sleeves (n=4), shorts (n=3), and tights and a long-
sleeve shirt providing whole-body compression (n=1).
Sixteen studies included elite or well-trained subjects, 13
recreational athletes or participants competing at a regional
level, and three involved untrained participants. In 26 of
these investigations graduated compression, with pressure
decreasing in the distal to proximal direction, was applied.
Moreover, 27 provided information concerning the level of
pressure exerted (7–40 mmHg), six included no such
information, and five referred to information from the
manufacturer on this matter (Table 1).
The various ESs relating to the effects of applying
compression clothing during running and recovery are
illustrated in Fig. 2.
3.2 Analysis of Performance
Altogether, the findings indicate that compression cloth-
ing has little or no positive effect (mean
g=0.03 ±0.15; range -0.23 to 0.23 [13,19,20,23,
25,42]) on running performance (Table 1), as reflected in
the times for a (half) marathon, 15-km trail running, 5-
and 10-km runs and 400-m sprint. Of the 11 studies in
which the time to exhaustion in incremental or step tests
or runs until exhaustion were examined, seven reported
small mean effects of compression garments on variables
related to performance (mean g=0.27 ±0.33; range
0.01–0.96 [4,13,1517,26,43]). Three studies docu-
mented a moderate-to-large effect of compression gar-
ments (g=0.39 [16]; g=0.41 [43]; g=0.96 [4]),
whereas four found small negative effects on the time to
exhaustion (mean g-0.22 ±0.11; range -0.31 to -0.07
[12,15,18,24]).
3.3 Running Economy
In the four investigations that evaluated the influence of
calf compression sleeves [6], compression socks [18],
compression tights [15], or three different compression
garments (socks, tights, whole-body compression) [26]on
the running economy of well-trained and highly trained
runners, a small positive effect was observed (mean
g=0.21 ±0.38; range 0.00–0.88).
3.4 Biomechanical Parameters
Compression sleeves [6] and stockings [18] exerted a
small positive effect (mean g=0.21 ±0.38; range
-0.33 to 0.72 [6,18]) on biomechanical parameters (i.e.,
ground contact time, step frequency, step length, and
swing time).
Table 1 continued
References
(year)
Subjects (n),
sex, age (y)
[mean ±SD]
Characteristics of
participants
a
Characteristics of compression clothing Study protocol
(occasion when
compression
was applied)
Effects of compression clothing
Study population Type of
compression
clothing
Pressure applied
(mmHg)
Measure
Trenell et al.
[22]
11 M, 21 ±3 Recreational athletes (type of sport
not specified, VO
2max
: n.i.)
Tights (G) 10–17 R 30-min downhill
treadmill walking
(6 kmh
-1
,25%
grade; compression
48 h after exercise)
R: DOMS $, damage marker :;
$no significant effect of compression, :significant positive effect of compression, ;significant negative effect of compression, :; contradictory results: positive, as well as negative effects of
compression, BF blood flow, CK creatine kinase, CMJ counter movement jump, CP cardiac parameters (HR, cardiac output, cardiac index, stroke volume), CRP c—reactive protein, DOMS
delayed onset of muscle soreness, Ffemale, Ggraduated, HR heart rate, HR
max
maximum heart rate, HR
peak
peak heart rate, IL-6 interleukin 6, La blood lactate concentration, LDH lactate
dehydrogenase, Mmale, MVC maximal voluntary contraction, MVIC maximal voluntary isometric contraction, n.i. not indicated, Pperformance, PB personal best, PMS perceived muscle
soreness, pO
2
oxygen partial pressure, Rrecovery, RE running economy, RER respiratory exchange ratio, RPE rating of perceived exertion, SO
2
oxygen saturation, T2 skeletal muscle proton
transverse relaxation time, TT time trial, temp
amb
ambient temperature, temp body temperature, TTE time to exhaustion, V
max
maximum running velocity, VL vastus lateralis, VO
2
oxygen
uptake, VO
2max
maximal oxygen uptake, VO
2peak
peak oxygen uptake, WBC whole-body compression
a
Highly trained—national/international level and VO
2max
[65 mLkg
-1
min
-1
; well trained—VO
2max
C50 mLkg
-1
min
-1
; moderately trained—VO
2max
C45 mLkg
-1
min
-1
or running
volume [30 km/week; recreational—running volume \30 km/week
Benefits of Compression Clothing for Runners
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3.5 Physiological Parameters During Running
Whereas maximal oxygen uptake was not affected in most
cases (mean g=0.05 ±0.35; range -0.28 to 1.16 [9,12,
13,1518,26]), one study found a large positive effect on
this parameter in well-trained runners performing a test to
exhaustion (best g=1.16 [18]). In the case of parameters
related to endurance, such as submaximal oxygen uptake
(mean g=-0.01 ±0.10; range -0.21 to 0.16 [6,8,15,
26,44]), compression clothing had no effects. In most
cases there were no effects on blood lactate concentra-
tions either (mean g=-0.04 ±0.33; range -0.96 to
0.54 [13,810,12,15,16,18,26,44]), although
two studies reported moderate positive effects on this
parameter (mean g=0.49 ±0.33; range 0.46–0.54
[8,15]).
Neither blood saturation and partial pressure of oxygen
(mean g=-0.05 ±0.20; range -0.37 to 0.31 [9,12,26]
nor cardiac parameters, including heart rate, cardiac output,
cardiac index, and stroke volume, were influenced to any
great extent by the compression garments (mean
g=0.08 ±0.37; range -0.48 to 1.77 [1,3,810,12,13,
15,16,18,19,21,24,42,44]), although two studies did
observe moderate-to-large positive effects on maximal
heart rate (g=1.77 [18]) and heart rate during submaxi-
mal running (g=0.53 [10]).
Fig. 2 Hedges’ g effect sizes
(square) and associated 95 %
confidence interval (lines) of the
application of compression
clothing according to various
markers of performance and
recovery during and after
running
F. A. Engel et al.
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3.6 Body and Perceived Temperature
Body core temperature during and after running was
affected to small and moderate extents by compression
clothing in two studies [20,45], with no effect on body
temperature (p=0.00) (mean g=0.24 ±0.21; range
0.00–0.41 [20,45]). Although in one case the perceived
temperature during running with compression was not
altered (g=0.00 [25]), Vencku
¯nas and colleagues [42]
detected a moderate negative effect on perceived
body temperature during 30 min of submaximal running
(g=-0.32).
3.7 Psychological Variables While Running
The overall effect of compression clothing on perceived
exertion during running was small but positive (mean
g=0.28 ±0.38; range -0.31 to 1.21 [13,7,13,1820,
2326,42,4446]), although certain investigations showed
moderate-to-large positive effects [2,23,26,45] and others
small-to-moderate negative [19,20] or no effects [7,13,
18,24,25,42].
3.8 Responses After Running
3.8.1 Recovery of Parameters Related to Performance
The present analysis revealed trivial, small, moderate, and
large positive, as well as small and large negative effects
on recovery in strength-related tasks such as jumping after
running (mean g=0.02 ±0.33; range -0.64–0.53 [13,
7,19,44]). Single and repeated jumping performance
(counter movement jump) following different running
protocols was associated with small to large negative
effects [1], as well as small [7,20], moderate [19], and
large [3] positive effects.
Maximal voluntary isometric contraction and peak leg
muscle power immediately after running were somewhat
greater with than without compression garments (mean
g=0.19 ±0.22; range -0.05 to 0.53 [2,3,5,1921]).
Leg strength following running protocols as reflected in
maximal voluntary (isometric) contractions and isometric
knee extensor torque, showed trivial negative effects [3,
21], as well as trivial [2], small [19,20], moderate [5], and
large [3] positive effects.
3.8.2 Clearance of Blood Lactate
Clearance of blood lactate following running exhibited a
small positive effect (mean g=0.29 ±0.32; range -0.02
to 0.62 [10,13]).
3.8.3 Markers of Muscle Damage
On average, compression clothing exerted a small effect on
post-exercise levels of creatine kinase, a marker for mus-
cle-damage (mean g=0.11 ±0.47; range -0.42 to 0.73
[2,5,19,20]. In three studies this effect was moderate-to-
large and positive (range 0.35–0.73 [2,5,20] and in
another small-to-moderate negative at three different time-
points (1, 24, and 48 h) after exercise [19]. For other
markers of muscle damage, such as serum levels of myo-
globin, interleukin 6, and C-reactive protein, both trivial
negative [19] as well as trivial, moderate, and large positive
effects were detected [2,5,19,20]. The overall average ES
for different inflammatory markers was small and positive
(mean g=0.24 ±0.44; range -0.09 to 1.14 [2,5,19,
20]).
3.8.4 Perceived Muscle Soreness
Compression exerted a large positive effect on post-exer-
cise leg soreness and delay in the onset of muscle fatigue
(mean g=0.67 ±1.06; range -0.44 to 3.80 [2,5,14,19,
20,22,23,26,47]).
4 Discussion
Compression clothing led to trivial [1,3,19,20,25,42]
and small [1,2,20,23] ES values in connection with
running performance (400 m to 42,195 km). Comparable
ES values for improving time to exhaustion were obtained
in eight studies [12,13,15,18,24,43], whereas three
others reported moderate-to-large values [4,16,43]. This
degree of improvement is in line with that reported by Born
and colleges [29], as well as with the influence of com-
pression garments on performance in other disciplines such
as cycling and repeated sprinting.
From a physiological point of view and depending on
the duration and environmental conditions, performance
during running is determined mainly (although not exclu-
sively) by the athlete’s peak oxygen uptake, fractional
utilization of VO
2peak
, velocity at the lactate threshold,
running economy (including biomechanical factors [48],
and heat exchange processes [49]). Other physiological
mechanisms of relevance in this context include enhanced
hemodynamics, i.e., elevated venous return [50,51], arte-
rial inflow [52], and lymphatic outflow [53]. Since our
statistical analysis revealed that the ES between compres-
sion and non-compression running for peak oxygen uptake,
oxygen uptake, and blood lactate was trivial, a runner will
most probably not benefit from compression in these
respects.
Benefits of Compression Clothing for Runners
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However, the small positive ES for body temperature,
running economy, and biomechanical variables during
running indicate a potential (small) benefit of compression
with regard to running economy (due potentially to altered
biomechanics). This is consistent with previous reports [28,
29] that compression clothing improves neuro-mechanical
parameters, including lower presynaptic inhibition [54,55]
and coordinative function [56], as well as recruitment of
fewer muscle fibers [45,57].
In contrast to performance and physio-biomechanics,
compression appears to exert positive effects on the psycho-
logical parameters examined, i.e., a small positive effect on
perceived exertion [13,7,13,1820,2326,42,4446], as
well as a large positive effect regarding leg soreness [2,5,14,
19,20,22,23,26,47] both during running and recovery. As
described previously [29], this psychological improvement
may be a result of (1) attenuated oscillatory displacement ofthe
leg muscles [57,58], (2) a reduction in the number of muscle
fibers recruited [59], (3) less structural damage to muscles [47,
60], and/or (4) improved lymphatic outflow leading to less
muscle swelling and, thereby, greater comfort [53]. Since it is
difficult to design an appropriate placebo conditionfor wearing
compression garments, the possibility that the improvement
in psychological parameters is influenced by more positive
perceptions and the participants’ intuitions concerning
the results to be expected cannot be excluded.
The mean serum levels of creatine kinase were reduced
in all of the studies (small ES), indicating that compression
may help diminish structural damage to muscle and facil-
itate the clearance of metabolites through improved lym-
phatic outflow. The analytical review by Hill and
colleagues [30] found higher (moderate) ES values for
post-exercise levels of creatine kinase, but their investi-
gation involved vertical jumping, repeated sprinting, and
resistance training, rather than running. These effects have
been attributed to attenuated release of creatine kinase into
the blood and improved clearance of metabolites [61], as
well as better muscle repair [62]. Furthermore, improve-
ment of the pump function of muscles by compression
clothing (described in detail by Born et al. 2013 [29]) may
enhance circulation and thereby removal of creatine kinase.
In this connection it is important to note that we also cal-
culated increases (small ES) in the temperatures of both
muscles and the whole body [20,45] with compression.
Since biochemical processes are controlled by temperature,
these changes may also contribute to the differences in
physiological and psychological variables.
The various hemodynamic (venous return and arterial
inflow) and neural mechanisms and mechanical properties
by which compression enhances performance and recovery
have been described in detail previously [28,29]. Since the
methods (apparatus, study design, intensity and duration of
running, range of compression) employed in the different
studies examined here varied, we have refrained from
meta-analysis. However, unlike Born [29], we have
focused on running only and the reasonably large number
of studies (n=32) involving 494 participants analyzed
here provides an adequate overview (Fig. 2) of the
responses of various parameters of importance for running
performance and recovery to compression.
5 Conclusions
On the basis of the mean ES-values for variables related to
performance and recovery calculated from 32 studies, we
conclude that compression exerts a trivial mean effect on
running performance (times for a (half) marathon, 15-km
trail running, 5- and 10-km runs and 400-m sprint), max-
imal and submaximal oxygen uptake, blood lactate con-
centrations, blood gas kinetics, cardiac parameters
(including heart rate, cardiac output, cardiac index, and
stroke volume), and body and perceived temperature, or on
the performance of strength-related tasks after running.
Small positive effects were observed for the time to
exhaustion (in incremental or step tests), running economy
(including the biomechanical variables ground contact
time, step frequency, step length, and swing time), clear-
ance of blood lactate, perceived exertion, maximal volun-
tary isometric contraction and peak leg muscle power
immediately after running, and markers of muscle damage
and inflammation. Body core temperature was calculated to
be moderately affected by compression. The ES values for
post-exercise leg soreness and the delay in onset of muscle
fatigue indicated large positive effects of compression.
Apparently, by wearing compression garments runners
might slightly improve variables related to endurance
performance (i.e., time to exhaustion), due to improve-
ments in running economy, biomechanical variables, per-
ception, and muscle temperature. They should also benefit
from reduced muscle pain, damage, and inflammation
during recovery.
Compliance with Ethical Standards
Funding Financial support for the collection and analysis of data
was received from the Nike Company. However, this company did
not influence preparation of the manuscript in any way.
Conflict of interest Florian Engel, Hans-Christer Holmberg, and
Billy Sperlich declare that they have no conflicts of interest relevant
to the content of this review.
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... Studies have also reported neurobiomechanical evidence for improved precision of movement (Hooper et al., 2015), increased responsiveness and movement-related cortical potentials (Lee et al., 2017) when wearing CGs. The current consensus appears to indicate that the compression may not directly enhance strength or power output, but it could influence neural control through its physical benefits of pressurization, providing stability, and proprioceptive input (Engel et al., 2016;Lee et al., 2017). ...
... This finding is consistent with our hypothesis and previous studies that during single or short-term exercise. For example, no differences were observed in 60 m and 400 m sprint time while wearing CGs (Doan et al., 2003;Engel, Holmberg, and Sperlich, 2016). Another study's findings support this concept: Initially, CGs did not enhance sprint performance. ...
... Likewise, our investigation revealed that the immediate application of CGs led to changes in hip and knee joint kinematics (Figure 1), Based on the above evidence, we speculate that the effect of CGs indeed exists and influences performance through muscle management (i.e., the muscle synergy under the control of the nervous system). In review of previous research on CGs, these effects may demonstrate benefits in prolonged exercise (these benefits may be manifested in both kinetic (Born et al., 2014) and physiological (Engel, Holmberg, and Sperlich, 2016; aspects). Therefore, the key point is that our findings of changes in muscle synergies may be able to bridge the gap between these evidences. ...
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The utilization of compression garments (CGs) has demonstrated the potential to improve athletic performance; however, the specific mechanisms underlying this enhancement remain a subject of further investigation. This study aimed to examine the impact of CGs on running mechanics and muscle synergies from a neuromuscular control perspective. Twelve adult males ran on a treadmill at 12 km/h, while data pertaining to lower limb kinematics, kinetics, and electromyography were collected under two clothing conditions: whole leg compression garments and control. The Non-negative matrix factorization algorithm was employed to extract muscle synergy during running, subsequently followed by cluster analysis and correlation analysis. The findings revealed that the CGs increased knee extension and reduced hip flexion at foot strike compared with the control condition. Moreover, CGs were found to enhance stance-phase peak knee extension, while diminishing hip flexion and maximal hip extension during the stance-phase, and the ankle kinematics remained unaltered. We extracted and classified six synergies (SYN1-6) during running and found that only five SYNs were observed after wearing CGs. CGs altered the structure of the synergies and changed muscle activation weights and durations. The current study is the first to apply muscle synergy to discuss the effect of CGs on running biomechanics. Our findings provide neuromuscular evidence for the idea of previous studies that CGs alter the coordination of muscle groups, thereby affecting kinematic characteristics during running.
... These findings are further supported by the metaanalyses of Machado et al. (2018), andHill et al. (2014), which also identified a significant reduction in creatine kinase (CK) levels associated with the use of compression garments, suggesting an acceleration in muscle recovery process and a reduction in delayed onset muscle soreness (DOMS). It has been found that the use of compression garments enhances the economy of sports movements, promotes better management of soft tissues, reduces post-exercise limb swelling, and tends to lower blood lactate levels during physical activity (Leabeater, James & Driller, 2022;Engel, Holmberg & Sperlich, 2016). While not showing a significant impact on overall endurance performance, the use of compression garments has shown positive effects on specific sports variables, such as counter-movement jump height (Leabeater, James & Driller, 2022). ...
... The combination of these factors might contribute to reducing the perception of exertion during physical exercise, allowing athletes to maintain higher activity intensities or complete a greater volume of work during training (Loturco et al., 2016). It is important to consider that the results obtained in this study are consistent with other studies in the scientific literature that have reported improvements in muscle pain perception, RPE, and/or fatigue with the use of compression garments during physical exercise (Engel, Holmberg & Sperlich, 2016;Rugg & Sternlicht, 2013;MacRae, Cotter & Laing, 2011). However, there are also studies that report contrasting results (Mizuno et al., 2017;Venckūnas et al., 2014;Del Coso et al., 2014;Houghton, Dawson & Maloney, 2009;Bringard, Perrey & Belluye, 2006). ...
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Compression garments have gained popularity in the sports world as a means to enhance athletic performance and accelerate recovery. This study investigates the effectiveness of upper-body compression garments and their impact on the rate of perceived exertion (RPE) during maximal isometric contractions. Eight adult males, students of a Master's degree program in Sports Sciences, participated in the study, conducting tests in controlled conditions at the University of Salerno. The subjects performed maximal isometric contractions in three separate sessions, wearing compression garments (CG), traditional sportswear (noCG), and a tight-fitting garment without compression effect, to minimize the placebo effect (Placebo), respectively. Perceived exertion was assessed using the modified CR-10 scale. Statistical analysis revealed a significant reduction in RPE when athletes wore compression garments compared to other conditions, suggesting a benefit in the use of such clothing. The findings indicate that compression garments can attenuate the perception of exertion during intense physical activities, with potential implications for performance, comfort, and recovery. This study contributes to the existing literature by expanding the understanding of the effects of compression clothing and highlighting the importance of further research to optimize the use of these garments in enhancing athletic performance.
... The most frequently used outcome variables were selected for further analysis. The results were assessed using criteria from Born et al. (2013) and Engle et al. (2016) [23,24] and divided into four categories: positive effects (↑), negative effects (↓), no effect (↔), or contradictory effects (↑↓) of positive as well as negative effects (see Additional file 4: Table S4). ...
... Nineteen reviews focused on passive recovery, of which eight examined the effects of nutrition or nutrition supplements [25-27, 33, 35, 37, 44, 45], six reviews conducted research on cryotherapy [28,30,36,38,40,42] and three reviews focused on the use of CG [24,29,39]. Two reviews focused on the effects of massage [31,43] (see Table 1). ...
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Background Recovery strategies are used to enhance performance and reduce injury risk in athletes. In previous systematic reviews, individual recovery strategies were investigated to clarify their effectiveness for mixed groups of athletes. However, the current evidence is ambiguous, and a clear overview of (training) recovery for endurance athletes is still lacking. Methods We conducted an umbrella review based on a literature search in PubMed, Cochrane Database of Systematic Reviews, and Web of Science. Reviews published in English and before December 2022 were included. Systematic reviews and meta-analyses were eligible if they investigated the effectiveness of one or more recovery strategies compared with a placebo or control group after a training session in endurance athletes. Results Twenty-two reviews (nine systematic reviews, three meta-analyses, and ten systematic reviews with meta-analyses included) met the inclusion criteria. In total, sixty-three studies with 1100 endurance athletes were included in our umbrella review. Out of the sixty-three studies, eight provided information on training recovery time frame for data synthesis. Among them, cryotherapy and compression garments showed positive effects, while applying massage showed no effect. In general, none of the included recovery strategies showed consistent benefits for endurance athletes. Conclusion There is no particular recovery strategy that can be advised to enhance recovery between training sessions or competitions in endurance athletes. However, individual studies suggest that compression garments and cryotherapy are effective training recovery strategies. Further research should improve methodology and focus on the different time courses of the recovery process. Registration The review protocol was registered with the International Prospective Register of Systematic Reviews with the number CRD42021260509.
... As such, indicating that CGs with a constant pressure might help reduce fatigue after a running test. In their meta-analysis, Engel et al. (2016) reported, based on 16 original studies, small but positive effects of wearing lower extremity CGs during running on perceived exertion in recreational, well trained, and elite runners (Hedges' g = 0.28±0.38 mean±SD; range -0.31 to 1.21) (16). ...
... In their meta-analysis, Engel et al. (2016) reported, based on 16 original studies, small but positive effects of wearing lower extremity CGs during running on perceived exertion in recreational, well trained, and elite runners (Hedges' g = 0.28±0.38 mean±SD; range -0.31 to 1.21) (16). However, their review did not distinguish between different types of CGs (i.e. ...
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The objective of this study was to systematically review the literature on the effect of CGs versus non-CGs (such as regular socks) or versus placebo garments on 1) the incidence of lower extremity sports injuries and 2) subjective ratings of fatigue and biomechanical variables in athletes at participating in any sport that required any level of running performance, given that fatigue-related biomechanical alterations may increase the risk of sports injuries. This study was a systematic review with meta-analyses. PubMed, Embase, CINAHL, Cochrane, PEDro, and Scopus were searched for eligible studies until 7 July 2021. Two reviewers independently assessed the risk of bias using the Cochrane Collaboration’s tool for risk of bias. Meta-analyses were performed using a random-effects model. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence for all outcome measures. Twenty-three studies, all with a high risk of bias, were included. Nineteen studies were used in the meta-analyses. No studies focused on the effect of CGs on the incidence of lower extremity sports injuries in athletes. Seventeen studies investigated the effect of CGs on subjective ratings of fatigue, but meta-analysis showed no difference in effectiveness between CGs versus non-CGs (such as regular socks) and versus placebo CGs (low certainty evidence). Because of heterogeneity, pooling of the results was not possible for the biomechanical variables. Nonetheless, low certainty evidence showed no effect of CGs. We identified no evidence for a beneficial or detrimental effect of lower leg CGs on the occurrence of lower extremity sports injuries, subjective ratings of fatigue, or biomechanical variables in athletes at any level of running performance. Based on the variable use of running tests, definitions used for biomechanical variables, and reporting of CG characteristics and more standardized reporting is recommended for future studies evaluating CGs.
... Reasons might be the source of information or the athletes' knowledge on the potential benefits of recovery strategies. In general, a number of reviews on a variety of recovery strategies were published, for example, carbohydrate and protein feeding, 13 stretching, 14 massage, 15 hydrotherapy, 16 wholebody cryotherapy, 17 wearing CG, 18 and sleep. 19 Understanding the sources from which athletes and coaches derive their recovery strategies can also deepen our understanding of the current state of recovery at its source. ...
Article
Purpose : This study explored endurance athletes’ and coaches’ views on recovery strategies, focusing on their use across competition levels, perceived importance and effectiveness, and common barriers. Methods : Endurance athletes (26.6% international, 35.7% national, 28.7% regional, and 9.1% other levels; mean experience 10.04 [7.84] y, n = 143) and coaches (mean experience 17.45 [12.44] y, n = 20) completed an online survey on frequency of usage, perceived importance, effectiveness, and common barriers of 25 recovery strategies. Data were coded and analyzed thematically. A Fisher exact test ( P < .05) was conducted on 5-point Likert-scale responses. Results : Predominant strategies among athletes were hydration, hot showers, and carbohydrate (mean scores 4.62 [0.60], 4.32 [0.82], and 4.17 [0.87]). Only antioxidants showed significant variation in use across levels ( P = .033). Coaches favored warm-down/cooling (4.56 [0.62]), hydration (4.41 [0.80]), and extra protein (4.12 [0.70]). Both groups ranked hydration as most important and effective. Athletes ranked extra protein and warm-down/cooling second and third, while coaches considered extra sleep/naps, warm-down/cooling, and extra protein equally important. Barriers of both populations included insufficient time (14.41%), limited knowledge (13.72%), lack of resources (12.63%), and skepticism regarding benefits and effectiveness (12.63%). Conclusions : Athletes show no significant differences in recovery choices based on competitive level, except for antioxidants. Coaches and athletes have partially different views on effective recovery. Furthermore, a lack of time, as well as a lack of (shared) knowledge and education, hinders the effective implementation of recovery strategies for athletes.
... One such piece of equipment is the compression garment. Currently, compression garments are widely used among athletes despite a lack of literature to support their overall effectiveness [4][5][6]. While preliminary research has highlighted some benefits of compression garments, additional work needs to explore their potential impact on performance and the underlying mechanisms. ...
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To the purpose of this study was to compare muscle oscillation, muscle activation time, and oxygen consumption while wearing compression pants vs. a control garment during running. Methods. Eleven injury-free and recreationally active participants (26.73 ± 12.74 years) were recruited for this study. Participants ran in full-leg compression pants (COMP) and a loose-fitting control garment (CON). Participants ran for 6 min at three submaximal speeds: preferred speed (PS), preferred speed minus 10% (PS − 10%), and preferred speed plus 10% (PS + 10%). The muscle activity of the leg was measured through electromyography (EMG). Muscle oscillation (MO) was measured with accelerometers attached to the thigh and shank. The rate of oxygen consumption (V.O2) and heart rate (HR) were recorded during each condition. MO was assessed over the 0–60 Hz range by averaging power across 10 Hz bins per leg segment. EMG data was processed to identify the activation time. Following each condition, a belief score was recorded. Dependent variables were each compared between conditions using 2 (garment) × 3 (speed) repeated measure ANOVAs (α = 0.05). The relationship between the belief score and dependent variables (compression-control) was analyzed using Pearson’s product-moment correlation (α = 0.05). Results. MO was lower with the full-leg compression pants vs. the control garment (p < 0.05). The muscle activation time for each muscle was shorter while wearing the full-leg compression pants (p < 0.05). Neither the V.O2, RPE, SF, nor the HR were influenced by the garments (p > 0.05). There was no significant correlation between changes in the dependent variables and belief. Conclusion. Wearing compression pants resulted in reduced MO and activation time; however, these changes did not translate into a reduction in V.O2.
... In clinical settings, CGs are used to promote blood flow from superficial veins into deep veins and prevent cutaneous venous statis (Mayberry et al., 1991), though these circulatory changes have generally not been demonstrated in settings when CGs are worn during exercise (Rennerfelt et al., 2019). Other potential mechanisms of CGs that may influence exercise performance include compressive support for large muscle bellies (Doan et al., 2003) and a reduction in soft tissue movement (Broatch et al., 2020), both of which have the potential to reduce energy expenditure by the athlete and lessen exercise-induced inflammation and muscle damage (Brophy-Williams et al., 2019;Engel et al., 2016). In turn, this may contribute to improvements in subsequent exercise bouts, as shown in running time trial performance (Brophy-Williams et al., 2019) and repeated vertical jump performance (Duffield et al., 2010). ...
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Compression garments are commonly used during athletic tasks. However, the effect of compression garments on balance, sprinting, jumping and change of direction performance requires further investigation. In the current study, 24 recreationally active participants (12 males, 12 females, age 27 ± 3 years) completed single-leg balance tasks, countermovement jumps, drop jumps, 10 m straight line sprints and change of direction tasks wearing either compression tights (COMP) or regular exercise tights (CON). There was a significant main effect of the condition for 10 m sprint time (p = 0.03, d =-0.18) and change of direction time (p = 0.03, d =-0.20) in favour of COMP. In addition, there was a significant, small difference (p = 0.05, d =-0.30) in ellipse area and a small (p = 0.16, d = 0.21) difference in balance time in favour of COMP during a single-leg balance task. There were no significant differences between trials for any of the other balance or jump tests (p > 0.05). The application of compression tights during exercise may offer small benefits to the performance of balance and change of direction tasks, though these benefits are likely within the typical error of measurement for the tests used. ARTICLE HISTORY
Article
Purpose The circular design process in contemporary fashion design, from two-dimensional (2D) sketching and pattern making to three-dimensional (3D) prototypes, can be facilitated by virtual prototyping. Virtual pressure representations on avatars provide visual and quantitative information regarding garment fit and comfort, which are particularly important for active wear. The purpose of this study is to investigate the benefits of using avatars in active poses from 3D body scans and the use of digital 3D tools for the design process and the prediction of fit of active wear. Design/methodology/approach This research initially explores virtual fit of cycling wear in active poses and compares the actual pressure values from humans with virtual pressure maps on custom avatars made from body scans in cycling poses across a range of sizes. Findings Similar fit results were achieved visually in both the standing and cycling poses. However, the comparisons showed no correlation between the actual and virtual pressure data. Of the 32 cases representing different combinations of the parameters of this research (four sizes, two garment types, four active poses), the differences were significant. The results suggest that, rather than providing a direct correlation with pressure values on the body, the main value of avatar data is in providing comparative visual support for fit evaluation. Originality/value The approach taken in this research, which considers the active pose and the size range, potentially contributes to the improvement of virtual fit technology, and its more effective use in apparel product development and fit evaluation.
Article
Compression socks have an effective role in the performance activity of athletes. This study aims to quantify the effect of fiber materials and structure on physical, mechanical, thermo-physiological, sensorial, and ergonomic comfort on sports graduated compression socks (SGCS). Two natural fibers, cotton and viscose, and two synthetic fibers, Coolmax and acrylic, were used to develop three different types of SGCS. Data have been analyzed by full factorial design of experiment. The finding exhibited that Coolmax-based socks have better moisture management and dimensional properties as compared with other materials. Acrylic-based SGCS are better to use in winter because of their higher thermal resistance, besides moderate moisture management. Moreover, it is verified that higher bursting strength is achieved by using higher-strength fibers. Additionally, it was observed that the effect of structure and material on desired properties without compromising compression/interface pressure is statistically significant. The overall properties of the developed stockings are better in terms of properties than market stockings. For all the socks, compression pressure between 15 and 20mmHg, as per requirements of sports socks, was maintained. The effect of materials and structure on the aforementioned responses were examined using analysis of variance statistical analysis. The functional properties are greatly influenced by the material and structure. In this study, the comfort properties are considered to play a major functional role regarding usage by the end user. Its use not only maintained blood circulation by applying external pressure but also defended against unexpected harm or damage of vessels because of high pooling of blood during sports, running, or performance. This study will help to select suitable structure and materials for comfortable SGCS and is expected to fulfill the potential requirements of the athletes.
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Compression socks have become a popular recovery aid for distance running athletes. Although some physiological markers have been shown to be influenced by wearing these garments, scant evidence exists on their effects on functional recovery. This research aims to shed light onto whether the wearing of compression socks for 48 hours after marathon running can improve functional recovery, as measured by a timed treadmill test to exhaustion 14 days following marathon running. Athletes (n = 33, age, 38.5 ± 7.2 years) participating in the 2012 Melbourne, 2013 Canberra, or 2013 Gold Coast marathons were recruited and randomized into the compression sock or placebo group. A graded treadmill test to exhaustion was performed 2 weeks before and 2 weeks after each marathon. Time to exhaustion, average and maximum heart rates were recorded. Participants were asked to wear their socks for 48 hours immediately after completion of the marathon. The change in treadmill times (seconds) was recorded for each participant. Thirty-three participants completed the treadmill protocols. In the compression group, average treadmill run to exhaustion time 2 weeks after the marathon increased by 2.6% (52 ± 103 seconds). In the placebo group, run to exhaustion time decreased by 3.4% (-62 ± 130 seconds), P = 0.009. This shows a significant beneficial effect of compression socks on recovery compared with placebo. The wearing of below-knee compression socks for 48 hours after marathon running has been shown to improve functional recovery as measured by a graduated treadmill test to exhaustion 2 weeks after the event.
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This article investigates whether there is currently sufficient scientific knowledge for scientists to be able to give valid training recommendations to longdistance runners and their coaches on how to most effectively enhance the maximal oxygen uptake, lactate threshold and running economy. Relatively few training studies involving trained distance runners have been conducted, and these studies have often included methodological factors that make interpretation of the findings difficult. For example, the basis of most of the studies was to include one or more specific bouts of training in addition to the runners’ ‘normal training’, which was typically not described or only briefly described. The training status of the runners (e.g. off-season) during the study period was also typically not described. This inability to compare the runners’ training before and during the training intervention period is probably the main factor that hinders the interpretation of previous training studies. Arguably, the second greatest limitation is that only a few of the studies included more than one experimental group. Consequently, there is no comparison to allow the evaluation of the relative efficacy of the particular training intervention. Other factors include not controlling the runners’ training load during the study period, and employing small sample sizes that result in low statistical power. Much of the current knowledge relating to chronic adaptive responses to physical training has come from studies using sedentary individuals; however, directly applying this knowledge to formulate training recommendations for runners is unlikely to be valid. Therefore, it would be difficult to argue against the view that there is insufficient direct scientific evidence to formulate training recommendations based on the limited research. Although direct scientific evidence is limited, we believe that scientists can still formulate worthwhile training recommendations by integrating the information derived from training studies with other scientific knowledge. This knowledge includes the acute physiological responses in the various exercise domains, the structures and processes that limit the physiological determinants of long-distance running performance, and the adaptations associated with their enhancement. In the future, molecular biology may make an increasing contribution in identifying effective training methods, by identifying the genes that contribute to the variation in maximal oxygen uptake, the lactate threshold and running economy, as well as the biochemical and mechanical signals that induce these genes. Scientists should be cautious when giving training recommendations to runners and coaches based on the limited available scientific knowledge. This limited knowledge highlights that characterising the most effective training methods for long-distance runners is still a fruitful area for future research.
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Compression garments on the lower limbs are increasingly popular among athletes who wish to improve performance, reduce exercise-induced discomfort, and reduce the risk of injury. However, the beneficial effects of compression garments have not been clearly established. We performed a review of the literature for prospective, randomized, controlled studies, using quantified lower limb compression in order to (1) describe the beneficial effects that have been identified with compression garments, and in which conditions; and (2) investigate whether there is a relation between the pressure applied and the reported effects. The pressure delivered were measured either in laboratory conditions on garments identical to those used in the studies, or derived from publication data. Twenty three original articles were selected for inclusion in this review. The effects of wearing compression garments during exercise are controversial, as most studies failed to demonstrate a beneficial effect on immediate or performance recovery, or on delayed onset of muscle soreness. There was a trend towards a beneficial effect of compression garments worn during recovery, with performance recovery found to be improved in the five studies in which this was investigated, and delayed-onset muscle soreness was reportedly reduced in three of these five studies. There is no apparent relation between the effects of compression garments worn during or after exercise and the pressures applied, since beneficial effects were obtained with both low and high pressures. Wearing compression garments during recovery from exercise seems to be beneficial for performance recovery and delayed-onset muscle soreness, but the factors explaining this efficacy remain to be elucidated.
Article
Full-text available
Compression socks have become a popular recovery aid for distance running athletes. Although some physiological markers have been shown to be influenced by wearing these garments, scant evidence exists on their effects on functional recovery. This research aims to shed light onto whether the wearing of compression socks for 48 hours after marathon running can improve functional recovery, as measured by a timed treadmill test to exhaustion 14 days following marathon running.Athletes (n=33, age = 38.5 ±7.2yrs) participating in the 2012 Melbourne, 2013 Canberra or 2013 Gold Coast marathons were recruited and randomised into the compression sock or placebo group. A graded treadmill test to exhaustion was performed 2 weeks prior and 2 weeks following each marathon. Time to exhaustion, average and maximum heart rates were recorded. Participants were asked to wear their socks for 48 hours immediately after completion of the marathon. The change in treadmill times (seconds) was recorded for each participant.33 participants completed the treadmill protocols. In the compression group average treadmill run to exhaustion time 2 weeks following the marathon increased by 2.6% (52s ±103s). In the placebo group run to exhaustion time decreased by 3.4% (-62s ±130s). P=0.009. This shows a significant beneficial effect of compression socks on recovery compared to placebo.The wearing of below knee compression socks for 48 hours after marathon running has been shown to improve functional recovery as measured by a graduated treadmill test to exhaustion 2 weeks following the event.
Article
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Purpose: Compression garments are often worn during exercise and allegedly have ergogenic and/or physiological effects. In this study, we compared hemodynamics and running performance while wearing compression and loose-fit breeches. We hypothesized that in neutral-warm environment compression breeches impair performance by diminishing body cooling via evaporative sweat loss and redistributing blood from active musculature to skin leading to a larger rise in body temperature and prolonging recovery of hemodynamics after exercise. Methods: Changes in hemodynamics (leg blood flow, heart rate, and blood pressure during orthoclinostatic test), calf muscle tissue oxygenation, and skin and core temperatures were measured in response to 30 min running (simulation of aerobic training session) followed by maximal 400 m sprint (evaluation of running performance) in recreationally active females (25.1 ± 4.2 yrs; 63.0 ± 8.6 kg) wearing compression or loose-fit breeches in randomized fashion. Results: Wearing compression breeches resulted in larger skin temperature rise under the garment during exercise and recovery (by about 1 °C, P < 0.05; statistical power > 85%), while core temperature dynamics and other measured parameters including circulation, running performance, and sensations were similar compared to wearing loose-fit breeches (P > 0.05). Conclusion: Compared with loose-fit breeches, compression breeches have neither positive nor negative physiological and performance effects for females running in thermoneutral environment.
Article
Study design: Case-control study; ecological study. Objectives: To examine the efficacy of wearing compression stockings to prevent muscle damage and to maintain running performance during a marathon competition. Background: Exercise-induced muscle damage has been identified as one of the main causes of the progressive decrease in running and muscular performance found during marathon races. Methods: Thirty-four experienced runners were pair-matched for age, anthropometric data, and best race time in the marathon, and randomly assigned to a control group (n = 17) of runners who wore conventional socks or to a group of runners who wore foot-to-knee graduated compression stockings (n = 17). Before and after the race, a sample of venous blood was obtained, and jump height and leg muscle power were measured during a countermovement jump. Serum myoglobin and creatine kinase concentrations were determined as blood markers of muscle fiber damage. Results: Total race time was not different between the control group and the compression stockings group (210 ± 23 and 214 ± 22 minutes, respectively; P = .58). Between the control group and the compression stockings group, postrace reductions in leg muscle power (-19.8% ± 17.7% versus -24.8% ± 18.4%, respectively; P = .37) and jump height (-25.3% ± 14.1% versus -32.5% . 20.4%, respectively; P = .27) were similar. At the end of the race, there were no differences between the control group and the compression stockings group in serum myoglobin (568 ± 347 ng·mL(-1) versus 573 ± 270 ng·mL(-1), respectively; P = .97) and creatine kinase concentration (390 ± 166 U·L(-1) versus 487 ± 227 U·L(-1), respectively; P = .16). Conclusion: The use of compression stockings did not improve running pace and did not prevent exercise-induced muscle damage during the marathon. Wearing compression stockings during long-distance running events is an ineffective strategy to avoid the deleterious effects of muscle damage on running performance. Level of evidence: Therapy, level 2b.
Article
Most sporting compression stockings possess a graduated pressure profile. However, it remains unclear whether the graduated pressure profile is an essential feature for reducing the development of muscle fatigue. This study sought to examine the effect of the pressure profile of compression stockings on the degree of muscle fatigue of lower leg muscles induced by submaximal running exercise. 15 male subjects performed 30-min treadmill running in 1 control and 4 compression stocking conditions with the following profiles; 1) graduated low pressure, 2) graduated high pressure, 3) uniform pressure distribution, and 4) localized pressure just over the gastrocnemius muscle belly. Before and immediately after the exercise, T2-weighted magnetic resonance images of the right lower leg were obtained without testing garments. T2 values of the triceps surae and tibialis anterior were calculated from the images. T2 was significantly increased after the running in all conditions. The magnitude of T2 increase was significantly greater in the control than in other 3 conditions except for the one with graduated low pressure, whereas there were no significant differences among the latter 3 conditions. The findings suggest that a graduated pressure profile is not an essential feature of compression stockings for reducing the development of muscle fatigue during submaximal running exercise.