What about Compression Garments?

Amateur and pro athletes alike are wearing compression gear and using compression machines to (hopefully) improve their performance and/or speed up their recovery. But do these skin-tight suits really do anything?

Compression Clothing – Coles notes

What was once an industry supported by professionals who spend the majority of their time on their feet (read: nurses and waitstaff), these skin-tight (or tighter) pants, socks, sleeves and so on have gained popularity beyond the all-night medical staff and local diners.

Compression garments are often marketed and sold as a type of (magical) second skin that promises to “improve your athleticism.” When reading the ads you might believe that by simply tossing on a pair of tight pants or socks you are suddenly going to be able to run faster, jump higher, and lift heavier. But – surprise, surprise – it is not really that simple (or easy).

To start with, compression gear doesn’t provide enough support to make your muscles perform any different than normal. Despite what it feels like, that invincible feeling you get from sliding on those hardcore-looking socks is mostly in your head. Your muscles may feel more supported, but that support is minimal. We’ll get into that later.

Next, while some compression gear manufacturers promote their products as a quick and easy way to get the appearance of a flat belly, enhanced chest, or slim legs, the fitness industry has marketed their compression gear more specifically for muscle recovery and physical performance.

So, even though we see compression gear being worn by everyone from NBA Players to Triathletes these days, the studies and science of using these garments during an event is hard to nail down. Some researchers say that wearing compression socks or pants during a workout or event can help decrease muscle vibrations (which can cause muscle bruising) and other researchers say that the benefits of compression are mostly related to improved blood flow and circulation.

On the other hand, evidence that wearing these garments after or between workouts and events can improve workout recovery is more substantial. These researchers say that if you wear them after exercise, that extra tightness around your body has been shown to reduce delayed onset muscle soreness by promoting optimal blood flow to those muscles that get beat up during exercise.   

What Does Science Say?

Don’t worry, I am not going to bore you by recounting all 17 studies that I just pored over on whether or not compression garments help with performance or recovery — or both. But I will give you a quick summary of the results.

Let’s start with the results of the studies where the athletes wore compression socks during the workout.

Compression During Exercise?

1. There was no significant difference in 10km times, heart rate, or blood lactate levels regardless of the type of stocking worn.
2. There were no significant differences in oxygen uptake, heart rate, or blood lactate during the runs. There were no benefits post-exercise.
3. There were no differences in performance or other measures except for muscle soreness which was less after using the compression stockings.
4. There was no performance enhancement in the time trial (as measured by total work achieved in kilojoules).
5. There were no differences in performance, ratings, of perceived exertion, muscle soreness, time to exhaustion, and lactate concentrations.
6. There were greater distances covered and faster velocities, although the enhancements were minimal.

Now let’s look at the results from the studies where the athletes wore the compression garments as a recovery tool.

Compression and Recovery?

These are a little more mixed.

1. The decrease in max power was less when the compression stockings were worn during the preceding recovery and lactate was significantly decreased with the compression stockings also.
2. After 10km running trials, recreationally active men experienced a reduction in delayed-onset muscle soreness 24 hours after wearing compression stockings (18-22 mmHg) compared with traditional sports socks.
3. For the first experiment (VO2 max tests) there was no difference in VO2 max with or without compression stockings. But blood lactate levels after the test were lower with compression stockings. For the second experiment (3-minute max efforts) post-exercise lactate was lower only when compression stockings were worn during recovery.
4. Cold-water produced better recovery results than carbs + stretching or the compression garments.
5. Post-exercise lactate removal was significantly faster with compression stockings.
6. Compression stockings improved all markers of recovery except for creatine kinase (a marker of muscle cell damage).
7. Wearing a full-body compression garment for 24 hours after a challenging, heavy-resistance strength workout enhanced psychological, physiological and performance markers of recovery when compared with non-compressive garments

So, all in all, it’s looking pretty good for the recovery aspect of compression gear. I am tempted to slip on some tight socks and call it a day, but there are still a couple of ways you can use compression that we haven’t talked about yet.

Compression and Weight Loss?

As you probably guessed, most of the research on compression gear is focused on performance and recovery, but there are also claims that compression can benefit people who are overweight. Specifically, compression gear has been touted as especially helpful for people with a greater BMI.

Exercisers that carry larger amounts of weight are often more susceptible to repetitive use injuries like strains, shin splints, sprains, and other joint issues. This is especially true when they are starting a new training program. Compression gear can actually help compress muscles against a person’s skeleton and minimize the tiny muscle tears that are caused by muscle vibration and oscillation.

It is true that larger bodies move more during exercise and compression gear can limit that movement and possibly prevent some of that wear and tear. But could it also help with losing weight?

Well, no. All the claims that I could find skirted the issue quite adeptly and only made assertions that compression can aid in the exercise portion of an overweight person’s weight loss regimen. This is assuming that the types of workouts overweight people are engaged in usually involve higher volume and higher intensity.

So, yes, wearing compression gear could aid in minimizing that muscle damage we talked about earlier and also help overweight people recover faster so they can be more consistent in their training. And yes, all of these factors can certainly help with fat loss – but not in a very direct route or as a direct result of the compression.

So it would seem that compression is not a magic sock for weight loss. It doesn’t burn more calories, and it doesn’t boost your metabolism—no surprise there, not much really can—but if compression gear makes you feel more comfortable when you move, helps you get back at it faster, and perhaps gives you confidence in your appearance, then it is probably a worthwhile investment.

One last compression deviation before I wrap up…

Peristaltic Pulse Dynamic Compression (PPDC)

The key to this type of compression is something called “Sequential Pulse Technology,” which is based on our own body’s physiology. These dynamic compression machines replicate the action of blood pumping through the veins in our legs, arms, torso, or wherever else you apply it, and they liken it to peristalsis (a series of wave-like muscle contractions) on steroids.

These systems usually include a control unit, air compressor, and attachments (or sleeves) for the legs, arms, or hips. They use compressed air to inflate and then deflate the sleeves to massage your limbs and mobilize fluid. They first pre-inflate, so that the sleeves become moulded to your exact body shape, then they begin compressing your feet, hands, or upper quad depending on which sleeve you are using. Similar to the way an RMT will rub, knead, gouge, and apply variable pressure during a massage, each segment of the attached sleeve will compress, pulse, and release.

The technology behind these machines combines three different massage techniques to aid the body’s recovery process.

Pulsing: Instead of using static compression like the socks and pants we talked about earlier to squeeze fluid out of the limbs, this technology uses dynamic compression (or pulsing). This is said to greatly enhance the movement of fluid and metabolic waste out of the limbs after a workout.

Gradients: In our bodies, our veins and lymphatic vessels have a one-way valve that prevents the backflow of fluid and keeps everything moving in one direction. The Sequential Pulse Technology uses what is called a gradient hold pressure to keep your body’s fluids from being forced down to your feet. And this can help deliver maximum pressure all over the entire limb, evenly.

Distal release: Because squishing your body for extended amounts of time can be hard on your body’s circulatory flow, the Sequential Pulse Technology releases its grip once it is no longer needed to prevent backflow. By releasing the pressure as soon as possible, each portion of your limb gets the perfect amount of rest and the perfect amount of compression.

Science and Peristaltic Pulse Dynamic Compression?

Again, I won’t bore you with going through each of the studies with a fine-tooth comb but here are the highlights:

1. We conclude that PPDC is a promising means of accelerating and enhancing recovery after the normal aggressive training that occurs in Olympic and aspiring-Olympic athletes.
2. An acute bout of PPCD transiently upregulates PGC-1α mRNA (related to cellular metabolism), while also upregulating eNOS protein and NOx concentrations in vastus lateralis biopsy samples.
3. PPDC provides a means of rapidly enhancing acute ROM requiring less discomfort and time.
4. Acutely, whole limb, lower pressure PPCD improves conduit artery endothelial function systemically and improves RH blood flow locally (i.e., compressed limbs).

Based on what I read and saw, if you can justify the dough (these devices are not cheap) and recovery time is a significant factor for you, the PPDC machines are clearly the way to go. And I can tell you from first-hand experience that they really feel nice. Like a hug for your legs.

How Tight is Tight?

Compression is meant to be tight but not restrictive but also tight enough that you feel compressed. Got it? No… well here’s some science to help.

One study, in particular, looked at the effect of three different sizes of compressing gear: normal clothing, compression garment fitted to the manufacturer’s instructions, and one size smaller than was recommended by the manufacturer. The researchers found that the one-size-too-small compression garment caused a drop in performance for both power and strength in tests when compared to the properly fitted compression garment. But both sizes were better than the control, so there is clearly an optimal fit but also this shows that any compression was better than no compression, at least in this study.

An interesting theory that was proposed for the performance benefits during the previous test is the increased stiffness at the joints that the athletes experienced when wearing compression garments. If we take this theory a step further, it might suggest that the tighter the compression, the better the performance. But that was not the case in the study. So even when taking that into account, it seems there is indeed either an optimal stiffness for compression gear or there is a more subtle interplay of many different factors going on.

In any case, a good rule of thumb when you are choosing your gear is that compression is meant to be tight but not restrictive and certainly tight enough that you feel compressed. And as with the previous study, following the recommendations of the manufacturer will likely yield the best results.

So what did we learn?

After looking at all the studies, it is clear that compression is no panacea. It is not going to fix your running form, increase your vertical leap, or eliminate muscle soreness from your life. But I do see enough beneficial evidence to warrant giving it a try if you are interested or can find some on sale at your local sporting goods store.

Keep in mind that your legs are the largest muscle group in your body and wearing compression there will likely return the best and most noticeable recovery results. But a compression top can also help to support your chest, abdomen, and arms and can give you a feeling of comfortable tightness. If that extra support helps you to get out the door for your workout, helps you last longer during your workout, and perhaps helps you feel ready for your next workout sooner, well then I think we have ourselves a winner.