The Science of Compression Gear for Runners

One of the recent big fads in the running world is compression wear. Whether it’s compression shorts for sprinters or compression socks for marathoners, it’s hard to attend an athletic event without seeing somebody decked out in skin-tight gear.

As with all fads, the brands producing these products brag about the performance-enhancing properties of their apparel. But, there is some legitimate science that’s investigating the utility of compression wear too – and that’s what we’ll look at today.

How Compression Gear Works

Compression wear was initially developed as a treatment for swelling disorders like lymphedema, where limbs swell up like balloons because the body’s lymph drains don’t work properly. Compression was quickly adopted to treat vascular issues as well; doctors found that graduated compression stockings (a knee-height sock in which compression is the highest at the ankle and tapers off towards the knee) helped manage varicose veins and helped to prevent blood clots in bed-ridden patients after surgery.

Compression socks accomplish this task by creating positive pressure across the various one-way valves in the blood veins. The difference in pressure between the ankle and knee encourages blood in the veins to flow back towards the heart and counters the effects of gravity, which can cause blood to pool in the veins of immobile patients (for this reason, frequent air travelers are sometimes advised to wear compression stockings to reduce the risk of deep vein thrombosis during long-haul flights).

But it wasn’t long before runners began to take interest in the effects of graduated compression on endurance performance. Perhaps spurred by the now-ubiquitous compression shorts worn by sprinters (which some studies have shown to increase jumping ability), exercise physiologists started investigating whether compression socks—referred to in the literature as compression stockings—had any effect on performance or recovery.

The Science of Compression Gear

Compression gear and soreness

One of the earliest studies on the matter was conducted by Ajmol Ali et al.1 at Massey University in New Zealand. His 2007 study used two experiments to test the effects of compression socks, each using a (separate) group of 14 recreational athletes.

The first experiment was a gym-class-style “shuttle run” test, followed by an hour’s rest and another identical shuttle run. The participants then returned 24 hours later and were evaluated on soreness and muscular pain. This was repeated three days later. In one trial, the subjects wore compression socks; in the other, they wore regular ankle-height running socks.

The second experiment was a 10-km training run on the roads with a similar evaluation of fatigue and soreness 24 hours later.

While the shuttle-run experiment showed no difference in any variables between the compression socks and the regular socks, the 10km run experiment showed a marked lessening in soreness for compression sock users.

There was a slight trend towards faster times and lower heart rates in the compression wear, but these were not statistically significant.

Compression gear and endurance

Ali’s work spurred further studies into the effects of compression socks. One of the first to directly investigate their effects on a maximal running effort was published in 2009 by Wolfgang Kemmler and coworkers in Germany.2

For this study, 21 “moderately trained” runners (average 10k PR of about 40 minutes) completed two maximal effort treadmill tests, one wearing compression socks, and another wearing regular running socks (presumably ankle-height).

Unlike Ali’s study, Kemmler’s group did find a slight improvement in endurance in the maximal treadmill test, but only a small part of this was explained by an increase in oxygen intake. The authors proposed that the compression stockings increased the mechanical efficiency of the runners.

Compression gear and maximum heart rate

At this point, it still is not clear what the exact benefits of compression socks are. A more comprehensive study published last year by Adrian Varela-Sanz et al.3 at the European University of Madrid attempted to clarify this. It used more experienced runners (10k PRs averaging 37-38min for men and 43-46min for women) and 26 subjects in total.

The subjects’ efficiency and oxygen consumption were monitored as they ran on a treadmill, first in four 6-minute bouts at half-marathon pace, then in a run to exhaustion at about 5k pace.

The compression socks had no statistically significant effects on running economy or performance, but like Ali’s 2007 study, a nonsignificant trend was seen towards slightly improved economy and performance in the compression socks. There was, however, a notable desirable change in maximal heart rate:

During the run to exhaustion, the runners had slightly lower heart rates at 5k pace than the runners in regular socks.

Compression gear and blood lactate levels

In June 2014, the Journal of Strength and Conditioning Research published a study from Rider et al. detailing the effect of compression stockings on physiological responses and running performance in division III collegiate cross-country runners during a maximal treadmill test.

Heart rate, blood lactate, blood lactate threshold, maximal oxygen consumption (V̇o2max), respiratory exchange ratio, rating of perceived exertion, and time to fatigue were measured

The results showed no significant differences between most the variables other than a lower blood lactate level at the 1 minute recovery mark for those wearing the compression socks. This means that compression socks may not improve running performance, but could lend credence to certain manufacturers’ claims of improved recovery through lower blood lactate values after exercise.

Validity of scientific research on compression gear

One major flaw of all of these studies is that they did not adequately control for the placebo effect. There was no way of knowing if the prospect of a high-tech knee-high sock, which was visibly different than a regular ankle-height running sock, was independently affecting the measurements. And since the observed effects for compression socks are comparatively small, the placebo effect could be having a significant impact on the study’s results.

in 2011, Ajmol Ali published a more rigorous investigation of compression socks and running performance, one which aimed to eliminate these control issues.4

In this study, twelve runners participated in five 10km time trials on an outdoor track. The first was a familiarization trial, and the next four investigated various compression socks. One was a “control” sock, which, while being a knee-high sock like the real compression socks, did not significantly compress the lower leg. The other three were socks with “low,” “medium,” and “high” degrees of compression. Before and after each 10k time trial, a vertical leap test was administered to measure the runners’ ability to generate explosive power.

None of the various levels of compression wear had any effect on performance, lactate accumulation, or heart rate; however, the low and medium-level compression socks prevented the runners from losing maximal muscular power during the 10k time trial.

While runners in the non-compressive socks and runners in the high-compression socks both experienced a drop in their vertical leap height after their 10km run, the runners in medium and low-compression socks actually increased their leaps, indicating they had better-preserved their explosive power (which would perhaps prove useful in a sprint-finish). This may also have implications for recovery, since presumably their leg muscles were less fatigued in the time trial in the low and medium-compression socks.

Is compression gear worth the money?

One thing’s clear: compression socks aren’t a game-changer. There’s some evidence they could increase your performance by a small amount, but their best use is probably in preventing excessive soreness and muscle damage from hard training sessions.

While the effects on performance were not consistent across the studies we’ve seen here, a small protective effect does seem to emerge: the runners in Ali’s first study reported less soreness 24 hours after their workout, small shifts towards more energetically efficient running were seen in Kemmler’s and Varela-Sanz’s studies, and muscles seemed to retain more power in Ali’s second study.

So, if you’re willing to shell out the $50-60 for graduated compression socks, you should wear them for your toughest hill workouts, longest runs, and fastest intervals. If you feel like they boost your performance, wear them on race day too! As the old saying goes, “any medicine that works is good medicine!” If you’re short on cash, though, you’re not missing out on much.

What should you look for when purchasing compression gear

One final note when it comes to shopping for compression socks: All of these studies used medical grade “compression stockings,” which are different from the knee-high Nike socks you might find at your local sporting gear store marketed as “compression wear.”

Medical grade compression socks are rated in millimeters of mercury or mmHg (an arcane unit, to be sure) at the ankle and calf. So a sock labeled 15-20 mmHg is 20 mmHg at the ankle and 15 at the calf.

For reference, studies 1, 2, and 3 used 18-22 mmHg, 18-24 mmHg, and 15-22 mmHg, respectively. For Ali’s 2011 study (4), “low” corresponded to 12-15 mmHg, “medium” to 18-21 mmHg, and “high” to 23-32 mmHg.

If you’re shopping for compression socks, I recommend something around 15-20 mmHg. If these numbers are a bit confusing, just remember that true compression stockings need to be sized by calf and ankle circumference, not simply by shoe size. Otherwise you won’t get the proper compression levels.

Have you tried compression gear? If so, did you experience a difference or did you feel like it was all marketing hype? Let us know in the comments section.

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References

1. Ali, A.; Caine, M. P.; Snow, B. G., Graduated compression stockings: Physiological and perceptual responses during and after exercise. Journal of Sports Sciences 2007, 25 (5), 413-419.
2. Kemmler, W.; von Stengel, S.; Köckritz, C.; Mayhew, J.; Wassermann, A.; Zapf, J., Effect of compression stockings on running performance in men runners. Journal of Strength and Conditioning Research 2009, 23 (1), 101-105.
3. Varela-Sanz, A.; Javier, E.; Carr, N.; Boullosa, D. A.; Esteve-Lanao, J., Effects of gradual-elastic compression stockings on running economy, kinematics, and performance in runners. Journal of Strength and Conditioning Research 2011, 25 (10), 2902-2910.
4. Ali, A.; Creasy, R. H.; Edge, J. A., The effect of graduated compression stockings on running performance. Journal of Strength and Conditioning Research 2011, 25 (5), 1385-1392.

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13 Responses on “The Science of Compression Gear for Runners

  1. What year was the above article wrtitten? I need a refernce so i can use it in a article i am writing asap please

    • Hi Nick, I am glad you found the article useful. The article was posted February 22nd, 2012. The author is John Davis. Please let us know where and when you publish your article, we would love to read it. Good luck!

  2. My experience has been that I have had no benefit from wearing compression socks during exercise, if anything slightly negative, but that wearing the socks for up to four hours after exercise speeds up recovery. Have any tests distinguished between using compression gear after exercise rather than only during?

  3. I’ve been using graduated compression calf guards for about the last 8 months following a number of calf strains in the early part of last year. I tend to wear them mainly for long runs (8-20 miles) and will often wear them during the hours after a long run or sometimes overnight afterwards. I have not experienced any form of calf strain since purchasing them and have felt that I recover well and feel better during my runs than without them.

    This could all be placebo of course!

    Would be good to see some research on longer endurance runs and focusing more on recovery, especially under fairly heavy, repetitive loads such as experienced training for marathons and ultras.

  4. Well, I don’t use compression socks but I am using tight shorts for my 100m sprint. But only on competitions. On the trainings I use only thights in the winter to keep my muscles warm.
    Does it improve my results? I only think with my shorts does, I use adidas techfit and there is some elastic material in it wich helps me a little bit with running I think. But to say tights work? I dont know, I think its a subjective thing wich can be related to your sport prestations.

  5. I’m 48 going on 49. I regularly do 5k runs and longer. In the last season or two i have noticed that almost every one of my injuries was in my calves. I bought some compression socks this season and have had no calf problems what so ever, this despite the fact that I am doing much more mileage as I am training for my first marathon. They may not improve my times but they sure have eliminated the pulls and soreness I used to have. Highly recommend them to anyone with calf issues.

  6. Pingback: To Compress or Not to Compress? | Movéo Sport and Rehabilitation Centre

  7. Great article from your always impressive blog.

    I have not run in my compression socks. They’re too pricey for me to wear out like that. But I _love_ them for recovery. I think they have greatly reduced inflammation and may be a good alternative to NSAIDs for this purpose when there is only minor pain.

  8. Sounds like anybody with difficulty with compression socks or leg sleeves during a work out has not found the right fit. In my experience, i have found that going with one size fits all or measured by shoe size is garbage. I swear by my cep running socks. They are always improving their product and just came out with the cep running 2.0 line. For men AND women of course! They are measure specifically to my calf size and wow can i tell the difference. I find my legs not only staying energized longer through my 13.1’s but the day after my legs are sure thanking me for wearing the cep recovery sleeves. They come in a run and recover pack. :)

  9. YES! They work! BUT. The ONLY improvement is in individuals like myself with circulation problems (For me it’s weak valves/varicose veins). My father and my mother both have this problem. I went on a run after purchasing some compression socks and WHAT a DIFFERENCE! Seriously though, had less fatigue and felt better afterwards. Would recommend it if you have problems like me, but if not it’s not worth your money because there’s nothing to improve upon if you don’t have circulation problems.

  10. Thanks for the article I have to wear compression thigh high stockings (30-40) and am looking for compression pants or leggings for walking since it aleviates my lymphedema condition. Any suggestions ?

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