We鈥檝e all got our biases, and mine is that I find compression garments uncomfortable. I don鈥檛 know why, but that鈥檚 just the way it is. Keep that in mind as you read what follows鈥攂ecause when it comes to the athletic benefits of compression, perception may well be reality.
Compression garments鈥攊nitially long socks, but these days also half-tights, full leggings, arm sleeves, shirts, and even full-body suits鈥攈ave been around for decades. The first sports-related study in this area, on lactate clearance while running or biking in medical-grade compression socks, was published. And there鈥檚 been plenty of research since then: published in Sports Medicine by an Australian team led by Jonathon Weakley of Australian Catholic University synthesizes the results of 183 studies, most of them published in the last decade. But nailing down exactly what, if anything, these garments actually do remains surprisingly elusive.
There鈥檚 no shortage of theories. They might make you jump higher or run more efficiently. They might accelerate recovery, or reduce muscle damage and soreness. They might improve your balance and body awareness. They might make you feel good. And they might accomplish these things by reducing muscle vibration, enhancing blood circulation, or stimulating proprioceptive sensors.
So what does the evidence show? Summing up 183 studies isn鈥檛 easy, especially when the goals and methodologies are so inconsistent. Did the subjects wear compression during exercise, for an hour after exercise, or for the entire day? How tight was the compression at different places on the body? What was the garment made of? What did the subjects expect that it would do? That said, I鈥檒l take a crack at summarizing the data: overall, the studies show that compression does very little, or perhaps nothing, but almost certainly doesn鈥檛 hurt you.
Here鈥檚 what that looks like in practice. There were 49 studies that measured lactate levels with and without compression; 40 of them found no effect. Another 39 looked at creatine kinase, a blood marker of muscle damage; 27 of them found no effect. For heart rate, 53 of 68 studies found no effect. In all these cases, the other studies found generally small positive effects. The picture is roughly the same for performance measures like jump height or time trial, and for measures of inflammation and swelling.
Things get a little more interesting when you look at subjective measures. For perceived muscle soreness in the days following a hard workout, 29 of 50 studies reported positive effects. For perceived muscle pain, six of nine studies were positive. That鈥檚 still not a fantastic batting average, but you start to see why these products are still on the market. Lots of people do like how they feel. (If you want to dig into the details of all the outcomes, the entire review is.)
Of course, there are some important caveats. Compression is one of those things that鈥檚 very hard to blind. Many of the studies do try, for example by comparing compression tights to an ordinary pair of non-squeezing tights. But people aren鈥檛 stupid: they can tell when their legs are being squeezed and when they aren鈥檛. So if they expect the tights to help them feel better, then it鈥檚 not surprising if they do.
Along those lines, the review notes in which volunteers ran two 5K time trials with an hour of rest in between. When the volunteers wore compression socks during the first 5K, they seemed to recover better and run the second 5K marginally faster than when they didn鈥檛 wear the socks at all. Interestingly, when these results were first presented, they broke down the results based on which subjects thought the socks would help them. The believers actually ran their second 5K 3.6 seconds faster than their first one, while the skeptics got 17.9 seconds slower.
That鈥檚 not even the strangest result. In, researchers at Indiana University found that compression socks didn鈥檛 improve running economy (a measure of how efficiently you run). But compression believers did seem to have a more positive response than skeptics. That鈥檚 surprising because running economy, for the most part, isn鈥檛 under your conscious control: you can鈥檛 鈥渢ry harder鈥 to run more efficiently. One possibility is that some of the runners had prior experience with compression garments and had developed an intuitive feel for whether or not they benefited, but that seems like a stretch.
The upshot is that, among those 183 studies, you can find ample evidence for whatever position you want to defend about compression鈥攖hat they鈥檙e a miracle, a scam, or somewhere in between. The authors of the review take a middle position. They鈥檙e clear that the majority of studies suggest no acute performance benefits, and not much support for reduced muscle damage and inflammation. But on the plus side, they conclude, there鈥檚 the improved perception of soreness鈥攁nd 鈥渢he research to date does not suggest that compression garments have a negative effect on performance.鈥
In other words, the glass is half full. Compression isn鈥檛 bad for you, so carry on if you like it. At this point, I can鈥檛 help checking the conflicts of interest: none are reported, and they say that 鈥渁t no point was funding received by any of the authors for the writing of this manuscript.鈥 I鈥檓 sure that鈥檚 true, but they鈥檙e interpreting that question very narrowly. It doesn鈥檛 take much digging to find, funded by the compression gear company 2XU, that features three of the authors from the review, or these from 2020 that feature two of them, once again with a research grant from 2XU and direct support to one of the authors.
There鈥檚 nothing nefarious here: this is how the sausage gets made. But it would be na茂ve to think that financial influence doesn鈥檛 color your perceptions of ambiguous research鈥攊n the same way that my dislike of tight-fitting clothes makes me view the same findings skeptically. The overall body of research leaves open the possibility that compression does something useful, and it鈥檚 entirely to the credit of companies like 2XU that they鈥檙e funding high-quality research to find out what that might be.
As for practical takeaways, here鈥檚 where I end up. It鈥檚 clear that compression has physiological effects on the body: it鈥檚 not just a sugar pill or a. It鈥檚 not clear whether those effects have any practical utility. Lots of athletes, from casual to very elite, swear by their compression gear, and that鈥檚 not something to be dismissed. But I鈥檇 suggest being honest with yourself about your rationale: if you鈥檙e addicted to the squeeze, it鈥檚 because athletes you admire do it and/or you like the way it makes you feel, not because it鈥檚 backed by science.
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