Improving physical performance is as much about maximizing performance quality as balancing and mitigating injury risks and maximizing recovery to prevent maladaptation in response to accumulated and progressive training loads. There is a lot of research focused on post-exercise muscle recovery, and many products claim to boost the recovery process in a multitude of ways.
Compression garments are examples of these types of products used by athletes and recreationally active people to increase sports performance and recovery. Compression garments have been around for some time, and whether in the Olympics, on the running trail, or at the local gym, you have probably seen compression apparel worn in various fashions.
While compression garments were initially designed to treat specific vascular conditions, they are becoming increasingly popular and frequently worn for their additional benefits for exercise and post-exercise recovery. However, there has only been a limited number of studies focused on the benefits of wearing compression garments regarding performance and recovery, which only provides a limited understanding despite many confident claims by apparel companies and experts.
The current belief is that compression garments aid in various biochemical, physiological, and functional ways by easing DOMS-related pain, reducing fatigue, improving sport-specific performance, enhancing stability, and speeding post-exercise recovery. Let's review what research has determined to better guide your decisions regarding compression apparel.
Check out the NASM Guide to Muscle Recovery for more on this topic!
What is Compression Apparel?
Compression garments were initially used to aid the recovery of vascular conditions by helping to increase circulation in the arms and legs, typically related to cardiovascular diseases, heart failure, lymph pooling, cancers, and post-surgical recovery. Athletic apparel has evolved to include compression garments in various forms for general sportswear.
These garments can be worn as individual pieces to cover specific parts of the body or the entire body. Common sports compression garments include full-length tights, knee sleeves, three-quarter-length pants, shorts, calf sleeves, shirts, socks, and thigh-sleeves. You can find them in a range of pressures, with the higher range of pressures meant for medical use.
The Cause of Muscle Soreness
Exercise-induced muscle damage (EIMD) is thought to be caused by unaccustomed, strenuous, high-intensity, or endurance exercise, resulting in a temporary decrease in muscle force production, a rise in passive tension, swelling, and increased muscle soreness (Dupoy, et al., 2018).
The post-exercise increases in muscle soreness, also referred to as delayed onset muscle soreness (DOMS), is common and often the focus of post-exercise muscle recovery as it typically occurs 48 to 72 hours after training and is thought to be related to several factors regarding EIMD.
Individuals suffering from EIMD and DOMS may decline in physical and functional performance, fatigue, movement discomfort, and lower cumulative physical activity (Dupoy, et al., 2018). DOMS should not be confused with sharp pains, sprains, swelling, or lasting pain, which may signify something more serious, such as an injury requiring medical attention.
Do Compression Garments Aid Performance During Exercise?
During exercise, compression apparel may increase blood flow and oxygen delivery, which is not unreasonable considering medical compression garments have had similarly measurable results for those suffering from vascular conditions.
In addition, compression apparel may enhance body awareness (proprioception) during exercise, providing enhanced postural and movement performance. Finally, many researchers believe that compression may also reduce muscle vibrations and mitigate ground reaction forces to reduce functional stress and improve muscle control.
Unfortunately, while many of these claims are reasonable, research is extremely limited. A more extensive review of the existing studies on compression garments regarding functional and performance yielded mixed results; for example, some studies showed marginal increases in jump height and power and maintained power output while performing repeated jumps, while others showed decreases (Hong et al., 2022; Leabeater et al., 2022; Perez-Soriano et al., 2019). Also, compression garments showed little to no benefit to running performance and only a small benefit to cycling performance (Leabeater et al., 2022; Perez-Soriano et al., 2019).
Enhanced Proprioception
Enhancing proprioception increases an athlete's perception and awareness of their body position and movement, which is essential to sport-specific performance and stability. Athletes demonstrated greater proprioception when wearing compression garments, although this effect was greater for high-level athletes than ordinarily active individuals; additionally, lower pressure garments seemed to negatively impact proprioception (Hong et al., 2022; Leabeater et al., 2022).
Unfortunately, the exact mechanism is not fully understood. However, Hong et al. (2022) and Perez-Soriano et al. (2019) suggested that the enhanced proprioception may be related to the increase in Golgi tendon organ activation and feedback from proprioceptors to the muscles but that the increase in muscle efficiency may not provide any performance benefits.
Reduced Impact Stress
Some evidence suggests using compression stockings to reduce impact during running and the risk of overuse and overload injuries from cumulative impact (Perez-Soriano et al., 2019). Perez-Soriano et al. (2019) suggested that the reduction in vibration during impact may have something to do with this but could also be related to better proprioception during running.
Perceived Fatigue
Compression garments improve athletes' perceptions of fatigue and muscle soreness (Leabeater et al., 2022). While there are many benefits to reducing an athlete's perception of soreness and fatigue during activity, it is still unclear whether compression garments impact fatigued performance or delay the onset of fatigue despite the stabilizing effects provided by the compression (Serez-Soriano et al., 2019).
Unfortunately, it is still unclear whether compression garments reduce EIMD as results have been inconsistent, with many of the tests not being intense enough to cause EIMD (Dupoy et al., 2018).
Do Compression Garments Aid Post-Exercise Recovery?
Wearing compression garments post-exercise for muscle recovery is claimed to have several benefits. Many experts claim that wearing compression garments post-exercise will reduce muscle damage, pain and inflammation, soreness, and fatigue and lead to a faster return to functional performance. Again, while many of these claims are reasonable, the evidence is inconclusive, and the exact mechanisms of recovery are still being understood, especially regarding the use of compression apparel.
However, still, limited research has determined that wearing compression garments do provide certain recovery benefits in certain situations and are relatively safe to use for healthy individuals (Armstrong et al., 2015; Brown et al., 2017; Dupoy et al., 2018; Hettchen et al., 2019; Kim et al., 2017; Leabeater et al., 2022; Perez-Soriano et al., 2019).
DOMS/Physiological Recovery
It seemed that the most significant benefits of wearing compression garments post-exercise were within the first 24 hours after resistance exercise and cycling (Brown et al., 2017; Dupoy et al., 2018; Hettchen et al., 2019; Perez-Soriano et al., 2019). Intermittent use of compression garments after the first 24 hours continued to show some benefit over an additional 48-72 hours (Dupoy et al., 2018; Hettchen et al., 2019). Compression garments showed a significant positive impact on post-exercise DOMS and perceived fatigue, although not quite as pronounced as massage therapy (Dupoy et al., 2018; Kim et al., 2017; Leabeater et al., 2022).
Researchers suggested that these beneficial effects regarding DOMS and perceived fatigue have to do with the compression leading to a reduction in space available for swelling and edema, improving venous return and circulation (Armstrong et al., 2015; Dupoy et al., 2018; Kim et al., 2017; Leabeater et al., 2022). However, Perez-Soriano et al. (2019) suggested that there is little to no evidence that compression garments cause changes in venous hemodynamics, maximal oxygen consumption, body temperature regulation, force development, or perceived exertion. The different conclusions often have to do with the difference in study inclusion criteria which may further limit an already limited body of evidence.
Functional/Performance Recovery
In addition to reduced perceptions of DOMS and fatigue, studies have consistently shown a faster recovery of functional movement and performance for runners, cyclists, strength, and power athletes primarily related to eccentric exercise within the first 24 to 48 hours of recovery for those wearing compression garments (Armstrong et al., 2015; Brown et al., 2017; Kim et al., 2017).
The most significant benefits seemed to be experienced by endurance cyclists and runners, as well as strength athletes emphasizing eccentric exercise (Brown et al., 2017; Leabeater et al., 2022). Armstrong et al., (2015) suggested that recovery parameters for runners may be as high as 6% faster within the first 48 hours for those wearing compression garments for the lower limbs.
Summary
While many of the claims regarding compression apparel are likely overstated, using compression garments for elite-athletes and generally active adults is found to be safe and beneficial for strength and endurance athletes.
Like most things, whether compression garments are suitable for you must be determined by various factors such as personal preference, exercise intensity, exercise type or sports activity. If you want to try compression garments during or after your next workout, choose a compression level that you find comfortable and fit your needs.
For example, heavier, stiffer compression garments may offer more stability but limit flexibility. Next, select a garment that covers the limbs or muscles you wish to emphasize, such as below-the-knee stockings for runners.
Finally, you will want to emphasize their use during the first 24 hours and intermittently beyond that. As researchers continue to explore the potential for compression garments and their various effects, advice regarding their use will become more nuanced in time.
References
Armstrong, S. A., Till, E. S., Maloney, S. R., & Harris, G. A. (2015). Compression socks and functional recovery following marathon running: A randomized controlled trial. Journal of Strength and Conditioning Research, 29(2), 528-533. https://doi.org/10.1519/jsc.0000000000000649
Brown, F., Gissane, C., Howatson, G., van Someren, K., Pedlar, C., & Hill, J. (2017). Compression apparels and recovery from exercise: A meta-analysis. Sports Medicine, 47(5), 1-23. https://doi.org/10.1007/s40279-017-0728-9
Dupuy, O., Douzi, W., Theurot, D, Bosquet, L., & Dugue, B. (2018). An evidence-based approach for choosing post-exercise recovery techniques to reduce markets of muscle damage, soreness, fatigue, and inflammation: A systematic review with meta-analysis. Frontiers in Physiology, 9(403), 1-15. https://doi.org/10.3389/fphys.2018.00403
Hettchen, M., Glockler, K., von Stengel, S., Piechele, A., Lotzerich, H., Kohl, M., & Kemmler, W. (2019). Effects of compression tights on recovery parameters after exercise induced muscle damage: A randomized controlled crossover study. Evidence-Based Complementary and Alternative Medicine, 1-11. https://doi.org/10.1155/2019/5698460
Hong, W., Lo, H., & Chiu, M. (2022). Effects of compression garent on muscular efficacy, proprioception, and recovery after exercise-induced muscle fatigue onset for people who exercise regularly. PLOS One, 17(2), 1-17. https://doi.org/10.1371/journal.pone.0264569
Kim, J., Kim, J., & Lee, J. (2017). Effect of compression apparels on delayed-onset muscle soreness and blood inflammatory markers after eccentric exercise: A randomized controlled trial. Journal of Exercise Rehabilitation, 13(5), 541-545. https://doi.org/10.12965/jer.1735088.554
Leabeater, A. J., James, L. P., & Driller, M. W. (2022). Tight margins: Compression apparel use during exercise and recovery—a systematic review. Textiles, 2, 395-421. https://doi.org/10.3390/textiles2030022
Perez-Soriano, P., Garcia-Roig, A., Sanchis-Sanchis, R., & Aparicio, I. (2019). Influence of compression sportswear on recovery and performance: A systematic review. Journal of Industrial Textiles, 48(9), 1501-1524. https://doi.org/10.1177/1528083718764912
