The Role of Compression Garments in Performance and Recovery

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In developing an athlete, an important part of improving competition performance is enhancing both the intensity of key individual sessions and supporting the accumulation of high volumes of training, while at the same time avoiding injury and unnecessary fatigue. Balancing the need for performance within sessions, accumulation of load, and injury and illness reduction can be very difficult—and is potentially the hardest part of the coach’s job.

As a result, in recent years there has been a focus on what athletes do away from the track, gym, or training field to improve their subsequent performance. This focus on recovery is important; there are 24 hours during the day, and an athlete may only spend 1-3 hours per day training. This leaves a lot of time available to either support or destroy training adaptations. While some of the key drivers of recovery can be reasonably simple—optimizing sleep and nutrition—there are always new products and interventions that are purported to help. Wearing compression garments, including leggings, socks, and t-shirts, has become more popular over the last 15 years, and there are a variety of products now on the market. In this article, I’ll explore the evidence underpinning compression garments as a recovery tool, and discuss just how useful they might be for athletes wishing to enhance their performance.

Post-Exercise Recovery

The strongest evidence supporting compression garments comes from their influence on post-exercise recovery. Meta-analyses are a type of study in which the authors take the results from individual studies and pool them together into one “mega” study, which allows us to better understand the true effect of a specific intervention. When it comes to compression garments, the results from meta-analyses are clear: compression garments reduce feelings of DOMS and muscle damage. As a result, they likely enhance recovery between training sessions held on different days.

For example, a 2013 meta-analysis, published in the British Journal of Sports Medicine, pooled the results of 12 eligible studies and suggested that wearing compression garments moderately reduced DOMS and moderately enhanced the recovery of muscle strength and power post-exercise. This appeared to be true when the athletes wore the compression garments after exercise or both during and after exercise.

A second meta-analysis, this time from 2016, again found that using compression garments improved the recovery of power and strength post-exercise and was also associated with lower levels of muscle swelling. A further meta-analysis, from 2017, found a significant and small—but very likely—beneficial effect of compression garments in enhancing post-exercise recovery. Importantly, there was no significant difference in the garments’ effectiveness in trained and untrained participants, suggesting that beginners and elites alike can harness a benefit. When the authors looked at different exercise types, they found that wearing compression garments enhanced recovery to a greater extent in terms of strength recovery, followed by the recovery of power and then endurance. Compression garments also supported recovery following resistance training to a greater extent than running and metabolic-orientated exercise, although they were still effective after the latter two exercises.

Currently, it’s unclear why compression garments enhance recovery. Some researchers speculate that the compression from the clothing reduces the space available for swelling and inflammation to occur. Similarly, the pressure from compression garments may promote venous return, allowing for the removal of waste products. Either way, while the mechanism is perhaps unclear, the effectiveness of compression garments in supporting post-exercise recovery is clear and well-established.

It’s important to keep in mind that it’s very difficult to blind the participants in studies as to whether they’re wearing compression garments, given that we can all tell whether we’re being compressed or not. As a result, there is the possibility that some of the positive effects come from the placebo effect; because individuals know they’re wearing the compression garments, they believe they’ll recover quicker. This isn’t necessarily a bad thing—the placebo effect can be harnessed to improve performance—but it is something that we must consider when drawing conclusions.

Finally, we should consider how compression garments compare to other often-used recovery methods, such as massage and cold water immersion and ice baths. A 2018 meta-analysis did this, finding that massage was perhaps the most effective recovery technique for reducing DOMS and perceived fatigue, with compression garments and cold water immersion coming a close second. As always, by trying to be pragmatic, a mixed approach to recovery is perhaps best. Massage can be used a couple of times a week in a structured manner while we probably can wear compression garments daily.

Acute Performance

While the evidence for using compression garments to support recovery is strong and well established, many athletes use compression garments in competition in an attempt to improve performance. Here, the evidence is less clear. For example, a 2007 study, comprised of two separate experiments, showed that the use of knee-length compression socks did not enhance performance in two repeated shuttle running tests an hour apart. Still, they did reduce DOMS the next day—again, further suggesting that recovery was enhanced. A similar study, this time from 2011, showed that the use of compression garments did not acutely improve 10-km running performance but did improve performance in a vertical jump test that took place immediately after the 10-km run. Similar results have been reported for other running distances, varying from a 400m sprint to a half marathon.

These results, and others like them, were analyzed together in a 2018 meta-analysis—the highest tier of evidence—published in the prestigious Sports Medicine journal. The authors noted that, while compression garments are often effective for supporting performance variables, such as time to exhaustion and running economy, these variables are not directly associated with sporting success or failure. Meaning you don’t win a gold medal for having the best running economy; you win the gold medal for covering the race distance in the shortest time.

Focusing on lower limb compression garments, the researchers looked for any performance advantage during competition for all running distances. They concluded that wearing compression garments offered no acute performance gains during competition. It’s important to point out, however, that compression garments don’t harm performance either.

Conclusions and Recommendations

Based on the evidence discussed above, we can draw some tentative conclusions from the research to date about the use of compression garments in sport:

  1. Compression garments appear to be effective in enhancing post-exercise recovery following different types of exercise, with the size of effect potentially greatest following resistance training. These benefits can be seen very quickly—one meta-analysis states between 2-8 hours—but are perhaps most robust when it comes to the 24- to 48-hour (and potentially up to 96) window after exercise.
  2. Wearing compression garments during exercise does not appear to enhance performance acutely, but it also isn’t negative. And there might be some psychological benefits from using compression garments through the sensation of pressure.

As a result, we can recommend wearing compression garments for athletes looking to maximize their recovery and optimize performance in their training sessions in the days following a hard training session, especially following resistance training.

In terms of the timing of wearing the compression garments, the evidence is less clear and quite hard to determine from the meta-analyses. In some studies showing a compression garment’s beneficial effect on recovery, the participants wore the garments during and after exercise. In other studies, they wore them only once the exercise session was complete. Typically, the compression garments were worn for 12-24 hours following exercise. This can end up being a big ask—I can’t think of many people that want to wear compression garments most (if not all) of the day, including while sleeping—and it could well be uncomfortable.

It might pay to be pragmatic; wearing compression garments for some of the time is likely much better than not wearing them at all. So putting on compression clothing following training—and then leaving them on for as long as possible—is probably the best approach. During my career, I used to wear compression leggings for 5-6 hours following training (maybe a bit longer if I was lazy). And after competitions, I would sleep in a pair of compression socks, which I perceived to enhance my recovery. In summary, it appears that compression garments are worth exploring and experimenting with for athletes looking to take their performance to the next level.

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