Compression Socks and Apparel: Worth It or Not?

I'm guessing that if I performed a survey among triathletes, I would find that more triathletes wear compression apparel than underwear on a regular basis. Compression apparel has quickly become commonplace in the triathlon world. Yet, runners don't seem to be jumping on the bandwagon nearly as fast. Are we just suckers for good marketing, or is there some legitimacy to compression apparel?

The Origin of Compression Apparel

The short story is that compression apparel originated as a treatment for individuals with poor circulation and/or edema in their legs, commonly people with diabetes, chronic vein insufficiency, congestive heart failure, or lymphedema. Did it work? Absolutely! For these individuals, compression socks can be magic, improving their mobility and circulation within just a day or two after putting them on. Such success eventually led to thought that compression apparel can help athletes as well.

The Compression Apparel Claims

The following claims have been made regarding the benefits of compression wear by manufacturers:

• Improved circulation to compressed muscles;
• reduced muscle fatigue;
• reduced muscular vibration;
• quicker muscle recovery following workouts (due to the above);
• reduced muscle soreness;
• improved muscle power

The above benefits have been deduced into one hypothetical conclusion, that compression wear improves performance. But, does this conclusion hold up in unbiased studies?

The Research Findings

Much of the research available is on unhealthy subjects. This research tends to show favorable results in performance for those with medical problems that lead to poor circulation and/or edema (swelling). However, there is an emerging body of research on healthy subjects due to the popularity of compression apparel. So far, the findings are not as favorable. In fact, they don't seem to show much benefit other than mild improvement in delayed onset muscle soreness (DOMS). 

In one study published in the Journal of Sports Physiology and Performance, researchers found no improvements in time to muscle exhaustion, blood lactate levels, heart rate, expired gas, muscle oxygenation, ability to run further, or run faster with the use of compression apparel. The researchers did find improved circulation, however this did not translate to any benefits in performance or recovery based on the parameters they studied.

Other studies have shown no improvement in VO2 max recovery, VO2, plasma volume shifts, or vertical jump. And still, other research has shown consistent findings as the study above. 

A very recent published study looking at the effects of compression garments found that study subjects had higher heart rates while wearing larger garments, suggesting compression wear may cause some vascular compression that results in the heart having to work harder to get blood to the muscles. This only held up with larger compression garments, such as full pants or shirts. The authors suggested a possible risk to wearing such garments DURING competition or training due to the heart having to work harder.

There are, however, two regular findings in most studies performed in either healthy or unhealthy subjects. They are improved circulation and mild improvements in delayed onset muscle soreness. The improved circulation DOES appear to improve performance in subjects with circulatory problems, however DOES NOT appear to have any benefit to performance in healthy subjects. 

My Conclusions

In the end, it appears compression apparel does not seem to carry the wonderful benefits claimed. The theory is an excellent one, however when the rubber meets the road, the theory simply does not seem to hold true in the real world. 

One constant seems to be that there are not performance benefits to wearing compression apparel. The only benefits seem to come only after a hard workout.

Of course, the body of research on healthy subjects is relatively small, and several studies were performed on a small scale (10-25 subjects). So, there is a possibility of the verdict changing. But, some of the studies I reviewed were well performed, and likely very valid.

Whether or not you wear compression apparel appears to be more about comfort if you are a healthy person without circulatory problems. The primary consistent benefit found was a mild reduction of delayed onset muscle soreness (the improved circulation did not show any improvements in performance/recovery/etc, so I am not considering it a "benefit"). So, if you would like that soreness you occasionally experience to be slightly reduced the day following a race or tough training session, you will be happy with your compression socks/pants/shorts. Don't expect dramatic reductions in soreness, just mild. If you embrace that soreness, save your dollars.

Regarding wearing compression socks in a race, there does not seem to be any benefit to this. Save yourself the trouble and skip it.