Do Compression Garments Work?

Do Compression Garments Work?

When it comes to compression garments and triathletes, is there a need for the extra squeeze?

The use of compression garments amongst triathletes has become almost standard. It seems that the majority of competitors are employing some kind of compression clothing for most races, particularly on the run. 

As opposed to pneumatic compression garments, which require an athlete to be tethered to a device that sequentially inflates and deflates air bladders, compression garments are meant to be used during activity. The explosion in popularity of this kind of apparel is driven by some really impressive marketing—however, you may have noticed that these ads never really make any explicit claims about improved performance or recovery associated with the use of their products.

The question is, do these garments actually do what they claim to do? Here we’ll look at a few main selling points for compression garments to help you determine if the benefits justify the cost. 

Increased Blood Flow

The first theory behind compression garments is pretty simple. It stems mostly from the idea that by keeping pressure on a limb, compression garments can improve venous return back to the heart and decrease local swelling that can occur with prolonged exertion and exercise-induced muscle injury.

There is a fair amount of research looking into these effects and in fact, nothing has really been found to bear out this theory. When we are exercising, our muscles are continually contracting and this contraction works to squeeze the blood vessels contained within them. In other words, blood-return to the heart is already pretty maximized when we are training and racing, so wearing elastic compression clothes does little to change it.

Body Awareness and Efficiency

A second theoretical benefit of compression clothing is that it enhances sensation of joint position and reduces muscle vibration, leading to improved form and decreased fatigue. Here the science is mixed. Some studies have shown that an increased awareness of limb and joint position has translated to slight improvements in maintaining good form over time, and several studies have shown that compression garments do in fact decrease vertical oscillation of muscle, particularly when jumping or running, compared to when not wearing these types of clothes. 

However, these findings have never been shown to translate to any measures of improved performance metrics in any sport. Researchers have repeatedly found that runners were no faster at any distance with or without compression gear, and the same was found for cyclists, despite the effects on position awareness and decreased oscillation.

Recovery

The other main theoretical benefit for compression garments is that they can aid in injury prevention and have a role in enhancing recovery after prolonged or intense exercise. With respect to the former, there are no great studies to support this (and to be clear, no manufacturer of compression garments that I am aware of makes any claims of injury prevention associated with their products). As for recovery, there are some positive findings to suggest that recovery is in fact improved when using compression wear, but here again there is inconsistency and it does not appear to be true across sports.

Most of the positive findings reported on recovery can be found in the literature pertaining to weight training. There, objective outcomes at 24 hours do seem to be better when using compression wear when compared to not. Aside from weight training, there is little evidence to suggest that compression garments enhance recovery in any other sport. Runners did not show improvement in repeat performances at any time interval when running sprints, and cyclists showed similar results. 

Muscle Soreness

The last recovery issue that has been looked at extensively is the effect of the use of compression garments on the incidence of delayed onset muscle soreness or DOMS. DOMS is a result of exercise-induced muscle injury and comes about from subsequent inflammation and swelling that happens within the muscle cells, as damage is being cleared out and repaired. To date, none of the many studies to look into this question have shown any benefit to the use of compression wear in reducing either the severity, duration or incidence of DOMS.

Psychological Benefits

The one area in which compression gear continues to be shown to have positive effects (and in my mind the reason for which these types of clothing continue to be so popular) is the psychological benefit. People like the way they look in compression garments, and they like the way compression garments feel. While I don’t want to diminish the importance of these psychological effects, it’s worth noting that in all likelihood, the main benefit compression garments provide is a healthy boost of self-confidence.

References:

Azad Engel F, Holmberg H-C, Sperlich • Billy, Engel FA. Is There Evidence that Runners can Benefit from Wearing Compression Clothing? Sport Med. 2016;46:1939-1952. doi:10.1007/s40279-016-0546-5

Brown F, Gissane C, Howatson G, et al. Compression Garments and Recovery from Exercise: A Meta-Analysis. Sport Med. 2017;47:2245-2267. doi:10.1007/s40279-017-0728-9

Hill JA, Howatson G, van Someren KA, Walshe I, Pedlar CR. Influence of Compression Garments on Recovery After Marathon Running. J Strength Cond Res. 2014;28(8):2228-2235. doi:10.1519/JSC.0000000000000469

Macrae BA, Cotter JD, Laing RM. Compression Garments and Exercise Garment Considerations, Physiology and Performance. https://link-springer-com.proxy.hsl.ucdenver.edu/content/pdf/10.2165/11591420-000000000-00000.pdf. Accessed December 19, 2019.

Dr. Jeff Sankoff

Jeff Sankoff is an Emergency Physician, long time triathlete and IRONMAN University Certified coach. He has completed 6 IRONMAN races (including Kona) and more than fifty races at the 70.3 distance including 5 World Championships. He produces the TriDoc Podcast that can be found on most popular podcast platforms and is the owner of TriDoc Coaching.