Wearing compression garments during exercise and in recovery

Compression garments were originally developed for clinical patients, but have become increasingly popular among athletes. Manufacturers claim that compression garments can improve performance when worn during exercise and enhance recovery when worn after exercise.

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Performance

Wearing compression garments during exercise has been suggested to increase performance via a number of mechanisms. Firstly, it has been proposed that the venous hemodynamic response may increase, which is the arterial pressure derived from the pumping action of the heart. Improving venous hemodynamics could result in a greater end-diastolic blood supply to the heart, therefore increasing an athlete’s stroke volume and maximal oxygen uptake (VO2max). One study1 using upper- and lower-body compression garments reported a lower heart rate (HR) and blood lactate concentration while roller-skiing at various intensities, which could be related to a higher stroke volume and may positively influence overall performance. However, the majority of research in endurance sports has found no beneficial effect of compression garments on HR or oxygen uptake (VO2) at any exercise intensity.

A second potential mechanism is that external pressure from compression garments induces arterial dilation, causing a higher blood flow in underlying tissues. Therefore, it has been theorised that greater oxygen delivery and muscle oxygenation, as well as increased metabolite removal, may occur during continuous exercise with compression garments. Despite this, the vast majority of research has found no difference in muscle oxygen saturation or blood lactate during exercise with compression garments compared to without.

Thirdly, wearing compression garments during exercise may lead to improvements in muscle proprioception and reductions in muscle fibre recruitment and muscle oscillations. A previous study1 observed small increases in cycle length and decreases in cycle rate during roller-skiing with compression garments, which could lead to small improvements in skiing economy due to associated positive effects on muscle function. However, despite some studies finding small improvements in cross-country skiing and running economy, lactate removal and muscle oxygenation, several review articles agree that wearing compression garments during exercise provide either no or only trivial benefits to endurance performance. Only one cross-country skiing study2 has assessed the effects of wearing upper-body compression garments on performance, concluding no physiological differences and no change in the performance of 3 x 3-min double-poling sprints. Overall, the evidence appears to suggest that wearing compression garments during exercise could cause some physiological changes, but performance is unaffected or only slightly improved.

A final mechanism specifically relevant to cross-country skiing is the increased skin temperature associated with wearing compression clothing. Increasing skin temperature in cold environments reduces heat lost due to the core-to-skin gradient, which may help to maintain a higher muscle temperature and improve an athlete’s thermal state when racing outdoors. As higher muscle temperatures have been associated with higher power production, it is possible that wearing compression garments in cold temperatures may improve cross-country skiing performance. However, this possibility is yet to be investigated scientifically.

Recovery

It has been reported that oedema of the muscle cells occurs after exercise, which causes muscle soreness, reduced mobility and greater muscle damage due to higher osmotic pressure. However, compression garments have been shown to decrease muscle swelling and may therefore be responsible for enhancing recovery after exercise-induced muscle damage (EIMD). Furthermore, it has been suggested that increased blood circulation caused by wearing compression garments has the ability to increase cellular regeneration and protein synthesis by improving nutrient delivery. As a result, it has been proposed that wearing compression garments for 12-24 h after muscle-damaging exercise can reduce muscle soreness and muscle impairment, therefore leading to faster recovery of muscular strength and power.

Overall, review articles have reported that wearing compression garments for 24 h after muscle-damaging exercise can moderately improve muscle strength. Small but not likely beneficial improvements to muscle power and endurance performance have also been observed. Greater performance improvements following the use of compression garments in recovery are often observed after more extreme muscle damage, such as that experienced after resistance or plyometric training, or eccentric muscle actions. Therefore, it is possible that cross-country skiing performance could be improved by wearing compression garments for 24 h after completing more extreme muscle-damaging exercise. One study3 investigating the effects of wearing compression garments for ~ 18 h following a cross-country sprint race, however, showed no improvements in the recovery of physiological, performance or perception markers compared to a control group.

Pressure

Although the optimal pressure for compression garments is unknown, research has shown that approximately 20 mmHg can improve venous return and therefore cardiac output, whereas pressures lower than 15 mmHg were unable to improve venous return. Commercial compression garments are usually fitted according to generic anthropometric measurements, such as height and waist circumference. However, since individuals have different limb morphologies, pressure applied to specific areas of the body will vary from person to person when wearing generically-fitted compression garments. The limited evidence for compression clothing contributing to improved performance or recovery may therefore be due to insufficient or inappropriate pressures exerted by the garments.

Practical recommendations

Athletes should aspire to wear compression garments that are custom-fitted to apply approximately 20 mmHg of pressure to every region of the body covered. Although wearing compression garments during exercise does not appear to significantly benefit performance in moderate temperatures, there may be meaningful advantages during exercise in the cold (e.g., cross-country skiing), due to maintenance of higher muscle temperatures. In recovery, it is recommended that compression garments are worn for 12-24 h following more extreme muscle-damaging activity to ameliorate muscle soreness and improve muscle function and mobility in the following days. However, since some of the adaptive responses to training are reliant on the physiological effects associated with muscle-damaging exercise (i.e., inflammation and reactive oxygen species [ROS] release), artificially speeding up the recovery process by wearing compression garments may in some cases be detrimental to training and subsequent performance.

References

  1. Heil, D. P., & McLaren, J. (2014). Influence of upper-and lower-body sports compression garments on markers of cross-country ski performance. Science and Skiing VI, 406-413.
  2. Sperlich, B., Born, D. P., Zinner, C., Hauser, A., & Holmberg, H. C. (2014). Does upper-body compression improve 3 × 3-min double-poling sprint performance? International Journal of Sports Physiology and Performance, 9(1), 48-57.
  3. Govus, A. D., Andersson, E. P., Shannon, O. M., Provis, H., Karlsson, M., & McGawley, K. (2018). Commercially available compression garments or electrical stimulation do not enhance recovery following a sprint competition in elite cross-country skiers. European Journal of Sport Science, 18(10), 1299-1308.

Further reading

Born, D. P., Sperlich, B., & Holmberg, H. C. (2013). Bringing light into the dark: effects of compression clothing on performance and recovery. International Journal of Sports Physiology and Performance, 8(1), 4-18.

Brown, F., Gissane, C., Howatson, G., van Someren, K., Pedlar, C., & Hill, J. (2017). Compression garments and recovery from exercise: a meta-analysis. Sports Medicine, 47(11), 2245-2267.

Hill, J. A., Howatson, G., van Someren, K. A., Davidson, S., & Pedlar, C. R. (2015). The variation in pressures exerted by commercially available compression garments. Sports Engineering, 18(2), 115-121.

MacRae, B. A., Cotter, J. D., & Laing, R. M. (2011). Compression garments and exercise. Sports Medicine, 41(10), 815-843.

About the author: Tom Toolis

Tom completed an undergraduate degree in Sport and Exercise Science at the University of Bath in 2017 and subsequently completed his Master’s degree in Applied Sport and Exercise Physiology at St Mary’s University in London. Tom’s Master’s thesis investigated pre-cooling strategies, with an aim to help endurance athletes perform better in the heat. Tom is passionate about developing athletic performance, having completed a number of internships working as a performance scientist within various sports. He also spent some time at the Swedish Winter Sports Research Centre during the summer of 2018. Tom is an elite athlete himself, competing for Great Britain in Modern Pentathlon.