Compression Stockings: Function or Fashion
Make no mistake, I do like fashion; however, when it comes to running and working out, I typically choose function over fashion. Yet, the other day, as I put my compression stockings on before doing a speed workout, I questioned myself as to why I was wearing them. Did I truly believe these neon-green knee-high socks were going to improve my performance or make my legs feel better afterwards? I suddenly doubted it.
I had first started using compression stockings during residency because of the long hours of standing in the operating room. They appeared to help with leg swelling and fatigue, so, at some point after doing some trivial research online, I decided to try them out running. I used them mainly for interval training and races, but they seemed to make my legs feel better afterwards, so I continued to use them. Now, after years of being away from training and races, putting the stockings back on, I questioned their authenticity and maybe rightfully so.
Over the past several years, the findings on the physiological and perceived benefits of compression garments in runners appear to be inconsistent. Before their use in athletics, compression stockings were mainly seen in the medical industry for such applications as improving leg swelling and helping with venous return insufficiency. Now, they can be found on the legs of not only recreational runners, but also elite athletes. The actual and significant benefits of compression stockings in distance runners, though, remain in question. Some potential benefits include delaying the onset of muscle fatigue, improving mechanical efficiency by decreasing muscle oscillation, favorable effects on the cardiac system, reducing runners’ leg complaints, and aiding in recovery (1,2,3,4,5). Advertising companies have also made claims that they will improve performance, circulation, and/or energy (3).
Reading through the scientific literature, it makes it difficult to compare studies and outcomes because of the inconsistent nature of the variables being evaluated. Likely much due to the marketing and advertising world, there are now countless brands of compression garments that come in several different styles (i.e. socks, sleeves, tights), lengths (i.e. below-knee, full lower extremity), and pressures (constant vs graded).
Keeping this in mind, a systematic review was published last year of original research articles studying the effects of compression garments on distance running, Thirty-two articles were analyzed in depth. In the end, the authors concluded that compression garments had no significant effects on running performance (as measured by times for runs, including sprints, marathons, and trail running), blood lactate concentrations, and certain cardiac indicators (including heart rate and cardiac output). Small improvements were found, though, for time to exhaustion, running economy, perceived exertion, and post-exercise levels of inflammatory markers & creatine kinase (i.e. muscle damage), and a larger effect, in favor of compression garments, was seen when it came to perceived muscle soreness (2).
Based on this review, it appears that there may be more of a psychological benefit of using compression stockings than an actual performance one. However, one cannot ignore the small objective improvements that were noted in the review. As we know, elite athletes will do about anything to gain an advantage over their competition. So even if that means their time to exhaustion could potentially be lengthened by a few seconds or there is any chance of preventing an injury by wearing the stockings, I have a hard time believing that any elite athlete wouldn’t give them a try. I am sure Meb Keflezighi, Kara Goucher, & Shalane Flanagan all have their reasons for wearing them for competition. As for me, I think I will continue to use them for the perceived (and potential physiological) effects, which means, I may be choosing fashion over function this time around.
Disclaimer: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult your own healthcare professional with questions or concerns related to your health.
Wei-Chun Hsu, et al., Effects of compression garments on surface EMG and physiological responses during and after distance running, Journal of Sport and Health Science (2017), doi: 10.1016/j.jshs.2017.01.001
Engel, FA, Holmberg, H, and Sperlich, B. Is There Evidence that Runners can Benefit from Wearing Compression Clothing? Sports Medicine. 2016.
Watson, B, Rorke, S, and Phil, D. Are Compression Garments Beneficial For Endurance Runners? American College of Sports Medicine Health & Fitness Journal. 2016;20(2):13-18.
Bovenschen, HJ, te Booij, M, and van der Vleuten, CJM. Graduated Compression Stockings for Runners: Friend, Foe, or Fake? Journal of Athletic Training. 2013;48(2):226–232.
Varela-Sanz, A, Espana, J, Carr, N, Boullosa, DA, and Esteve-Lanao, J. Effects of Gradual-Elastic Compression Stockings on Running Economy, Kinematics, and Performance in Runners. The Journal of Strength and Conditioning Research. 2011;25(10):2902-2910.