Can Compression Raise Your Game?
Vein specialists have long touted the benefits of graduated compression garments for patients with venous symptoms, but in recent years, athletic coaches and fitness trainers have begun to get on board.
Compression socks or stockings are worn over the leg and foot to create a gradient “squeeze” that is greatest at the ankle and lessens up the length of the garment. Compression works by helping the veins in the legs to pump the de-oxygenated blood back up towards the heart to prevent “pooling” in the lower limbs.
Compression worn on the legs can help athletes at every level in three ways: during the activity, post-activity recovery, and during long-distance travel. During exercise or sports, compression increases calf muscle-pump efficiency, which clears out lactic acid and prostaglandins more effectively and results in less muscle soreness during and after the activity. Compression has also been found to reduce muscle pain in the leg by reducing the myofibril microtrauma, or tiny damage to the slender threads of muscle fiber along the muscle.
The real question for many athletes is: Will compression improve my performance? Well, the answer is yes…and no.
The more efficiently blood flows through our bodies, the more likely we are to recover quickly from workouts and injuries and be in better condition to train more often or at a higher intensity, which improves performance in the long run. But while compression can minimize things like calf strains, shin splints or Achilles’ issues, it’s probably not going to take a minute off of your mile.
Most studies have not been able to demonstrate any statistically significant difference in performance while wearing compression sleeves or stockings, but anecdotal reports from athletes suggest that compression can help improve athletic performance, at least from a psychological point of view. In other words, if someone believes that compression helps optimize performance, it just might. Although there has been little evidence that compression actually improves performance, athletes with venous insufficiency should consider wearing graduated compression during sports events to reduce swelling and venous pooling.
There is more research that supports the benefits of post-exercise compression, including promoting the removal of lactic acid and relieving delayed onset muscle soreness after a strenuous workout.
Choosing the right garment
Depending on the manufacturer, sports compression comes in a variety of styles, colors, and materials. For lower extremities, a compression sleeve covers the calf and lower leg but not the foot and ankle like a compression sock or stocking does.
Calf sleeves are very popular among athletes because they’re easy to get on and off and are applicable across many types of sports. There is some possibility for swelling to occur in the ankle where the sleeve stops, so be sure you’re applying them correctly. Additionally, calf sleeves should be worn only during activity, not before or after.
Although sleeves provide compression from ankle to knee, it is important to get the full compression offered by a compression sock or stocking post-exercise to receive the most benefit in recovery.
Most athletes who use compression are long-course endurance athletes, however, tennis players, golfers, or anyone who is moving around on their legs may find that their legs feel better with compression.
There are also numerous options on the market for hikers; hiking socks come in wool and other materials appropriate for various climates. Compression works well for hikers to support good venous return, since they often put excessive stress on their calves as they walk uphill.
Compression garments also come in a variety of grades. The gradient compression is expressed in millimeters of mercury, or mmHg, which is the measurement of how much compression or “squeeze” that is placed on the leg: the higher the number, the greater the compression. Socks and stockings are graded on the basis of the strength of the compression at the ankle.
Most athletic compression is 20-30mmHg, with some in the 10-20mmHg range. Compression is available over the counter, but remember to look for graduated, or gradient, compression, meaning the pressure is highest at the foot and ankle and gradually decreases as the garment rises up the leg. Some products marketed toward athletes may not be graduated and will not provide the benefits. Buy from a reputable company, one that has tested their products and lists the level of graduated compression on the packaging.
A good fit is also critical. Different brands fit individuals differently. Be sure you get properly measured and try the garment on if you can. A trained compression fitter will measure the ankle and calf circumferences on a customer’s leg, as well as take into account his or her shoe size.
Regardless of the style, graduated compression should not be worn to bed, unless specifically cleared by a healthcare provider. (“T.E.D” hose are not the same as graduated compression stockings.) Potential contraindications to graduated compression include arterial disease, diabetes and congestive heart failure, although that doesn’t mean that those who suffer with these conditions can’t wear compression.
One last important note: compression is a must-have for athletes who travel for competitions, especially post-competition and on long international flights. Extended periods of immobility can be associated with deep vein thrombosis, or DVT, a blood clot in the deep vein system. DVT can be cause for concern because the clot could break free from the vein wall and enter into the blood stream, traveling to the lungs and become a PE (pulmonary embolism), or to the brain and result in a stroke.
All in all, graduated compression is a good tool to consider, whether one is an elite athlete, a weekend warrior, or just likes to keep active.
Dr. Cindy Asbjornsen is the founder of the Vein Healthcare Center in South Portland, Maine. Certified by the American Board of Venous and Lymphatic Medicine, she cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers. She is the only vein specialist in Maine to be named a Fellow by the American College of Phlebology. You can contact Dr. Asbjornsen at 207-221-7799 or: [email protected].
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