(Listen to Podcast Episode 95 about Compression Gear)
Let’s take a look at the ubiquitous calf sleeves and their close relative, compression knee socks.
No matter where you run or race, you likely see many runners wearing compression garments, most often compression calf sleeves and socks, and maybe you even wear them, yourself. That’s our topic, today.
I think I first noticed people wearing compression gear in races about four years ago; so, they’ve been around for a while now, and their popularity shows no sign of waning. Yet, many questions remain: Do the work? Do they improve performance? Do they reduce recovery time? Do they help reduce DOMS (delayed onset muscle soreness)?
Wow! That expresses quite a range of unknowns, and I’ll tell you right now that despite quite a few studies, there is still little conclusive research to support the wealth of anecdotal reports. That said, there is definitely research to support some of the claims.
These garments are manufactured and sold by virtually every brand of running apparel, and you can buy compression garments for your upper body, arms, midsection, hips, thighs, and of course calves and feet. You can purchase compression shirts, shorts, and pants.
Imagine the variety of technologies used as each company executes their version of the most effective design. As you might expect, every manufacturer will tell you they have developed a superior design.
Another consideration is that fit is critical!
Then, consider that some – probably most – full compression calf socks are sold according to the shoe size. I’m pretty sure that a person’s shoe size is no more than a general indication of calf circumference. If these calf socks/sleeves do work, I’m sure it’s critical that they fit appropriately. I have half a dozen pairs, and some fit more snugly than others. Plus, they fit differently, some more snug in areas where others aren’t as snug. I wear the most snug-fitting ones when I’m hoping for any boost in performance or recovery. The others? Well, I just wear them because I like them, because they feel good and mostly to keep my legs warm on cold mornings.
My viewpoint is that if they’re not a real bear to put on and especially to remove, then, they’re probably not snug enough to be effective.
When you go to buy compression socks, the running store employee should measure your calf. Be very sure you get fitted properly because if they don’t fit, they definitely won’t improve performance or speed recovery.
Which brings us to the main point, do they work at all? In general, they are touted to make you
- run faster in races
- feel more energetic in races
- recover faster when worn for several hours or more, post race
Now, let’s get more specific and look at the claims of the various manufacturers.
This is from the Sigvaris website:
- Increased circulation and improved blood flow
- Increased oxygen to muscle tissue
- Reduced pulled muscles and less exercised-induced muscle soreness in the legs
- Less lactic acid buildup in the legs during exercise
- Improved energy, performance, and recovery
- Injury prevention and reduced shin splints & calf cramps
From the website of another well-known company, CEP:
“CEP products enhance performance and recovery through the targeted use of compression to improve blood circulation and speed up lactate metabolism. CEP offers the right product for every athlete to achieve a perfect balance between health and performance.”
From the website for the Pro Compression brand:
“Compression has long been a successful strategy for combating muscle soreness and fatigue. By applying graduated compression—or the right pressure in the right places—you increase blood flow. And when you increase the blood flow, your broken down soft tissue can repair itself more quickly. Put simply, compression helps your body move through its natural recovery process quicker so you feel better faster.”
From yet another company, Zensah:
- Increase oxygen blood flow to energize your legs pre-run
- Enhance athletic performance while running
- Aid in recovery after running.
Key here is that, of course, this is what the companies say about THEIR products. I certainly hope the socks do all those wonderful things, but I’m not – definitely not – going to tell you I believe they do all those things; however, they have been proven effective for some of these benefits in some studies.
In the ACSM’s Blog (American College of Sports Medicine), the article, “Active Voice: A Novel Strategy for Promoting Recovery of Muscular Strength after Strenuous Exercise in Competitive Athletes,” guest blogger Kazushige Goto says, “The wearing of compression garments after exercise promotes recovery of muscular strength and attenuates exercise-induced muscle damage.” I should point out that while his article is on their blog, their blog site clearly states that ACSM does not necessarily agree with the views of guest posters. This was from an article which he and colleagures published in the journal Medicine & Science in Sports & Exercise, in December, 2014. Kazushige Goto has his Ph.D in sports medicine at Ritsumeikan University.
He sounds pretty sure, but after looking at the research, I can tell you that most of the studies showed either no benefit or only a small benefit, certainly not enough to get really excited about.
Some people did experience some improvement, but it generally was not earthshaking, and it is worth pointing out that the participants knew what was being tested; so, there was no way to control for psychological bias.
The athletes wearing the compression socks knew they were wearing them, and how could they not? These socks are tight; they FEEL different. I can’t imagine any way to test the same athletes both wearing the socks and not wearing them in identical situations and no way for them not to know the difference; therefore, there is no way for their experiences and opinions not to be affected by their expectations.
And the only way to really know would be to have the same runner run the same race in the same weather on the same day, both with the compression socks and without, which is certainly impossible. The runner couldn’t run a race twice, back to back and be able to compare performance. The same runner would have to be able to actually be doing two things at once. Right? And that’s not possible.
If the runner did the same thing two days in a row, that’s still no good. Too many variables, too many things would have changed.
And consider this: Most of the athletes tested were elite athletes, or at least very serious competitive athletes, people who were quite dissimilar to 90 percent of the runners out there that are asking if these compressions socks will be effective for them. It seems to me that, in fact, the people who may benefit the most are the middle of the pack runners and beginner runners, and they are not the ones involved in the testing.
Just an aside: I think this happens a lot. Various equipment is marketed to ‘all’ runners, but it’s tested almost entirely by hot shot, very competitive athletes, which is a relatively small percentage of potential buyers.
Additionally, most of the studies were with athletes running short distances, at most 10k’s, but often, it was track athletes, not distance runners, and much of the research was done on treadmills – not at all the same.
I’m much more interested in seeing research to determine their effectiveness for average runners competing in half marathons, marathons and ultras.
Really, I think, in this case anecdotal evidence is perhaps the best information we can get – that and personal testing. By that I mean get your own pair and see what you think. It’s not like this is a $100 investment. I say buy yourself a pair and evaluate them, yourself. At best, you feel like they help. At worst, you have a new pair of knee socks for cold days.
The Placebo Effect
I’ve heard and read many anecdotal studies of people who report great benefits. Now, of course, some of these are, again, the result of these runners BELIEVING that they will perform better and recover quicker when using the socks, but, really, if these socks do provide that service, if they make people believe they’ll perform better, then that’s still good. It’s not really so important why they work or if there is some research to show they worked for someone else.
I think, from my experience in working with runners, the very most valuable use of these compression socks is to provide protection against shin splints. Honestly, if that was all they were good for, that would be plenty.
If you think about it, shin splints occur when the muscle gets pulled away from the shin bone, and it usually happens when runners do too much too soon, build their mileage too quickly, run hills when not gradually conditioned to do so, start doing speed work for the first time, or ramp up the quantity of speed work too quickly. Well, I believe there is a good chance that calf sleeves can prevent this or lessen its severity or help speed recovery. Unfortunately, I don’t find any studies to evaluate their value in achieving this goal. My personal opinion is that they definitely do help, but I have no research to back it up.
So, as for me, I really do believe they are effective for many runners, but not necessarily for the reasons advertised and not necessarily for all runners.
I’ll say that, for myself, I do very often wear compression socks; I wore them on my trail run, today.
In fact, I wear them on any longer run and in all longer races. As I record this podcast, I have already laid out my clothes for the long training run I have on my schedule for tomorrow morning, and you better believe my compression socks are draped over my shoes.
I wear compression calf sleeves, occasionally, but I usually wear the ones that are the full length socks. In other words, they’re actually compression knee socks. I prefer these just because I like the way they feel. I’m not going to tell you I think they help my feet in any way. I just like the way they hug my foot. I have several different brands, and one thing that I’ve found with these full length compression socks is that some brands are too tight through the toes. The ones I prefer do not compress the toe area, and I think that’s important because it’s best for toes to splay. That doesn’t happen much because the toe boxes of most shoes don’t provide enough room; however, my Altras definitely do. Well, what would be the point of wearing shoes that allow space for my toes to splay if I wear confining compression socks that prevent it?
So, if you wear the full socks, I recommend using the ones that do not restrict your toes.
Now, why do I wear them?
Honestly, I like the way they feel. How is that for scientific? They feel like they’re helping, and that’s good enough for me. I grew up on a swim team and later coached swimming. The boys on the swim team always shaved their legs and heads before the championship meets. Contrary to what you might think, this wasn’t because that made them slide through the water better; it was because it made them feel faster, and really I just think they liked the excitement of going to school with shaved heads, and seeing the reactions of their friends. You know what I say, “Whatever works.” It made them FEEL faster and it made them more excited about their races. That was good enough.
This is not too sophisticated, not a technical reason, just a preference, but I wear them because in the cooler months, they keep my calfs warmer. Oh, sure, I could just wear knee socks, but these are thicker, and having lived in Florida my whole life, the cold, even a little cold, does bother me just like Florida’s summer heat and humidity really bother people who move here from up north. I’d rather wear compression socks up to my knees and shorts than long pants.
I like the way they look. I have all different colors, and I enjoy wearing them. Again, nothing technical at all about that. But, hey, I think running should be fun.
Much like the prior reason, I like them because they keep my legs and ankles cleaner on trail runs. Again, this has nothing to do with performance or recovery.
They feel like they help me run a little better, stay stronger, longer, on long runs, but I can’t possibly know this to be true because there is no way to test it.
Now, as you can see, none of those reasons is terribly compelling, but they do seem to help my legs stay fresher in marathons, and that is compelling.
I do believe, as well, that they help me recover faster. It seems that I experience less DOMS, delayed onset muscle soreness when I wear them for the next 12 to 24 hours after I race, but the difference isn’t tremendous.
I should say that I only wear them in the cooler months. I live in Florida, which means much of the time when I’m running it’s in the 80’s with high humidity. I would never wear them in those temps. So, I only wear them when it’s in the 70’s or lower. When I started my run today, it was cool – ish at 66; so, I had them on, but it was 82 when we finished, and I was wishing I had left them at home.
A review of studies doesn’t help much.
A look at the dozen or so studies doesn’t help much because many are inconclusive and they mostly did not evaluate them in real world conditions on real people running half marathons and marathons and even if they did, it would be virtually impossible to evaluate their physiological effectiveness without that being affected by their psychological influence.
That said a couple of studies have shown slight improvement in both performance and recovery, supporting a wealth of anecdotal evidence.
There is one group I adamantly recommend use these, and that is new runners or runners doing speed work for the first time or runners building their mileage. These runners are most prone to shin splints, and I do believe they definitely help with this. Now, I haven’t seen a study proving that, but to my way of thinking, what do you have to lose?
Well $40 to $60 bucks, actually, but if it was me, I would consider that a worthwhile investment.
ACSM Blog “Active Voicle: A Novel Strategy for Promoting Recovery of Muscular Strength afterStrenuous Exercise in Competitive Athletes” published in April, 2015 by guest author Kazushige, Ph.D
“How Compression Apparel Works,” by Aaron Hersh, Feb. 14, 2014, Competitor.com,