Compression garments are widely accepted in the High Performance environment as a modality for enhancing recovery from exercise. As practitioners, I’m sure many of us have witnessed or perhaps even encouraged and implemented the use of these garments with our athletes. Their use has also been demonstrated in the literature, for example in one professional AFL team 75% of players chose to use a combination of compression garments and cold water immersion as their post-match recovery strategy when they were monitored across a season (Bahnert et al, 2013).
Many recovery strategies for elite athletes, including compression garments, are based on medical therapies used in patient populations and compression is widely described for treatment of acute injuries as part of the RICE protocol (Rest, Ice, Compression, Elevation). The first study to investigate the use of compression following soft tissue injury from maximal eccentric exercise (Kraemer et al, 2001) demonstrated the use of a compression sleeve garment for five days decreased the magnitude of muscle damage (inferred via Creatine Kinase (CK) values) prevented loss of motion about the elbow joint, decreased perceived muscle soreness, reduced swelling and improved recovery of force production.
With many brands of compression garments available and in use with sporting populations, research has gathered over the last seven or so years to try to establish their efficacy. The possible mechanisms put forward in favour of their efficacy as a recovery modality include optimising circulation by increasing blood flow at the extremities thereby increasing venous return as well as attenuating the inflammatory response. Given that Exercise Induced Muscle Damage (EIMD) can be a limiting factor in team sports, a modality that can accelerate muscle repair thus reducing the effects of EIMD may be advantageous to these athletes.
I have put together a summary of some of the literature that will be published in this series across four weekly posts (think of it as Sports Discovery’s Christmas present to you over the festive period!!):
Part 1 Introduction and Garment Considerations
Part 2 Muscle Damage and Inflammation
Part 3 Muscle Function and Physical Recovery
Part 4 Perceptual Recovery and Conclusions
Please note while this review focuses on post-exercise recovery in mainly team sports, there are other proposed benefits of compression garments both during exercise and in other sports.
Whilst all designed with the same function to enhance circulation and venous return, the actual pressure applied varies depending on the mechanical properties of the specific garment. The pressure applied by a garment is influenced by the following factors; fit and construction, structure and physical properties of materials used, size and shape of body parts to which it is applied and the nature of the sporting activity undertaken (Troynikov et al, 2010).
This reinforces the difficulty in making conclusions across the body of research given the range of garment commercially available and used in the literature, which include compression sock, waist to ankle, full leg length, arm sleeve and full body. Consideration must also be given between different brands and products over times especially given advances in technology for manufacturing compression garments. One study included analysis across three different brands of lower body compression garment and although measures of applied pressure were not noted, they found no statistical differences in outcome measures between them (Duffield and Portus, 2007). Whilst useful, given the variation already discussed, this finding should not be taken as a consensus statement between brands and further research is warranted.
Commercially available compression garments specifically for sport do not align with the recommendations for an optimal pressure gradient that would generate the fastest venous flow and little attention is given in research to quantify the actual pressure applied by these garments (Troynikov et al, 2010). Researchers are urged to note the fabric and applied pressures and areas of the body, or if pressures were not measured, to list the source of the garment to allow comparisons across studies (MacRae et al, 2011). In light of these recommendations, Pruscino et al (2013) carried out pressure interface testing at three sites on the lower limb in each of their subjects and published the results.
Since the initial tension applied by a compression garment will reduce over its lifetime due to fabric fatigue (Troynikov et al, 2010), research should be carried out to ascertain the ‘shelf life’ of fabrics and commercially available compression garments and/or a valid method for monitoring the fabric tension of garments over time. These recommendations are required in the applied setting for athletes who purchase and use these garments.
Whilst we will be reviewing the evidence of how compression garments affect inflammation, muscle function and perceptual recovery, the variability across the factors discussed above in garments make consensus statements difficult. Researchers should consider measuring and noting these factors and publishing alongside the results. From an applied perspective we should consider are the garments designed and maintained to provide optimal compression – are we even able to know if they do?
Next week’s post will review the research on muscle damage and inflammation with compression garments.
Bahnert A, Norton K and Lock P. (2013) Association between post-game recovery protocol, physical and perceived recovery, and performance in elite Australian Football League players. J Sci Med Sport 16: 151-156.
Duffield R and Portus M. (2007) Comparison of three types of full-body compression garments on throwing and repeat-sprint performance in cricket players. Br J Sports Med 41: 409-414.
Kraemer WJ, Bush JA, Wickham RB, et al. (2001) Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. J Orthop Sports Phys Ther 31: 282-290.
MacRae BA, Cotter JD and Laing RM. (2011) Compression garments and exercise: garment considerations, physiology and performance. Sports Med 41: 815-843.
Pruscino CL, Halson SL and Hargreaves M. (2013) Effects of compression garments on recovery following intermittent exercise. Eur J Appl Physiol 113: 1585-1596.
Troynikov O, Ashayeri E, Burton M, et al. (2010) Factors influencing the effectiveness of compression garments used in sports. Procedia Engineering 2: 2823-2829.
More research just coming out about the considerations and variation of pressure by different garments:
The variation in pressures exerted by commercially available compression garments
Hill et al (2015)
Confounding compression: the effects of posture, sizing and garment type on measured interface pressure in sports compression clothing
Brophy-Williams et al (2014)