Do Compression Garments improve recovery and enhance performance?
Effects on Inflammatory Response
The effects of DOMS following strenuous exercise are very well-documented, however, the primary mechanism responsible for this phenomena is still not fully understood. Whilst some believe that DOMS results from the disruption of muscle fibres and surrounding tissues (2), others believe that it is associated with the inflammatory response (3). Perhaps the most realistic theory is that it is actually a combination of both the disruption of the muscle fibres and their surrounding tissues and the effects associated with the inflammatory response (4).
The inflammatory response is a process which follows tissue damage caused by strenuous activity. This response leads to an increase in osmotic pressure/swelling, therefore sensitising nociceptors (pain sensory nerves) and causing the sensations of pain and soreness (5). It is thought that wearing compression garments applies external pressure upon the body and thus decreases the osmotic pressure and reduces the space available for swelling and haematoma. A reduction in osmotic pressure may lessen the degree of chemotaxis, therefore reducing the inflammatory response and the experience of pain (1). However, due to a current lack of evidence, this theory still remains somewhat uncertain.
Effects on Creatine Kinase
In addition to alleged effects of compression garments on inflammatory responses, their impact on the attenuation of creatine kinase has also been substantially explored. Creatine kinase (CK) is a well-understood biomarker of muscular damage (6). In fact, the use of compression garments has been shown to be an effective recovery tool for reducing CK concentration after exercise (1). This reduction in CK concentration has been related to a lessening of CK release into the bloodstream, improved removal of metabolites (waste products), and an enhanced repair of muscle tissue (5, 7).
It is suggested that compression garments may improve circulation, potentially by enhancing the ‘muscle-pump’ function, however, this still remains uncertain (7). If this were to be true, then compression garments may result in an increased venous return, facilitating the removal of metabolites, and therefore explain the lowered CK concentrations. It is important to note however, that there are large inconsistencies in the current evidence – some suggesting compression garments can lower CK concentrations, and some suggesting no change (8, 9).
Despite there being a variety of mechanisms thought to be responsible for the reduced perception of DOMS and lower concentrations of CK post-exercise following the use of compression garments, it is shown that muscle strength and power recover quicker with the use of compression garments (1).
Effects on Cardiovascular Function
The impact of compression garments on cardiovascular function has also been well-explored. They have been shown to have very little effect on sub-maximal or maximal heart rate (7, 10), and sub-maximal and maximal plasma lactate concentrations (7, 11). So whilst it is obvious that compression garments have no benefit on the delivery and utilisation of oxygen during exercise, there is evidence to suggest they may improve sub-maximal running economy (12).
One study showed that the use of compression garments improved the oxygen cost of running (running economy) by approximately 9% at velocities of 10, 12, 14, and 16 km/h (12). However, as compression garments have been shown to have no effect on cardiovascular response (7, 11), it has been suggested that compression garments may actually improve running economy by increasing proprioception, muscle coordination, and the propulsive force during running (12).
Effects on Proprioception and Muscle Oscillations
Research has indicated that compression bandages may improve joint position awareness (proprioception) by the external pressure acting upon the receptors within the skin, thus enhancing proprioceptive abilities (13, 14). Whilst this is a possibility, to our knowledge, this theory has not been directly tested on compression garments, only compression bandages (13, 14).
It has also been demonstrated that compression garments reduce muscle oscillations during dynamic activities such as vertical jumping (15, 16). Reducing muscle oscillations during exercise is thought to reduce muscle fatigue and tissue damage.
Effects on Perceptual Responses
It is often believed that compression garments can have a positive psychological effect (i.e. placebo) on performance and recovery, by decreasing the individual’s perception of DOMS and their rate of perceived exertion (RPE). As previously discussed, the effects of compression garments on DOMS is still unclear. This recovery method has also been repeatedly shown to have little effect on the ratings of RPE during various running and sprinting protocols (7, 10, 16). This suggests that compression garments may have small, or non-significant, placebo effect on recovery.
Compression garments are worn not only to improve chronic recovery (between training sessions), but also as a method to enhance acute recovery (during training sessions). A 2013 meta-analysis concluded that they can improve chronic recovery of muscle strength and power between training sessions (1). However, there appears to be little evidence supporting their ability to enhance acute recovery during squatting, jumping, sprinting and agility tasks (17, 18, 19, 20). Though compression garments may not improve acute recovery during training sessions, it is important to note that no negative effects on performance have been observed whilst wearing them. This suggests that whilst compression garments may offer no additional acute recovery benefits, they are certainly not going to negatively impact performance.