Do Compression Socks Really Work?
Kelly O'Mara— It doesn’t take much to convince runners to jump on the latest trend promising faster marathons and quicker recovery.
With manufacturers claiming that compression socks and tights increase oxygen delivery, decrease lactic acid, prevent cramps, and minimize muscle fatigue, the wonder garments have been the hottest new item in athletic circles. But, whether or not the socks and tights deliver as promised has been an open question—one even researchers don’t have a clear answer for.
“There is no doubt that many runners trust compression garments,” said Ajmol Ali, a PhD in the Sports and Exercise Science Department of Massey University. Ali has conducted a number of studies on the garments with mixed results.
For decades, medical-grade graduated compression socks have been used to combat deep vein thrombosis, or the formation of blood clots. By increasing the circulation and blood flow, research has found the socks to be effective for bed-ridden and inactive patients.
Research on the effectiveness of compression garments in athletic pursuits, though, has been hit or miss.
“Very little evidence exists (ie. two to three studies out of 15-plus) from a sport and exercise perspective that compression garments improve performance when worn during exercise,” said Rob Duffield, a professor at the School of Movement Studies at Charles Sturt University.
One study found that when 21 male runners did two step tests – one with compression socks and one without – they were able to go slightly longer wearing the compressions before exhaustion. There have also been some small increases seen in anaerobic threshold, particularly in cycling, and in jumping performance. The theory is that the tights prevent oscillation of the muscles sideways and promote muscle efficiency.
But, Ali noted that many of the studies that have found increases in performance did not use a placebo or control, making it nearly impossible to tell if the increases were really from the compression or from the athlete’s perception of the compression.
And, countless other studies have found no differences in running times, VO2 max, oxygen consumption or heart rates between athletes wearing the socks and those who weren’t.
“Most of the research shows that there are no performance benefits,” said sports physiology professor Elmarie Terblanche, from Stellenbosch University in South Africa.
Terblanche, however, said that most studies are done in the lab. She recently conducted the first real-world study, following athletes running the Two Oceans ultra-race in South Africa. What she found was that the athletes who raced in compression socks, versus those in regular knee-high socks or those without either, had significantly less muscle damage and were able to recover more quickly, with some even ready to train again three days later. Those wearing the socks also ran on average 12 minutes faster.
“Considering that they ran one of the most difficult ultras in South Africa, this was significant,” she said.
Terblanche recommends that athletes wear the socks for long sessions and for the 24 hours following. While she acknowledges her study can’t be considered conclusive, because there’s always a chance for a placebo effect in the real-world scenario, the recovery findings are in line with other research.
Multiple studies, including one done by Ali, have found decreases in muscle soreness and perceived fatigue. Some possible increases in blood flow and lymph removal during the recovery period have also been found – though other studies found that wearing the socks after workouts had no greater recovery effect than taking an ice bath.
It was the recovery benefits that won over Chris Solinksy, the former American 10,000m record-holder, who wore compression socks when he became the first American to break 27:00 two seasons ago.
“I found I was able to come off the workouts much, much quicker,” said Solinksy. He wears the socks during hard workouts and races, and finds he recovers faster. He also originally thought he raced faster in them, but that proved not to necessarily be true.
Solinksy isn’t too worried, though, about how exactly it works or what the science says. He knows he likes it.
“I’m kind of a simplistic barebones type of runner,” said Solinksy.
For athletes to get the full benefit, the compression needs to be graduated (tighter at the ankle and decreasing to the hip), fit the individual, and have 22 – 32 mmHg of pressure. There haven’t been any differences found in brands. And, Terblanche said she hopes to study next how compression garments hold up with use.
To a degree, if there’s no harm done – as long as it’s not too tight or irritating or causes blisters – then it hardly matters whether the benefits are in the athlete’s head or not.
“If athletes like wearing them, and feel that the garments are helping their performance and/or recovery (whether it is a true effect or simply a placebo effect), then I don’t see any harm in recommending them,” said Ali.
About The Author:
Kelly O’Mara is a journalist/reporter and recovering professional triathlete. She lives in the San Francisco Bay Area and writes for a number of magazines, newspapers, and online news sites. And, she eats a lot of brownies.