If you read running magazines or follow popular exercise blogs, you've probably heard about compression therapy already. Many of the top athletes in the world have been seen wearing compression garments—Serena Williams, Lebron James, Usain Bolt. Fans of compression therapy claim that it shortens their recovery period and helps them to prevent injuries. After reading all the stellar reviews from professional and semi-pro athletes, you may be wondering how compression works and what exactly it can do to improve your running. In this article, we'll try to separate the fact from the fiction.
Here's the short answer. Yes, compression garments may help you experience less soreness and fatigue. No, a pair of compression socks will not magically turn you into Usain Bolt.
A Summary of the Science
In a review of scientific literature published in Sports Medicine, researchers tried to answer the question, “Is there evidence that runners can benefit from wearing compression clothing?" They came to the following conclusions, based on close analysis of 32 experiments conducted with 494 participants. The studies cited in the review tested the efficacy of different types of compression garments, including socks, stockings, tights, shorts, and sleeves.
Compression had small beneficial effects on:
- Time to exhaustion (in incremental or step tests)
- Running economy (including biomechanical variables)
- Clearance of blood lactate
- Perceived exertion
- Maximal voluntary isometric contraction
- Peak leg muscle power immediately after running
- Markers of muscle damage and inflammation
Moderate effects were observed for:
- Body core temperature
Experiments showed large beneficial effects for:
- Post-exercise leg soreness
- Delay in onset of muscle fatigue
The strongest positive outcomes from compression therapy were the reduction in post-exercise soreness and delay in muscle fatigue, and those benefits seem ideal for professional athletes with intense training regimens. Even for amateur runners, keeping soreness and fatigue at bay enables more training with less discomfort.
How Do They Work?
Next, let's talk about some of the mechanisms that contribute to reductions in soreness and fatigue.
Compression socks work by squeezing the legs and improving venous velocity. By improving blood flow, they eliminate deoxygenated blood and waste fluids from the feet and lower legs. While stagnant blood and waste fluid can cause edema (swelling) and inflammation, healthy blood circulation keeps legs light and lean. In addition to ridding the lower legs of blood and lymphatic fluid, compression socks also help to remove lactic acid. A buildup of lactic acid, which occurs when muscle cells use more oxygen than the blood can deliver, causes feelings of discomfort, soreness, and fatigue. As mentioned above, the Engel et al. review found a small link between compression garments and the clearance of blood lactate.
Runner's World explains more about lactic acid, writing,
When you’re in oxygen deficit your heart can’t deliver oxygen to muscles fast enough and you’ll produce lactic acid, which is the burning sensation and utter fatigue you feel when you push it hard. Lactic acid is ultimately what makes you stop. The key to beat lactic acid build up is to deliver oxygen more efficiently – and that’s where compression wear can help. ("The Science")
So, the faster you can eliminate deoxygenated blood and waste materials from your lower legs, the sooner your "used" blood reaches your heart. When that happens, the whole process starts again with oxygen-rich blood. By preventing blood and waste fluid from building up and stagnating in the lower legs, you ensure the healthy functioning of your circulatory system and give yourself a faster recovery.
Do Compression Socks Only Benefit Runners?
A study of athletes with cervical spinal cord injuries, published in 2016, generated some interesting results, reinforcing the idea that compression socks benefit the entire circulatory system. The study observed elite wheelchair rugby athletes, and the ones wearing compression socks demonstrated better average lap times and greater increases in blood flow to their arms. The scientists concluded, "These findings indicate that compression socks worn during exercise is an effective intervention for maintaining submaximal performance during wheelchair exercise, and this performance benefit may be associated with an augmentation of upper limb blood flow." (Vaile) So, this study suggests that it could be beneficial for endurance athletes to wear compression socks, even during times when the legs and feet aren't exerting energy.
Another study observed athletes performing a netball-specific circuit including 20m sprints and countermovement jumps. Some wore typical netball garments, some wore compression garments, and some wore placebo garments. The researchers found, "...Results of effect sizes analyses showed repeated performances at high speeds were improved in this [compression-wearing] sample of well-trained netball players." (Higgins) This result seems to reinforce the conclusions of Engel et al., which identified "peak leg muscle power immediately after running" as a factor improved by compression. Netball players who wore compression garments, like runners, were able to recover and perform well immediately after strenuous exertion.
Compression therapy has been shown to improve the capacity for performance in volleyball players as well. The researchers explain, "The data indicate that compression shorts, while not improving single maximal jump power, have a significant effect on repetitive vertical jumps by helping to maintain higher mean jumping power." (Kreamer "Influence...Garments") Once again, this study suggests that athletic performance can be improved with compression therapy, specifically when it comes to repeated exertion. As with the runners and the netball players, these results indicate that compression gear can improve performance that involves repetition.
Compression therapy can also be used to manage soft tissue injuries. After an injury, an enzyme called creatine kinase leaks out of damaged muscles. Scientists can use the presence of this enzyme to measure recovery. In a 2001 study, twenty women wore compression sleeves after eccentric muscle damage due to arm curls. According to the researchers, "...The experimental compression test group showed decreased magnitude of creatine kinase elevation following the eccentric exercise." This study suggests that compression therapy may clear away creatine kinase, perhaps using the same mechanism that removes lactic acid. The researchers added, "Compression sleeve use prevented loss of elbow motion, decreased perceived soreness, reduced swelling, and promoted recovery of force production." (Kreamer "Influence...Therapy")
In a variety of sports, compression therapy has been shown to provide measurable benefits for experimental subjects. In fact, diverse forms of exercise—wheelchair rugby, netball, volleyball, and weight lifting—may extend an advantage to players wearing compression gear.
What Are the Best Kind of Compression Socks for Running?
Graduated compression socks provide the best functionality for runners. They offer more compression in the ankle and less in the calf, giving an extra boost to the veins as they work against gravity. They're helpful during a run—and afterwards, too.
A 2015 study of graduated compression in The Journal of Strength & Conditioning Research explains, "...All runners would benefit from the use of compression socks for 48 hours following exercise and they should see a 6% improvement in their recovery parameters." (Armstrong) Researchers assessed runners two weeks after they completed a marathon, requiring them to run to the point of exhaustion. Those runners who wore graduated compression socks in the 48 hours after the marathon increased their average running time, whereas the placebo group was unable to sustain their previous average.
Sprinters and long-distance runners wear graduated compression socks to energize their legs, improve recovery time, prevent swelling, remove waste fluids (like lactic acid and creatine kinase), and reduce muscle soreness. Plus, compression socks keep your legs feeling light and comfortable.
Notice how we didn’t say anything about compression socks helping you to set a new world record in the 100 meter.
They’re good, but they’re not magic.
If you’re ready to give graduated compression therapy a try, check out our favorite compression socks for runners:
Companions | These 15-25 mmHg knee-high socks are made from SmartSilver fabric. Real silver binds with the fabric on a molecular level, so you only need to wash them once every 3-5 runs. Don't worry. Your gym bag won't smell.
One of our customers, Jaime R, says: "Soft, smooth material that make for great compression. Worked all day and then went for a 3 mile run. These socks are great."
Guides | These 15-20 mmHg graduated compression socks come in moisture-wicking merino wool. Because they're naturally temperature controlled, they're the perfect choice for trail running. Cozy, soft, and they're tall enough to protect you from poison ivy.
Judith P says: "These socks feel so good. I have less lactic acid burn in my calves and my legs feel less fatigued..."
Allies | With 360 degree targeted compression and arch support, these ankle-length socks are everyday heroes. SmartSilver fabric and quick-drying, breathable mesh make them the best compression socks for times when you're on the run and looking for a pair that's small and light.
Mat says: "I have tried so many ankle socks and many just end up sliding off. But these are great, just the right amount of compression to stay on. These are perfect for all uses from casual wear to workouts."
Armstrong, Stuart A., Till, Eloise S., Maloney, Stephen, & Harris, Gregory A. "Compression Socks and Functional Recovery Following Marathon Running," The Journal of Strength & Conditioning Research, Vol. 29, Iss. 2, 2015, pp. 528-533, https://journals.lww.com/nsca-jscr/Fulltext/2015/02000/Compression_Socks_and_Functional_Recovery.30.aspx,
Higgins, Trevor et al. “Effects of wearing compression garments on physiological and performance measures in a simulated game-specific circuit for netball.” Journal of science and medicine in sport vol. 12,1,2009, pp. 223-226, https://pubmed.ncbi.nlm.nih.gov/18078789/.
Kraemer, WJ, Bush, JA, Bauer, JA, Triplett-McBride, NT, Paxton, NJ, Clemson, A, Koziris, LP, Mangino, LC, Fry, AC, and Newton, RU. "Influence of compression garments on vertical jump performance in NCAA Division I volleyball players." Journal of Strength and Conditioning Research, vol.1, iss. 3, 1996, pp. 180-183, https://insights.ovid.com/strength-conditioning-research/jscr/1996/08/000/influence-compression-garments-vertical-jump/9/00124278.
Kraemer WJ, Bush JA, Wickham RB, et al. "Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise." Journal of Orthopaedic & Sports Physical Therapy, vol 31, iss. 6, 2001, pp. 282-290, https://pubmed.ncbi.nlm.nih.gov/11411623/.
“The Science Behind Compression Kit.” Runner's World, Rodale, Inc., 10 Sept. 2018, www.runnersworld.co.za/health/the-science-behind-compression-kit/.
Vaile, Joanna, Stefanovic, Brad & Askew, Christopher D. "Effect of lower limb compression on blood flow and performance in elite wheelchair rugby athletes," The Journal of Spinal Cord Medicine, vol. 39, iss. 2, 2016, pp. 206-211, https://www.tandfonline.com/doi/full/10.1179/2045772314Y.0000000287