Jan 29, 2015The Press Is On
With the latest research into compression’s effects and benefits, science is learning more and more about why many athletes today consider compression wear to be standard equipment.
By Kyle Garratt
Kyle Garratt is an Assistant Editor at Training & Conditioning. He can be reached at: [email protected].
A generation ago, if you saw athletes competing in ultra-tight apparel that compressed the skin beneath it, chances are they were gymnasts. The form-fitting material was perfect for a sport that emphasizes aesthetics.
Today, however, compression wear is donned by athletes in just about every sport, from field hockey to football. Athletes say they put it on to keep their muscles warm, because they believe the pressure supports optimal muscle function, or just because they like the way it feels. Compression products have also been touted as helping to limit muscle damage and boost recovery.
And judging from their widespread use, it’s clear that athletes are feeling benefits. “I can’t think of one sport on our campus in which the athletes don’t wear some sort of compression equipment,” says Fred Hina, MA, ATC, CSCS, Head Athletic Trainer for men’s basketball at the University of Louisville. “For many athletes today, it’s simply considered part of the uniform.”
REVIEWING THE SCIENCE
The term “compression wear” encompasses a wide variety of products with different effects. At one end of the spectrum, some provide extreme compression and are designed mainly for power lifters looking for muscle support. At the other end, some offer so little compression that they’re hardly more than athletic fashion. Most competitive athletes should wear compression clothing that falls somewhere in between.
“The most important thing to realize is that not all garments are the same, and various products have different effects under different conditions,” says William Kraemer, PhD, Professor of Kinesiology, Physiology, Neurobiology, and Medicine at the University of Connecticut and one of the country’s foremost experts on compression wear in athletics. He says the best garments for athletes contain roughly 25 percent synthetic compression fiber (commonly known as spandex or by the brand name Lycra), as those products tend to be more functional than ones made solely from natural fabric. And some compression garments now feature advanced proprietary fibers to further enhance the compressive effects.
Research into the physiological impact of compression clothing is still relatively new, and as a result, few firm conclusions have been drawn on how these products may help athletes. But as the inquiries continue, a picture is beginning to emerge of just what compression wear does.
In the 20 years Kraemer has been studying athletic uses for compression garments, one of the most commonly discussed benefits has been enhanced proprioception. “Some studies have shown that it helps with the understanding of kinesthetic sense–where the body parts are in space,” he explains. “That’s due to the force applied to pressure receptors on the skin.”
A study Kraemer and colleagues performed at Pennsylvania State University in 1995 showed that blindfolded athletes were able to tell where their hip and knee joints were in space more accurately while wearing compression garments than without. Further research a year later showed that athletes wearing compression shorts reached a higher average height in repetitive vertical jumps, suggesting compression wear enhances power endurance.
Another possible benefit involves limiting muscle damage. “Some of our research suggests that by keeping the muscle more supported, you get less oscillation, bouncing, and overall movement,” says Kraemer. “That reduces the amount of damage to muscle tissue.”
“When running or playing a sport, compression clothing is basically a way of adding support to the skin and soft tissue to lessen the forces of vibration so muscles can work more efficiently,” says Hina. “That way, they can work longer before fatigue sets in.”
For a study published in the January 2009 edition of the Journal of Science and Medicine in Sport, researchers at Australia’s Charles Stuart University School of Human Movement Studies looked at the role of lower-body compression garments in fatiguing exercise. Participants performed a 20-meter sprint and plyometric bounds and were tested for many signs of recovery at different intervals post-exercise.
The authors were unable to identify any specific fatigue-reducing effect of the compression clothing and found no direct performance effects, but athletes who donned the compression wear did report lower perceived muscle soreness 24 hours after their exercise bout.
Similar results were found by researchers at the Sports Council for Wales in a study published in the September 2009 edition of the Journal of Strength and Conditioning Research that looked at the effects of tights. They found that lower-body compression tights produced no measurable performance benefits during sprint and agility tests, but subjects who wore them following drop-jump training reported lower levels of perceived muscle soreness. In addition, the compression-equipped subjects had lower values of creatine kinase (CK)–a biochemical marker of muscle damage–than those who did not wear compression clothing.
Another study from Charles Stuart University, published in the July 2007 edition of the British Journal of Sports Medicine, followed cricket players wearing full-body compression garments through sprinting and throwing exercises. The players did not throw farther or more accurately with the compression wear, nor did they run faster, but they showed lower CK levels and had less perceived soreness post-exercise.
What may be causing these recovery benefits of compression? There’s no definitive answer to that question yet, though researchers offer some educated guesses.
“By increasing blood flow, there is a greater amount of waste removal, similar to that seen in active recovery,” says Christos Argus, a researcher at the Centre for Sport and Exercise Science at the Waikato Institute of Technology in New Zealand, who published a 2003 study on compression’s role in recovery and sprint times. Argus tested recreational athletes in sprints on three consecutive days, and then again four days after the initial testing block. The average sprint time was faster in the group wearing compression clothing on days two, three, and seven of the study, and those in compression gear also reported less pain on day seven.
“Due to less perceived soreness after wearing compression garments, athletes mentally feel better and more recovered,” says Argus. “If indeed the garments help with recovery, then athletes will be able to perform a greater volume of training, which may lead to greater training and performance adaptation.”
Argus recommends that competitive athletes who train frequently wear compression garments after exercise to take advantage of the potential recovery boost. In addition, he notes that the garments may be helpful when worn overnight and while traveling.
Kraemer agrees. “When compression garments surround muscles that are recovering and keep the limbs straight during sleep, they allow for better tissue repair,” he says.
While the research on compression’s role in recovery seems to have more scientific backing, the jury is still out on its role in enhancing performance. However, that hasn’t stopped athletes from considering compression to be essential for both training and competition.
Hina has a theory on why that is. “Many times, athletes draw their own conclusions on whether something helps them long before there is scientific proof to back it up,” he says. “Generally, an athlete knows if something makes a difference before you can prove it.”
IF IT FEELS GOOD
Despite what may or may not be happening in an athlete’s body due to compression clothing, if that athlete feels like it’s helping them, then it already is. Whether it’s through a slight boost in confidence or a perceived improvement in proprioception, compression clothing’s greatest impact might be on a part of the body it doesn’t cover.
“The mental side of competition is just as important as the physical side,” says Hina. “If wearing compression gear helps athletes feel good about themselves and feel they have the same advantages as their opponents, then it comes down to who has the most talent and skill.”
Another part of the mental side is comfort. Athletes who are comfortable during training and competition can have an edge, and the feeling of compression clothing as a “second skin” can be soothing. Conversely, any time an athlete focuses for even a split second on something that’s physically bothering them, they open the door for a missed read on the field or court, inefficient movement patterns, or even worse, an injury.
“I’ve seen studies in which they put wedges inside runners’ shoes that supinated the foot,” says Victor Runco, DC, CSCS, a Chiropractic Sports Kinesiologist based in San Diego. “The more the insole pushed the foot into a supinated position, the more uncomfortable the runners became. As they got more and more uncomfortable, their oxygen consumption went up. That would produce a decrease in performance over time.”
Athletes are also more comfortable when they don’t have skin-related problems. “Because the garments act like a second skin, they can be helpful for reducing blisters and chafing,” says Runco. “A blister can ruin your day. Besides the pain, they can cause altered mechanics that increase injury risk.”
Some experts even suggest that wearing a compression garment can play a useful role in injury prevention and management. As with other potential benefits of compression, little has been proven, but theories supporting this effect make sense.
“Every athletic trainer and strength coach will tell you that once fatigue sets in, biomechanics break down and injury is more likely to occur,” Hina says. “So if a garment provides some level of support that may delay fatigue, even if it’s minuscule, it can allow for a few more reps in practice or a few more minutes of competition with sound mechanics.”
Studies have found that tissue under compression tends to retain more body heat, and Runco believes this offers a therapeutic benefit. “If an athlete has a strained calf or hamstring, I’ll prescribe a compression garment to help keep the muscle warm,” he says. “In addition, by limiting vibration, it seems to be beneficial for muscle strains. When a runner has a minor calf or hamstring injury that’s bugging them before a race, a compression product may be helpful.”
At Cornell University, Head Athletic Trainer Bernie DePalma, MEd, RPT, ATC, uses compression as part of the treatment protocol for almost every injury he sees. “Anecdotally, I’ve found that it helps significantly decrease inflammation and soreness, and probably helps athletes come back from injury more quickly,” he says. “We use it with everything from hamstring pulls to quad contusions and strains, ankle and knee sprains, and tendonitis.
“It could be proprioception and neurological, it could be vascular, it could be on the cellular level, and it could be a combination of all those things that produces an athletic advantage,” he says. “The final word on compression clothing will probably be that it’s some combination we haven’t quite figured out yet. But at some point you just have to let the athletes decide what works and if it’s worth it. If they feel better with it on, it’s only going to help them.”
Sidebar: PADDING EVOLUTION
Football players have long suited up in compression bottoms with built-in pads. Now, other sports are copying the padding-inserted style.
Basketball and volleyball players regularly wear compression gear with padding built in at the knees, thighs, elbows, and rib cage. The extra layer of protection makes collisions with the hardwood and other athletes less painful and reduces the risk of minor injuries over the course of a season.
“In basketball, players are setting and coming off screens and they’re constantly bumping into knees and thighs,” says Fred Hina, MA, ATC, CSCS, Head Athletic Trainer for men’s basketball at the University of Louisville. “That padding significantly reduces the number of bumps and bruises during competition. It won’t prevent a deep thigh bruise, but the little ones here and there can be eliminated. Across an entire season, that makes a significant difference.”
At Cornell University, Head Athletic Trainer Bernie DePalma, MEd, RPT, ATC, finds the extra padding useful in protecting injury sites. “If we have a kid with a thigh contusion, he can wear padded compression as he’s walking around campus and at night when he’s sleeping,” DePalma says. “The pad helps prevent the injury from being aggravated and increases overall comfort.”
Sidebar: INDUSTRY INNOVATION
Compression garment technology has advanced significantly in recent years. As the industry has evolved, manufacturers are now offering specialized products designed to produce even greater benefits.
New fabrics are one important area of innovation. For example, Cho-Pat, Inc., makes compression sleeves with a knit material that’s more breathable than traditional spandex and efficiently moves moisture away from the skin.
“We now use a four-way stretch material that gives our sleeves more of a contoured shape for better fit and comfort,” says Cho-Pat President Dave Daily. “There is no neoprene or latex in them, and that improves breathability. We also offer a range of sizes, which gives athletes a more custom feel than they get with one-size-fits-most products.”
Daily says the new sleeves offer several benefits. “The garment uses warmth, compression, and reinforcement to help reduce pain and enhance healing,” he explains. “It can be worn preventively, but we often see it used reactively when someone has an injury.”
Another manufacturer, Stromgren Athletics, is focusing on state-of-the-art fabric design as well, applying its Nano Flex technology to ankle, knee, and elbow supports. The Nano Flex fiber uses negative ions to enhance healing and harnesses infrared rays to increase blood circulation and retain body heat.
“It’s also moisture-wicking, antimicrobial, and anti-odor,” says Stromgren Chief Operating Officer Steve Arensdorf. “The therapeutic value comes from increased warmth and better blood circulation in the muscles and joints.
“This new line will help athletes address joint pain on and off the field,” adds Arensdorf. “Because the supports are comfortable to wear all day, the therapy can continue after athletes leave the training room or athletic environment.”
Others companies are taking a full-body approach to innovation. “We’re developing a compression recovery suit for high school, college, and pro athletes to use after training and competition,” says Rey Corpuz, Director of Marketing at McDavid, Inc. “Athletes often don’t have time to properly cool down after a long training session or tough game. If their muscles haven’t had adequate cool-down time, the recovery suit will help them by applying compression to large muscle groups, enhancing blood flow, and reducing lactic acid buildup.
“It will give athletes the best shot at improving their next day’s performance,” continues Corpuz. “The day after heavy workouts, it will help them continue to train hard by speeding up muscle recovery.”