Do Compression Socks For Runners Really Provide Benefits?

Anyone who watched the recent New York City Marathon must have been impressed by the many runners who wore colorful over-the-calf compression socks. This trend has grown in popularity among both recreational and elite runners. Podiatric physicians will get the question: Is there any benefit to wearing compression stockings for sport training and competition?

Early modifications of sport socks were designed to provide compression to the legs to provide anticipated improvement of performance and recovery from performance.¹ The initial goal of compression therapy during sporting activity was to improve venous return with the possibility of improved blood flow to muscles.² Other researchers speculated that mechanical compression could reduce muscle damage and enhance recovery from training and exertion.³ However, studies verifying these benefits for athletes wearing compression socks have shown conflicting results.^4-7

Compression stockings in some studies have shown benefit in reducing post-exercise soreness while improving post-exercise muscle function.^4,5 In contrast, other studies have demonstrated that compression stockings did not reduce muscle soreness after running and did not reduce blood markers for muscle damage after repeated squats.^6,7 While these laboratory studies provide some insight into the physiologic benefits of compression stockings, studies of athletes in actual competition may provide better insight and understanding.  

A study of 36 athletes competing in a half-Ironman triathlon competition showed no advantage of wearing graduated compression socks in terms of prevention of lower limb muscle fatigue or reduction of post-race blood concentrations of myoglobin and creatine kinase.⁸ The researchers concluded that compression stockings were ineffective for averting muscle fatigue and muscle damage during triathlon events.

In another study involving 24 runners, researchers studied the role of compression stockings in the recovery from running a marathon race.⁹ Perceived muscle soreness was significantly lower in the group who wore compression stockings immediately after the race and for the following 72 hours. However, there was no significant improvement of muscular strength or blood markers of exercise-induced muscle damage.

Another study focused on the use of compression stockings during the actual running of a marathon race.¹⁰ Researchers compared 17 runners wearing graduated compression socks to 17 runners who wore conventional socks. The use of compression stockings did not improve running pace, affect post-race muscle power or prevent exercise-induced muscle damage during the marathon. The authors concluded that wearing compression stockings during long-distance running events is an ineffective strategy to avoid the deleterious effects of muscle damage on running performance.

Therefore, when patients ask if there is any benefit to wearing compression socks during running competition or training, simply reply that, depending on the colors and graphic design, you certainly may look better but will not perform better.

References

1. De Glanville KM, Hamlin MJ. Positive effect of lower body compression garments on subsequent 40-kM cycling time trial performance. J Strength Cond Res. 2012; 26(2):480–486.
2. Sperlich B, Born DP, Haegele M, Zinner C, Holmberg HC. Effects of compression textiles on performance enhancement and recovery. Sportverletzung Sportschaden. 2011; 25(4):227–234.
3. Kraemer WJ, Flanagan SD, Comstock BA, et al. Effects of a whole body compression garment on markers of recovery after a heavy resistance workout in men and women. J Strength Cond Res. 2010; 24(3):804–814.
4. Jakeman JR, Byrne C, Eston RG. Efficacy of lower limb compression and combined treatment of manual massage and lower limb compression on symptoms of exercise-induced muscle damage in women. J Strength Cond Res. 2010; 24(11):3157–3165.
5. Kraemer WJ, Bush JA, Wickham RB, et al. Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. J Orthop Sports Phys Ther. 2001; 31(6):282–290.
6. French DN, Thompson KG, Garland SW, et al. The effects of contrast bathing and compression therapy on muscular performance. Med Sci Sports Exerc. 2008; 40(7):1297–1306.
7. Ali A, Creasy RH, Edge JA. Physiological effects of wearing graduated compression stockings during running. Eur J Appl Physiol. 2010; 109(6):1017–1025.
8. Del Corso J, Areces F, Salinero JJ, et al. Compression stockings do not improve muscular performance during a half‐ironman triathlon race. Eur J Appl Physiol. 2014; 114(3):587–595.
9. Hill JA, Howatson G, van Someren KA, Walshe I, Pedlar CR. Influence of compression garments on recovery after marathon running. J Strength Cond Res. 2014; 28(8):2228–2235.
10. Areces F, Salinero JJ, Abian-Vicen J, et al. The use of compression stockings during a marathon competition to reduce exercise-induced muscle damage: are they really useful? J Orthop Sports Phys Ther. 2015;45(6):462-470.