Compression technology has precedence in the medical community to help those with edema (fluid build-up) or swelling of the lower extremities, among other afflictions. It has recently taken the sports community by storm and we see amateur and professional athletes wearing compression gear to enhance athletic performance. It is common for both patients and athletes of all levels to want a better understanding of how compression technology works, how it can benefit them, and the conditions in which the apparel is appropriate. Compression apparel is designed with the anatomy and physiology of the human body in mind, aiding in blood flow, reducing swelling, and reducing muscular/tissue vibrations.
Most importantly, the heart pumps blood, carrying oxygen, sugar, and other nutrients to every portion of the human body through arteries. Oxygenated blood flowing to the muscles consistently is important for performance, as every living cell in the body uses the nutrients carried by the blood regardless of activity level. Adequate blood flow is also important in wound healing and injury recovery, as it will carry antibodies, white blood cells, nutrients, clotting factors, and more to the weakened or injured site. The blood cells then carry away any waste products from the cells and tissue back to the heart through veins. Deoxygenated blood and lactic acid are among the byproducts leaving the muscles or tissue during exercise, through the veins back to the kidneys, heart and lungs. Sufficient blood flow is also important in temperature regulation of the body. As we get warmer with fever or exercise, signals are carried through the blood and “tell” us to sweat. Conversely, as we cool down the blood tends to focus towards the deeper, more vital organs. As we get older, our extremities tend to get colder more often, mostly due to decrease blood flow to our hands and feet. Compression has been shown to help with all of our blood flow and muscle stability needs.
The theories behind wearing compression technology in sports include the following. It will help increase blood flow to and from the muscles, causing an increase in oxygenation to the tissue, help warm and soothe of sore muscles, minimize energy loss due to excess muscle movement, and decrease lactic acid buildup.
Consistent compression to any large muscle group can cause the arterial walls to dilate (increase in size) and increase the amount of blood flow flowing through them (Ferber, 2016). Arterial blood flow can increase as much as 40% during activity and recovery, so more oxygen and nutrients are moving to the areas in which the body needs it the most. As mentioned previously, the more nutrients and oxygen getting to the surrounding muscle and tissue as any given time during strenuous exercise, the better the cells and tissue will perform.
Secondly, as we perform heavy exercise, we often require much more oxygen than our bodies can deliver, so the muscles then have to work anaerobically (without oxygen). In the process of glycolysis to create the energy needed in the absence of oxygen, the body temporarily produces lactate or lactic acid; often causing the “burning” feeling in our muscles during exercise (Roth, 2006). Lactic acid can build up to very high levels with long term exercise and may be a cause to muscle soreness and a decreased ability to perform, so the body must remain efficient in carrying away waste products such as this.
Lastly, something many athletes are not familiar with is the idea of energy expenditure with muscle vibrations. As a person is working out, the muscles are contracting and moving, but any additional movement or motion which causes them to have to work harder can waste energy as you are working out and they become fatigued faster. Compression can help minimize the localized movement and small vibrations caused by jumping or running on hard surfaces and increases the efficiency of muscle output. Smaller muscle vibrations can reduce oxygen and elastic demand from the muscle and aid in injury recovery. Also, the extra vibrations can also increase the amount of friction “felt” by the surrounding tissue and nerves over time and can cause irreparable damage. There is science out there that looks at muscle vibrations induced by sustained use of heavy machinery (Adamo, 2002), but there is speculation to think that repeated movements, such as running cause the same effects.
Those who suffer from tennis elbow, golfer’s elbow, arthritis, tendonitis and pain from sprains and strains and minor instabilities can benefit from compression technology. Arm and elbow wraps now also come with ice and heat therapy as well to aid in recovery. Padding can now be incorporated into the forearm sleeves (McDavid Hex Forearm) to provide protection during contact sports from impact injuries to the soft tissue. Increase performance without limiting mobility or range of motion.
Runners experience most of the strain within the knee joints and in consequence the muscles of the thigh and calf follow. Compression around the knee can provide ligament support and help relieve pain associated with arthritis, bursitis, and tendonitis. Compression also applies therapeutic warmth to the affected area with increased blood flow. Many knee braces (SureSport Knee Compression Sleeve) now offer compression as well as knee support.
The thigh is particular susceptible to strains and muscle tears. Compression can prevent unnecessary muscle movements during and after activity. Luckily, the compression wraps are non-restrictive like many leg braces and an athlete can maintain motility and flexibility. An added bonus to most thigh wraps is that they can helps wick sweat away from the skin and help prevent chafing and rashes. Many thigh wraps are adjustable to accommodate any size.
SureSport Infrared Thigh Sleeve offers compression and heat throughout the thigh to help ease the pain of hamstring, groin, or quadriceps strains during recovery.
If suffering from constant pain from calf cramps, calf strains, or shin splints, then a calf sleeve may be the best option for you. While providing muscle support and warmth during a workout, they can also prevent unwanted abrasions you might endure during a run in the woods or in a crowded road race. Both graded and ungraded sleeves can help increase blood flow to the lower leg as well as minimize muscle and tendon movement. In the case of shin splints, extra movement implies more pain while trying to recover.
Compression for your foot can be useful if you have an injury to your arch, ankle, or lower Achilles tendon. Calf sleeves are unable to support these regions. Also, if you have a favorite pair of running socks, the calf sleeve may be a preferred option. See the section on medical compression below for footwear that may help with pain not due to running injuries. Compression has shown to help with the pain from plantar fasciitis, Achilles tendonitis, minor pain from strains and sprains. Foot and ankle wraps now also come with ice and heat therapy as well to aid in recovery.
Choosing a compression tight might be beneficial for overall protection and recovery. The tights cover some or all of the muscles associated with the buttocks, groin, thigh, knee, and calf. Most tights are ideal for recovery and for wearing while not performing strenuous activity as well. Many compression tights now come with cup pockets for additional comfort and protection during contact sports.
Overall, when it comes to purchasing compression sports apparel, if you feel good wearing the apparel while performing activity, continue to wear it. Find what works for you and your body. Much more research needs to be done on the effects of compression in terms of injury prevention and recovery.
In summary, compression apparel can help:
- Reduce muscle soreness and muscle tears
- Enable more strenuous activity for longer periods of time
- Aid in muscle recovery
- Reducing lactic acid
- Increases blood circulation
Where compression might be necessary for the deep tissue and muscle groups, the use of kinesio tape may also aid in pain relief and recovery by increasing blood flow to the superficial tissue groups.
There are many medical reasons why one might consider compression apparel. If compression can help with blood flow to our extremities, then looking at any ailment which may hinder that is a good place to start. When it comes to blood flow in our legs and feet, gravity is the enemy.
As depicted in the figure above, a person will experience up to 90mmHg (“millimeters of mercury”) more pressure in the arteries and veins of their feet than at their chest or head. This implies that the body has to work against gravity to return blood back to the heart to get more oxygen. The body has a unique way to combat this pressure difference. As mentioned briefly in the beginning, arteries carry the blood away from the heart to the rest of the body and veins bring the blood back. Since the veins are responsible for carrying deoxygenated and waste-ridden blood to the kidneys, liver, and heart it is important that blood moves efficiently to their destinations and does not flow backward in any way. The blood moving through the veins does not rely on the heart as much as arteries do, so they contain valves to prevent backflow. The valves rely on the surrounding muscles to open and close; as a muscle contracts it squeezes the vein and pushes the blood up to the heart. Consistent contraction and relaxation cycles in the muscle are what help force the blood back to the heart.
Common ailments or diseases that may cause or result in problems with the motility of blood in the legs include, but are not limited to:
- Diabetes: With almost a tenth of the population suffering from diabetes, it is common to find patients with lower extremity pain and fluid buildup. Most of the following conditions can be complicated by or are a by-product of having diabetes. Sugar and nutrient imbalances can cause the body to react in other areas of the body, like the kidneys. If the kidneys are working overtime to compensate for the high amounts of sugars, it can cause salt build up and can affect the muscles and nerves in the extremities.
- oDiabetic Peripheral Neuropathy: Elevated blood sugar levels for long periods of time can damage nerve fibers and cause pain. Peripheral neuropathy implies the pain, numbness, and tingling due to nerve damage is located in the feet, lower legs, and hands. Upwards of 70% of diabetics have “measurable” neuropathy (Center for Disease Control). There are other causes as well, like AIDS and MS, but diabetics are especially at risk. (nfb.org, 2005) Using a compression stocking can help apply pressure to the legs and minimize pain.
- Deep Vein Thrombosis (DVT): The formation of a blood clot within the vein of a leg after prolonged periods of bedrest or immobilization of the legs. Lack of muscle movement prevents the veins from being squeezed and does not allow blood to move away from the legs back to the heart. Compression is shown to help those who are at risk for DVT, but over long periods of time pharmaceutical intervention is typically required as well.
- Lower Extremity Edema: Fluid build-up within tissue cavities which may cause swelling. Could be a result of deep vein thrombosis, kidney disease, or a side effect of oral diabetes drugs or insulin therapies with patients with diabetes, to name a few. Edema can increase calf and foot circumference as well as apply pressure to surrounding tissue and nerves, causing pain. It has been shown (Wu, 2012) that mild compression stockings, 18-25mmHg pressure reduced the amount of swelling in the feet of the subjects as well as minimalized pain, foot ulcers or abrasions, and pressure-related skin lesions.
- Vericose Veins: When the valves in the veins of your legs do not work properly, as described previously, blood can pool in the vein and make it more difficult for the muscle to help push the blood back to the heart. The added pressure from the extra blood can cause the walls of the vein to bulge and twist. Veins closer to the surface of the skin are more likely to experience this as they already have less muscle support. Applying graduated pressure can help streamline blood flow up the legs and minimize the appearance of varicose veins.
Compression hose with graduated compression, which is tighter at the foot and looser as it moves up the calf and lower leg, is the best in the fight against the effects of gravity and helps the blood return to the heart. BraceMart offers a variety of compression stocking styles to accommodate the pressure needs as well as the style so you have a stocking for every outfit. Pressure ranges currently include 15-20mmHg and 20-30mmHg. Pressure gradients any higher (35-45mmHg) may put someone at risk for serious damage to the arteries in their legs, especially if they have Peripheral Artery Disease (PAD) (Wu, 2012).
We currently carry both open and closed toe Jobst stockings at calf height, knee high and thigh high.
The active PressureLite Crew Length Energizing Diabetic socks are non-restrictive that apply 18mmHg throughout the sock. Great for mild pain relief in the feet and can be a great first step to wearing compression socks/stockings for medical purposes.
This information is provided as an educational service and is not intended to serve as medical advice. It is important to seek advice from a physician if chronic pain occurs and before starting any medical treatments or exercise programs. A medical professional will be able to advise you on the proper amount of pressure dependent on the medical condition you are suffering from. If you have problems wearing any stockings or compression socks, be sure to talk with your doctor.
- Adamo, D.E., Martin, B.J., Johnson, P.W. (2002). Vibration-induced muscle fatigue, a possible contribution to musculoskeletal injury. European Journal of Applied Physiology. 88: 134-140. DOI: 10.1007/s00421-002-0660-y
- Dai, G., Gertler, J.P., Kamm, R.D. (1999). The effects of external compression on venous blood flow and tissue deformation in the lower leg. Journal of Biomechanical Engineering. 121(6): 557-564. DOI: 10.1115/1.2800853
- Ferber, R. (2016). The science of compression clothing. http://www.ucalgary.ca/knes/news/compression
- Fleet Feet Sports. (2016). Compression: Does it really work? http://www.fleetfeethartford.com/sports-medicine/....
- Nfb.org. (2005). Diabetic peripheral neuropathy. https://nfb.org/diabetic-peripheral-neuropathy
- Roth, S.M., (2006). Why does lactic acid build up in muscles? And why does it cause soreness? Scientific American. https://www.scientificamerican.com/article/why-do....
- Wu, S.C., et. al. (2012). Safety and efficacy of mild compression (18-25 mm Hg) therapy in patients with diabetes and low extremity edema. Journal of Diabetes Science and Technology. 6(3): 641-647. PMCID: PMC3440039.