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What is meant by graded compression?
While they may look very similar to the lycra tights that were popular in the 80’s but there is far more physiology behind compression garments than meets the eye.
Graded compression means that the compression exerted by the garments differs over a given distance. If long lower body garments are used as an example, compression at the ankle and calf is higher than at the thigh. This facilitates the flow of blood through the deep veins back towards the heart. This increase in blood flow and venous return to the heart is one of the reasons why compression garments are used in clinical applications such as prevention of deep vein thrombosis post surgery. Although graded compression garments have been used clinically for many years, it is only more recently that the potential beneficial physiological effects of graded compression has been acknowledged in the athletic environment.
What is this new targeted compression technology?
- Patent pending design targets muscle groups via panels and seams so compression is applied to individual targeted muscle groups.
- Allows the garment to move with the targeted muscle groups in flexion and extension.
- Garment encloses each region like a muscle sheath, strengthening and providing support to the targeted muscle groups
Some companies quote the pressure exerted by their garments, is this accurate?
The truth is that there is no globally accepted methodology to measure the compression that commercially available compression garments provide. This is why many manufacturers will quote compression data without indicating the methodology they used to measure it. Compression data means nothing if the method used cannot be proven to be reliable and valid. Furthermore the compression exerted will depend on the individual wearing the garment. Anthropometric measurements differ greatly between individuals and even two individuals with the same height and weight can vary greatly in limb girths. So when companies give a single reading for the compression provided at the ankle, calf and thigh, these readings likely only apply to a single person and if anyone else tried on the same compression garment the pressures would not be identical.
Will compression garments reduce delayed onset muscle soreness (DOMS)?
Delayed onset muscle soreness (DOMS) occurs in the days following intense or novel activities and symptoms can range from muscle tenderness to severe debilitating pain (5).
Research has indicated that compression garments can reduce both the severity of DOMS and recovery time following eccentric muscle damage.
In a clinical trial Kraemer and co-workers (12) induced delayed onset muscle soreness through an eccentric resistance training protocol in 20 female participants. Immediately after the muscle damaging protocol the women were divided into two groups, one group wore a compression garment for 5 days while the other group received no treatment. The results indicated that compression garments facilitated recovery of muscle strength and power and resulted in significantly less perceived muscle soreness. Interestingly on day 5 the group receiving no treatment had a 2-3cm increase in upper arm circumference attributed to swelling, while the compression garment group had no swelling at all.
More recently a study was conducted in which subjects performed downhill walking with one leg covered by a compression garment while the other leg remained uncovered and acted as a control. The participants were then carefully monitored in the 48 hours after the exercise trial. The scientists conducting the study concluded that the compression garment accelerated the inflammatory and repair timeframe within the muscle (17). This could explain why compression garments have previously been reported to facilitate a more rapid recovery of performance following soft tissue damage.
Is there any research to suggest that compression garments can facilitate recovery in the hours following intense exercise?
A recent study investigated the effect of compression garments on recovery between two maximal exercise tests. The study investigated the effect of wearing compression garments during an 80 minute recovery period separating two all out 5 minute maximal cycle tests. The results indicated that the compression garments facilitated recovery and that performance on the second 5 minute cycle test was superior after wearing compression garments during the recovery period. Specifically the difference between wearing and not wearing compression garments during recovery corresponded to a 2.1% difference in performance (4)
Is there any research to suggest that compression garments could facilitate recovery in shorter periods of time such as a couple of minutes?
In recent times compression garments have become popular in many field based sports such as rugby league, rugby union, soccer and AFL. These sports require a fitness component termed “repeated sprint ability” or “RSA”. RSA is basically the capacity to perform multiple high intensity sprints with brief recoveries over an extended period of time. Many athletes who wear compression garments during training and competition perceive that compression garments allow them to recovery more quickly between high intensity efforts and subsequently perform repeated sprints at a higher intensity.
Enhanced repeated sprint ability would certainly be of benefit to athletes in field based sports, however at this point no research has specifically investigated the potential of compression garments under such conditions. Sprints in field based sports are generally short, and performed at a high frequency with very brief recoveries. They also involve rapid accelerations, decelerations and changes in direction. Given that compression garments have been reported to positively influence blood lactate concentrations, reduce muscle oscillation and enhance muscle proprioception then it would seem that there are certainly physiological mechanisms by which compression garments have the potential to enhance repeated sprint ability in field based sports.
Is wearing compression garments as effective as other recovery techniques?
In an attempt to facilitate post exercise recovery, many athletes and teams implement recovery strategies such as contrast water therapy and low intensity active exercise protocols. However sometimes it is not possible to implement such strategies and compression garments represent a passive recovery technique that is simple and convenient. In a recent study recovery after a rugby match was compared when four different recovery techniques were implemented (5). The four techniques included compression garments, contrast water therapy, low intensity active exercise and passive recovery. Creatine Kinase, an enzyme that provides and indication of muscle damage was measured before, immediately after, and at 36 and 84 hours post match. Results indicated that compression garments, contrast water therapy and low intensity active exercise enhanced CK clearance more than passive recovery. This study illustrates that compression garments are as effective as many other popular recovery techniques while offering the advantage of being more convenient under certain conditions (eg away games).
I hear that compression garments enhance proprioception and reduce muscle oscillation. What does this mean in English?
Proprioception refers to joint position sense or more simply an overall awareness of bodily position. The importance of propriocpetion can be appreciated in terms of injury. Proprioceptors in the skin, muscle and joints provide feedback to the central nervous system as to the position of a joint. If a joint (eg knee) is approaching a position that may place it at risk of injury (eg hyperextension and risk of ACL rupture) the proprioceptors can relay that information back to the central nervous system and adjustments in muscle activation can take place that may prevent that injury occurring.
Research has shown compression garments to positively influence proprioception. Kraemer and co-workers (11) reported increased hip joint proprioception when athletes wore compression garments. This enhanced proprioception may be a consequence of a greater feedback from skin proprioceptors as a consequence of the tactile interaction between the garments and the skin surface.
Although muscles are attached to the bone via tendons and are surrounded via connective tissue fascias and skin, a certain degree of lateral and vertical movement remains possible. During dynamic activities such as running and jumping oscillatory movement occurs in skeletal muscles as they are forced to accelerate, decelerate and absorb impact shocks.
In investigating muscle oscillation upon landing from a maximal vertical jump it was reported that compression garments were able to significantly reduce longitudinal and anterior-posterior muscle oscillation by 0.32 and 0.40cm respectively (7).
Reduced muscle oscillation and increased proprioception may have numerous potential benefits to athletes including:
Increased strength and power
Optimal muscle function involves a sequence of events beginning in the nervous system and finishing at the level of the muscle fibers. Any variable that interferes with any component of that sequence can produce less than optimal muscle recruitment patterns. It has been suggested that a reduction in oscillatory displacement of a muscle may optimize neurotransmission and the mechanics of muscle contraction at the molecular level (14).
Increased movement efficiency and superior technique
As a consequence of enhanced proprioception compression garments may reduce or even offset the detrimental effects that fatigue has on both technique and joint position sense. This has positive ramifications for both performance and injury prevention.
In a recent study in trained runners it was reported that compression garments worn during running may enhance circulation and decrease muscle oscillation to promote a lower energy expenditure at a given submaximal speed (2). Greater efficiency corresponds to reduced fatigue which is of obvious benefit to athletic performance and injury prevention.
Do compression garments reduce blood lactate concentrations?
Blood lactate is a by product of anaerobic muscle metabolism. High muscle and blood lactic acid concentrations can present a challenge to the body’s ability to maintain pH within the narrow physiological range. This in turn can negatively impact the force generating capacity of the muscle which results in muscle fatigue and impaired athletic performance. Data published by Berry and Mcmurray (1) showed a 14% decrease in blood lactate concentrations 15 minutes following high intensity exercise when compression garments were worn during and after exercise.
Is it true that compression garments can reduce the pain associated with intense exercise?
Pain in muscles working at high intensities is a natural occurrence (6). Preliminary research investigating the effect of compression garments on muscle pain has produced some interesting results. In a study of 63 year old cyclists it was reported that compression garments worn during an 80 minute recovery period following an intense cycle test had a beneficial effect on leg pain (4). No research at this point has specifically investigated muscle pain during high intensity exercise and this represents another exciting future research avenue.
Do compression garments enhance explosive power such as vertical jump?
A study conducted by Doan and co-workers (7) reported that vertical jump height increased by 2.4cm when performed wearing compression garments. In an earlier study it was reported that the average force and power production during 10 consecutive vertical jumps in volleyball player was significantly higher when wearing compression garments (9).
There are two potential mechanisms for the increased vertical jump height. Firstly it may be that much like an elastic band the stored potential energy in the compression garments under stretch can then be used to facilitate explosive power. This is similar to the concept behind the popular conditioning strategy of plyometric training.
A second potential mechanism related to proprioception and muscle oscillation. As compression garments have been shown to enhance proprioception and reduce muscle oscillation this may allow superior neuromuscular recruitment and more explosive and efficient muscular contractions.
Will compression garments enhance endurance performance, VO2max and anaerobic threshold?
VO2max and anaerobic threshold are physiological measurements that are deemed to be highly correlated to success in endurance sports. VO2max is defined as the greatest rate of oxygen uptake by the body measured during severe dynamic exercise (16). Anaerobic threshold is defined as the level of oxygen consumption at which there is a rapid and systematic increase in blood lactate concentration (16)
Recently a study reported that compression garments resulted in a 10% increase in VO2max and a 40% increase in the anaerobic threshold as measured during a graded exercise test (13). This data suggests that compression garments could be of significant benefits to the endurance athlete both during training and competition.
Would wearing compression garments during competition and training reduce injuries?
There is mounting scientific evidence that suggests that compression garments worn during training and/or competition may reduce the likelihood of injury. This is related to several of the physiological mechanisms of compression garments including:
Increased muscle temperature
It is well established that a warm up prior to intense exercise may reduce the incidence of some sporting injuries (15). One of the principle functions of a warm up is to progressively increase the muscle temperature in preparation for more intense activity. A study conducted by Doan and co-workers (7) reported that compression garments facilitated a more rapid increase in skin temperature during a controlled warm up. Consequently this could allow optimal muscle temperature to be reached more quickly during a standardized warm up protocol.
Enhancing muscle proprioception has become a key focus in recent years in an attempt to reduce serious sporting injuries such as ligament tears. Programs designed to increase muscle and joint proprioception have reported significant reductions in career threatening injuries such as anterior cruciate ligament tears (3). As research has also reported compression garments to enhance joint proprioception (11) this is another physiological mechanism by which compression garments may reduce injury rates.
I am concerned that compression garments may be restrictive and impair my running speed, is this likely.
This is a concern of many athletes who prior to trying compression garments perceive that they will be overly restrictive.
In a study conducted by Kraemer and coworkers (10) the scientists investigated the potential for compression garments to affect the work capacity or force production of the underlying muscles. In line with the concerns of many athletes, this study basically investigated the potential for the compression forces generated by the garments to add additional resistance to the contracting muscles underneath and therefore potentially cause fatigue and impair performance. In both the lower body squat and isokinetic leg extension/flexion test used to measure performance it was concluded that compression garments did not add any significant resistance to hip and thigh movements and consequently did not contribute to excess fatigue or negatively impair performance.
In a later study conducted by Doan and co-workers (7) it was reported that 60m sprint times were not impaired when track and field athletes wore compression garments. The scientists further reported that there were no major changes in the kinematics of sprinting. Basically this means that sprinting technique including the motion at the hip and the knee were not adversely affected.
Together these studies suggest that the degree of compression offered by sports compression garments does not increase resistance or restrict movement patterns to a degree that will contribute to fatigue and/or impair force production capabilities.
Compression garments seem popular among male athletes, can females benefit from them as well?
Although there are gender differences in terms of human physiology, the physiological benefits of compression garments are available to both males and females. Research reporting enhanced performance under fatigue, increased joint proprioception and reduced muscle oscillation has used both male and female athletes (10). Additionally a study reporting that compression garments reduced muscle soreness and facilitated faster recovery after soft tissue injury exclusively used female participants (12).
I am a 65 year old masters athlete. Am I too old to benefit from compression garments?
The physiological benefits of compression garments are not limited to young athletes. In a recent study scientists investigated the effect of compression garments on performance in 63 year old sportsmen. The study investigated the effect of wearing compression garments during an 80 minute recovery period separating two all out 5 minute maximal cycle tests. The results indicated that the compression garments facilitated recovery and that performance on the second 5 minute cycle test was superior after wearing compression garments. Specifically the difference between wearing and not wearing compression garments during recovery corresponded to a 2.1% enhancement in performance (4).
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