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Context: Compression socks have become increasingly popular with athletes due to perceived enhancement of exercise performance and recovery. However, research examining the efficacy of compression socks to reduce exercise-associated muscle damage has been equivocal, with few direct measurements of markers of muscle damage. Objective: To examine the influence of compression socks worn during a marathon on creatine kinase (CK) levels. Design: A randomized controlled trial. Setting: 2013 Hartford Marathon, Hartford, CT. Participants: Adults (n = 20) randomized to control (CONTROL; n = 10) or compression sock (SOCK; n = 10) groups. Main Outcome Measures: Blood samples were collected 24 hours before, immediately after, and 24 hours following the marathon for the analysis of CK, a marker of muscle damage. Results: Baseline CK levels did not differ between CONTROL (89.3 [41.2] U/L) and SOCK (100.0 [56.2] U/L) (P = .63). Immediately following the marathon (≤1 h), CK increased 273% from baseline (P < .001 for time), with no difference in exercise-induced changes in CK from baseline between CONTROL (+293.9 [278.2] U/L) and SOCK (+233.1 [225.3] U/L; P = .60 for time × group). The day following the marathon (≤24 h), CK further increased 1094% from baseline (P < .001 for time), with no difference in changes in CK from baseline between CONTROL (+ 1191.9 [1194.8] U/L) and SOCK (+889.1 [760.2] U/L; P = .53 for time × group). These similar trends persisted despite controlling for potential covariates such as age, body mass index, and race finishing time (Ps > .29). Conclusions: Compression socks worn during a marathon do not appear to mitigate objectively measured markers of muscle damage immediately following and 24 hours after a marathon.

Zaleski, Panza, Thompson, and Taylor are with the Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, CT, USA. Zaleski, Pescatello, Panza, Hosokawa, and Taylor are with the Department of Kinesiology, University of Connecticut, Storrs, CT, USA. Ballard is with the Department of Kinesiology, Miami University, Oxford, OH, USA. Adams is with the Department of Kinesiology, The University of North Carolina at Greensboro, Greensboro, NC, USA.

Zaleski (amanda.zaleski@hhchealth.org) is corresponding author.
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