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François Bieuzen, Jeanick Brisswalter, Christopher Easthope, Fabrice Vercruyssen, Thierry Bernard, and Christophe Hausswirth


Compression garments are increasingly popular in long-distance running events where they are used to limit cumulative fatigue and symptoms associated with mild exercise-induced muscle damage (EIMD). However, the effective benefits remain unclear.


This study examined the effect of wearing compression stockings (CS) on EIMD indicators. Compression was applied during or after simulated trail races performed at competition pace in experienced off-road runners.


Eleven highly trained male runners participated in 3 simulated trail races (15.6 km: uphill section 6.6 km, average gradient 13%, and downhill section 9.0 km, average gradient –9%) in a randomized crossover trial. The effect of wearing CS while running or during recovery was tested and compared with a control condition (ie, run and recovery without CS; non- CS). Indicators of muscle function, muscle damage (creatine kinase; CK), inflammation (interleukin-6; IL-6), and perceived muscle soreness were recorded at baseline (1 h before warm-up) and 1, 24, and 48 h after the run.


Perceived muscle soreness was likely to be lower when participants wore CS during trail running compared with the control condition (1 h postrun, 82% chance; 24 h postrun, 80% chance). A likely or possibly beneficial effect of wearing CS during running was also found for isometric peak torque at 1 h postrun (70% chance) and 24 h postrun (60% chance) and throughout the recovery period on countermovement jump, compared with non-CS. Possible, trivial, or unclear differences were observed for CK and IL-6 between all conditions.


Wearing CS during simulated trail races mainly affects perceived leg soreness and muscle function. These benefits are visible very shortly after the start of the recovery period.

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Rob Duffield, Johann Edge, Robert Merrells, Emma Hawke, Matt Barnes, David Simcock, and Nicholas Gill


The aim of this study was to determine whether compression garments improve intermittent-sprint performance and aid performance or self-reported recovery from high-intensity efforts on consecutive days.


Following familiarization, 14 male rugby players performed two randomized testing conditions (with or without garments) involving consecutive days of a simulated team sport exercise protocol, separated by 24 h of recovery within each condition and 2 weeks between conditions. Each day involved an 80-min high-intensity exercise circuit, with exercise performance determined by repeated 20-m sprints and peak power on a cart dynamometer (single-man scrum machine). Measures of nude mass, heart rate, skin and tympanic temperature, and blood lactate (La) were recorded throughout each day; also, creatine kinase (CK) and muscle soreness were recorded each day and 48 h following exercise.


No differences (P = .20 to 0.40) were present between conditions on either day of the exercise protocol for repeated 20-m sprint efforts or peak power on a cart dynamometer. Heart rate, tympanic temperature, and body mass did not significantly differ between conditions; however, skin temperature was higher under the compression garments. Although no differences (P = .50) in La or CK were present, participants felt reduced levels of perceived muscle soreness in the ensuing 48 h postexercise when wearing the garments (2.5 ± 1.7 vs 3.5 ± 2.1 for garment and control; P = .01).


The use of compression garments did not improve or hamper simulated team-sport activity on consecutive days. Despite benefits of reduced self-reported muscle soreness when wearing garments during and following exercise each day, no improvements in performance or recovery were apparent.

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Justin M. Stanek

Clinical Scenario:

The popularity of compression socks has increased substantially among athletes, particularly those participating in endurance events such as running and triathlon. Companies are increasingly marketing compression stockings to runners, triathletes, and other endurance athletes for the benefits of improved performance and/or decreased recovery time. Originally developed for the treatment of deep-vein thrombosis, compression socks are now marketed as a tool to improve venous return, thus believed to improve both performance and recovery in athletes. The use of compression socks during training aims to help the skeletal-muscle pump, increase deep venous velocity, and/or decrease blood pooling in the calf veins and alleviate delayed-onset muscle soreness. The scenario is a 28-y-old recreational triathlete seeking your advice while training for her first half-Ironman. She occasionally complains of tightness in the calves both during and after running. She wants your opinion on the effectiveness of using compression socks to help her performance and recovery.

Focused Clinical Question:

What is the effectiveness of using graduated compression socks for improving athletic performance and decreasing recovery time in healthy endurance athletes?

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Amanda L. Zaleski, Linda S. Pescatello, Kevin D. Ballard, Gregory A. Panza, William Adams, Yuri Hosokawa, Paul D. Thompson, and Beth A. Taylor

.2165/11591420-000000000-00000 21923201 5. Mosti G , Partsch H . Improvement of venous pumping function by double progressive compression stockings: higher pressure over the calf is more important than a graduated pressure profile . Eur J Vasc Endovasc Surg . 2014 ; 47 ( 5 ): 545 – 549 . PubMed ID: 24524814 doi:10.1016/j

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James R. Broatch, David J. Bishop, and Shona Halson

. Graduated compression stockings in the prevention of venous thromboembolism . Br J Surg . 1999 ; 86 ( 8 ): 992 – 1004 . PubMed ID: 10460633 doi:10.1046/j.1365-2168.1999.01195.x 10.1046/j.1365-2168.1999.01195.x 10460633 19. Watanuki S , Murata H . Effects of wearing compression stockings on

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Pedro L. Valenzuela, Guillermo Sánchez-Martínez, Elaia Torrontegi, Zigor Montalvo, Alejandro Lucia, and Pedro de la Villa

observed in the latter at the end of the recovery phase. Thus, our results suggest that EECP may reduce vagal recovery after exercise. Other authors found an increased postexercise parasympathetic suppression with the use of compression stockings. 33 In addition, as, in our study, both the limbs and the

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Ewan R. Williams, James McKendry, Paul T. Morgan, and Leigh Breen

consulted with Python Performance Ltd on the CG design during early developmental stages. This research was not sponsored by any funding body external to the University of Birmingham. References 1. Ali A , Creasy RH , Edge JA . The effect of graduated compression stockings on running performance

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Kelly A. Brock, Lindsey E. Eberman, Richard H. Laird IV, David J. Elmer, and Kenneth E. Games

contrast water therapy or compression stockings on subsequent 5-min cycling performance . J Sci Cycl . 2013 ; 2 ( 2 ): 49 – 56 . 11. Cochrane DJ , Booker HR , Mundel T , Barnes MJ . Does intermittent pneumatic leg compression enhance muscle recovery after strenuous eccentric exercise? Int J

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Guillaume Mornieux, Elmar Weltin, Monika Pauls, Franz Rott, and Albert Gollhofer

. Med Sci Sports Exerc. 2004 ; 36 ( 6 ): 926 – 934 . PubMed doi: 10.1249/01.MSS.0000128145.75199.C3 10.1249/01.MSS.0000128145.75199.C3 15179160 30. Ali A , Creasy RH , Edge JA . Physiological effects of wearing graduated compression stockings during running . Eur J Appl Physiol. 2010 ; 109

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Andrew A. Flatt and Daniel Howells

players on flights in accordance with their adjusted feeding schedule to reduce the risk of gastrointestinal disturbances associated with airline catering. Electrolyte tablets and sealed beverages were provided to promote hydration. Players wore compression stockings on flights and were encouraged to move