Men in tights – the triumph of compression garments in sport

It was 1993 when the parody of the Robin Hood story (Robin Hood: Men in Tights) came out and I did not find it funny at all. Now, in 2014, a common sight at work is men in tights chasing the ball while noone is even trying to be funny. I have seen compression garments leak into the sports teams slowly for the last 5 years. However, this year was definately the peak of it: you are one of the cool kids if you wear it and it doesn’t even matter if you understand the rationale behind it. It is like a decisive part of your social position in the team. I’d be willing to bet on my T-shirt collection that around 80% of athletes wearing any kind of compression gear do not know a thing about the research or the mechanics behind it. But does it really matter?

What benefits can you gain from compression garments?
Bowler Dick Ritger is often quoted as he has said „All sports are games of inches“. Although I do not consider bowling a sport, Ritger was right: every little step you take during practice or recovery can be decisive at the end. Huge sums of money are invested for better equipment, nutritional aspects, professional staff etc. In order to sell their products, manufacturers have to promise big things. When talking about compression garment, some of the most repeated effects stated in the advertisements are: reducing the vibration (and therefore stabilizing leg muscles), increasing blood flow and muscle oxygenation, reducing injury rate and muscle soreness and getting rid of lactic acid from the muscles.

Research related to compression products in sports has grown significantly along with their popularity but the results are conflicting and nothing has been properly confirmed. This is mainly due to unsteady research subjects (from non-trained to elite athletes), body-parts covered with compression (whole-body to single limbs), different sporting events and comparison to varying recovery modes (ultrasound, placebo, etc).
The main effects that studies have focused on and found are as promised in the advertisements: reduced muscle soreness, reduced swelling, improved blood-flow and muscle oxygenation (during the exercise as well as in quiet resting positions), reduced muscle damage, decreased perceived exertion and improved performance. For example, in a study conducted with netball players, it was found that players wearing compressions traveled greater distances at a faster velocity. A study done with female athletes revealed a better single-leg balance (especially with closed eyes) when wearing well-fitted compression garments. However, performance enhancements is quite an exception and most studies do not confirm it.

Studies are mostly carried out among endurance athletes, with some exceptions. For example, wearing whole body compression for 24 hours after a whole body strength session was found to decrease muscle soreness, resting fatigue ratings, swelling and creatine kinase values.

Primarily, the studies about compression garments focus on lower body products. The few upper body studies that have been done are controversial, either finding no effect or positive effects when the fabric is also posture-cueing.

Although hundreds of research papers have been published, the majority of it has found no effect whatsoever. More importantly, no study has found a negative effect on performance.

So how should one wear the clothing when there are so many alternative opinions?
My suggestion is that if you are for some reasons (discomfort, lack of evidence) not sure about wearing compressions at practice or a game, rather wear them during your recovery or travels. In addition, many sportsmen have found a positive effect using them before an important competition. An athlete should know his body and follow his instincts. It is important not to expect miracles such as improving personal records or winning a race.

In basketball, athletes use compressions widely during practices or games but also during recovery. In the NBA it is more common to wear them during travelling due to the time-consuming bus- and plane rides and therefore short recovery times. On the other hand, triathletes claim that it is uncomfortable to get compressions on during the race so they mostly benefit from it after the activity. Some say that during recovery, you should wear them twice as long as the workout you are recovering from. In research, the time varies from 1 hour to 48 hours. Medical studies have concluded that graduated compression (tighter at the ankle region, looser as it goes up towards the knee) is more effective and also the amount is decisive (20 mmHg improved blood flow, while 30 mmHg actually restricted it). Textile and its’ effect on performance and recovery has been studied extensively but since the data is different there is no general scientific consensus.

As with most things in this world: the perceived effects from the compression clothing are very subjective. Without much support from the studies, one may feel that he can run faster, get rid of the cramps, etc. I have had ahtletes finding relief from shin splints with compression sleeves, albeit that several studies found no proof for this. After all, if nothing else, compression garments can keep your legs warm and protect your legs from scratches.

There is no doubt that athletes love the sleeves and the socks. I could carry out a questionnaire and there would be at least 90% satisfaction from their side. In addition, no-one hesitates, in conceding that there are many perceived advantages. So if it makes you happy, it cannot be that bad, right?

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