Manufacturers tout the benefits of compression stockings by telling runners they improving running performance via aiding or increasing venous blood return.  They assert that the compression around the calves increases the calf muscle pump mechanism thereby increasing end-diastolic volume and cardiac output during exercise and allowing for higher intensity output.  However, research to date has not supported this assertion.

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Running a marathon presents a large physical challenge as a runner needs more than 30,000 foot strikes to finish a 26.2 mile race.  Studies to date have revealed that compression stockings may reduce muscular vibrations and oscillations in the calf with prolonged running.  They may also help decrease subjective feelings of pain following exercise bouts, but the use of them is still controversial as science also suggests they do not alter running performance.

A recent study in the Journal of Orthopaedic and Sports Physical Therapy sought to investigate the benefit of wearing graduated compression stockings for running pace, prevention of muscle damage and maintaining muscle performance during a real marathon race.  They had 34 experienced runners (running at least 5 years and completed no less than 3 marathons) take part int he study: 17 in the control group wore socks, while 17 runners wore foot-to-knee graduated compression stockings.

Runners were excluded if they were on medications in the 2 weeks prior to marathon, suffered a musculoskeletal injury in the 3 months prior to competition, and not completing the marathon.  The stockings were commercially available (NRG Energy - Medilast Sport) and covered from the foot to the inferior pole of the patella with graduated pressure.

Participants were given a pair of stockings 2 weeks before the marathon and encouraged to wear them at least 3x prior to race day.  Forty eight hours prior to the race a blood sample was taken, O2 saturation was measured, lower leg volume was assessed and maximum countermovement jump height was assessed.  On race day, participants wore their selected garments and were not given any instructions about food or drinking, while running at their own pace.  The same measurements taken pre-race were again measured following the race.

Results

  • Total race time similar between groups
  • Average running pace similar throughout the race
  • Change in body mass during the race was similar
  • Perceived exertion and lower limb soreness the same immediately after the race
  • At 24 hours post-race soreness was reported to be less in stockings group, but this difference was no longer present at 48 hours
  • Blood and serum responses were not different between groups
  • Blood markers for muscle damage revealed no differences between groups in pre-race and post-race values
  • Lower leg volume and countermovement jumps decreased in both groups after the race and no statistical differences or benefits to wearing the compression stockings

Summary

The use of compression garments in experienced runners is an ineffective strategy to reduce muscle damage over the course of a marathon.  Further, they do not reduce immediate post-race perceived soreness, nor do they increase performance compared to those runners wearing socks.  This is the first study to look at garments in a real race covering this distance.  Additional studies should be done to look at the impact of these garments on novice or less experienced half and full marathoners.

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Reference: The use of compression stockings during a marathon competition to reduce exercise-induced muscle damage: are they really useful? Areces F et al. J Orthop Sports Phys Ther. 2015 Jun;45(6):462-70.