Compression Socks for Runners - Do they work?
Over the past few decades, the popularity of compression socks has increased significantly amongst runners and athletes. Here is a summary of some research we found to help you decide if they're doing what you thought they were, and ultimately, if they're worth it?
Previously, compression garments were worn in clinical settings to treat conditions such as deep vein thrombosis ( DVT). Studies in the early 1980's have reported positive results in their effectiveness to help improve deep venous velocity, venous return, and help reduce venous pooling in diseased, post-operative, inactive hospitalised patients ( Sperlich et al, 2010).
More recently, a study by Vercruyssen (2012) et al, set out to determine if compression stockings had any physiological or performance influences for trail runners. Using non-graded compression stockings, 11 ( male) experienced trail runners were tested on a 15.6 km course, measuring everything from heart rate, blood lactate levels, and Vo2 Max profiles. They found there was no significant difference when wearing compression socks for either physiological or performance effects.
Varela-Sanz et al ( 2011) analysed the effects of using gradual compression stockings ( tight at the ankles that loosen gradually as they extend below the knee) on running economy at half marathon pace. They found that the percentage of maximum heart rate at which the athletes were working was lower in the socks, which they attributed to enhanced circulation whilst wearing the stockings. However, there was no differences in biomechanics, physiological measurements, or performance when wearing or not wearing the compression stockings.
Physiologically, the socks have been proposed to influence muscle oscillations, reduce muscle soreness, improve lactate kinetics and arterial perfusion ( Kemmler et al, 2009; Varela-sanz etal, 2011; Vercruyssen et al, 2012). Kemmler et al (2009) decided to focus on whether or not compression stockings had any effect on performance in male runners. Although they did not find significant differences in any physiological variables measured ( heart rate, oxygen uptake, Co2 production, pulmonary ventilation, and lactate levels) - they concluded that the compression stockings enhanced both sub-maximal and maximal running performance. This, however, was NOT a blind study, meaning that subjects knew whether or not they were wearing compression socks and therefore may have triggered motivational influences that could have affected performance results.
A more recent study by Armstrong et al (2015) found positive results after investigating the effect of compression socks on functional recovery following a marathon. They proposed using a double blind study with below the knee compression socks. Their findings showed that wearing compression socks below the knee for 48 hours following a marathon improve functional recovery as well as run times to exhaustion.
In comparison, but also in 2015, a study by Zaleski et al looked at the effects of homeostatic balance using compression socks before, during, and after running a marathon. They found that wearing compression socks did not appear to lower the homeostatic activation or have any other physiological effects.
One of the main limitations in these studies is that you can never make it completely blind, as the subject will clearly be able to tell if they are wearing a compression stocking or not! Armstrong et al (2015), attempted to address this issue by using diabetic stockings for the control group.
As you can see, for a sock, there is quite a lot of research out there, mainly because it is something that is marketed to improve performance, enhance recovery, and prevent injuries. However, judging by the mixture of research results, we still aren't really sure the effect that compression socks has on recovery, performance or biomechanics. Some say it works - others say it doesn't. Most research to date has found compression stockings do not have any physiological influences. However, one study found an increase in performance and another in improved recovery time. Other studies mentioned that athletes reported reduced calf strain and perceived muscle soreness when wearing compression socks compared to not ( Sperlich et al, 2010; Vercruyssen et al, 2012; Runners work, 2010), but it was not a measured effect or a significant finding.
Taking all of the research into account, that leaves us with a decision to make. Do compression socks work to improve performance or recovery? Honestly, we still don't know for sure. With their growing popularity, there is undoubtedly much more research to come in the future. There have been no reported adverse effects or harm from wearing compression garments, but also not exactly solid proof they do anything for runners. They might just be nothing more than a security blanket for your calves...but if it makes you run faster or recover a bit quicker? We'll leave that decision up to you.
Armstrong, S., Till, E., Maloney, S., & Harris, G. 2015, compression socks and functional recovery following marathon running: a randomized controlled trial, Journal of strength and conditioning research
Bringard, A., Perrey, S., Belluye, N. 2006, Aerobic energy cost and sensation responses during submaximal running exercise - positive effects of wearing compression tights, International Journal of Sports Medicine, Vol. 27, pp. 373-378.
Kemmler, W., von Strengel, S., Kockkritz, C., Mayhew, J., Wassermann, A., & ZapF, J. 2009, effect of compression stockings on running performance on men runners, Journal of Strength and Conditioning Research, Vol. 23, no.1, pp. 101-105.
Runners World, 2008, Owners Manual: Do compression socks work? Fashionable or Functional?, Article by Brian Metzler, Running Times.
Runners World, 2010, Feeling the squeeze, Article by Sarah Bowen Shea, Runners world.
Vercruyssen, F., Easthop, C., Bernard, T., Hausswirth, C., Bleuzen, F., Gruet, M., et al. 2012, The influence of wearing compression stockings on performance indicators and physiological responses following a prolonged trial running exercise, European Journal of Sport Science, Vol. 1, pp. 1-7.
Zaleski, A., Ballard, K., Pescatello, L., Panza, G. Kupchak, B., Dada, M. et al. 2015, compression socks and hemostatic balance in marathoners, Taylor & Francis.
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