Skip to main content
SpringerLink
Log in

Association of Lower Limb Compression Garments During High-Intensity Exercise with Performance and Physiological Responses: A Systematic Review and Meta-analysis

  • Systematic Review
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Background

Although compression garments are used to improve sports performance, methodological approaches and the direction of evidence regarding garments for use in high-intensity exercise settings are diverse.

Objectives

Our primary aim was to summarize the association between lower-limb compression garments (LLCGs) and changes in sports performance during high-intensity exercise. We also aimed to summarize evidence about the following physiological parameters related to sports performance: vertical jump height (VJ), maximal oxygen uptake (VO2max), submaximal oxygen uptake (VO2submax), blood lactate concentrations ([La]), and ratings of perceived exertion (RPE, 6–20 Borg scale).

Methods

We searched electronic databases (PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov) and reference lists for previous reviews. Eligible studies included randomized controlled trials with athletes or physically active subjects (≥ 18 years) using any type of LLCG during high-intensity exercise. The results were described as weighted mean difference (WMD) with a 95% confidence interval (95% CI).

Results

The 23 included studies showed low statistical heterogeneity for the pooled outcomes. We found that LLCGs yielded similar running performance to controls (50–400 m: WMD 0.06 s [95% CI − 1.99 to 2.11]; 800–3000 m: WMD 6.10 s [95% CI − 7.23 to 19.43]; > 5000 m: WMD 1.01 s [95% CI − 84.80 to 86.82]). Likewise, we found no evidence that LLCGs were superior in secondary outcomes (VJ: WMD 2.25 cm [95% CI − 2.51 to 7.02]; VO2max: WMD 0.24 mL.kg−1.min−1 [95% CI − 1.48 to 1.95]; VO2submax: WMD − 0.26 mL.kg−1.min−1 [95% CI − 2.66 to 2.14]; [La]: WMD 0.19 mmol/L [95% CI − 0.22 to 0.60]; RPE: WMD − 0.20 points [95% CI − 0.48 to 0.08]).

Conclusions

LLCGs were not associated with improved performance in VJ, VO2max, VO2submax, [La], or RPE during high-intensity exercise. Such evidence should be taken into account when considering using LLCGs to enhance running performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Partsch H. The static stiffness index: a simple method to assess the elastic property of compression material in vivo. Dermatol Surg. 2006;31:625–30.

    Article  Google Scholar 

  2. O’Meara S, Cullum NA, Nelson EA, et al. Compression for venous leg ulcers. Cochrane Libr. 2009;11:1–3.

    Google Scholar 

  3. Moseley AL, Carati CJ, Piller NB. A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol. 2007;18:639–46.

    Article  PubMed  CAS  Google Scholar 

  4. Rinehart-Ayres ME. Conservative approaches to lymphedema treatment. Cancer. 1998;83:2828–32.

    Article  PubMed  CAS  Google Scholar 

  5. Qaseem A. Venous thromboembolism prophylaxis in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011;155:625.

    Article  PubMed  Google Scholar 

  6. Sperlich B, Born DP, Swarén M, Kilian Y, Geesmann B, Kohl-Bareis M, et al. Is leg compression beneficial for alpine skiers? BMC Sports Sci Med Rehabil. 2013;5:18.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ali A, Creasy RH, Edge JA. The effect of graduated compression stockings on running performance. J Strength Cond Res. 2011;25:1385–92.

    Article  PubMed  Google Scholar 

  8. Gupta A, Bryers JJ, Clothier PJ. The effect of leg compression garments on the mechanical characteristics and performance of single-leg hopping in healthy male volunteers. BMC Sports Sci Med Rehabil. 2015;7:10.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Stickford AS, Chapman RF, Johnston JD, Stager JM. Lower leg compression, running mechanics and economy in trained distance runners. Int J Sports Physiol Perform. 2014;10:76–83.

    Article  PubMed  Google Scholar 

  10. Dascombe BJ, Hoare TK, Sear JA, Reaburn PR, Scanlan AT. The effects of wearing undersized lower-body compression garments on endurance running performance. Int J Sports Physiol Perform. 2011;6:160–73.

    Article  PubMed  Google Scholar 

  11. Rimaud D, Messonnier L, Castells J, Devillard X, Calmels P. Effects of compression stockings during exercise and recovery on blood lactate kinetics. Eur J Appl Physiol. 2010;110:425–33.

    Article  PubMed  Google Scholar 

  12. Kraemer WJ, Bush JA, Bauer JA, Triplett-McBride NT, Paxton NJ, Clemson A, et al. Influence of compression garments on vertical jump performance in NCAA Division I volleyball players. J Strength Cond Res. 1996;10:180–3.

    Google Scholar 

  13. Doan BK, Kwon YH, Newton RU, Shim J, Popper EM, Rogers RA, et al. Evaluation of a lower-body compression garment. J Sports Sci. 2003;21:601–10.

    Article  PubMed  Google Scholar 

  14. Born DP, Holmberg HC, Goernert F, Sperlich B. A novel compression garment with adhesive silicone stripes improves repeated sprint performance—a multi-experimental approach on the underlying mechanisms. BMC Sports Sci Med Rehabil. 2014;6:21.

    Article  PubMed  PubMed Central  Google Scholar 

  15. MacRae BA, Cotter JD, Laing RM. Compression garments and exercise: garment considerations, physiology and performance. Sports Med. 2011;41:815–43.

    Article  PubMed  Google Scholar 

  16. Born DP, Sperlich B, Holmberg HC. Bringing light into the dark: effects of compression clothing on performance and recovery. Int J Sports Physiol Perform. 2013;8:4–18.

    Article  PubMed  Google Scholar 

  17. Beliard S, Chauveau M, Moscatiello T, Cros F, Ecarnot F, Becker F. Compression garments and exercise: no influence of pressure applied. J Sports Sci Med. 2015;14:75–83.

    PubMed  PubMed Central  Google Scholar 

  18. Engel FA, Holmberg HC, Sperlich B. Is there evidence that runners can benefit from wearing compression clothing? Sports Med. 2016;46:1939–52.

    Article  PubMed  Google Scholar 

  19. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–9.

    Article  PubMed  Google Scholar 

  20. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Riley RD, Higgins JPT, Deeks JJ. Interpretation of random effects meta-analyses. BMJ. 2011;342:d549.

    Article  PubMed  Google Scholar 

  22. Borg GA. Perceived exertion. Exerc Sport Sci Rev. 1974;2:131–53.

    Article  PubMed  CAS  Google Scholar 

  23. Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. http://handbook.cochrane.org.

  24. Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol. 2008;61:991–6.

    Article  PubMed  Google Scholar 

  25. Egger M, Smith GD, Schneider M, Minder C, Mulrow C, Egger M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:597–9.

    Google Scholar 

  26. Bernhardt T, Anderson GS. Influence of moderate prophylactic compression on sport performance. J Strength Cond Res. 2005;19:292–7.

    PubMed  Google Scholar 

  27. Bringard A, Perrey S, Belluye N. Aerobic energy cost and sensation responses during submaximal running exercise-positive effects of wearing compression tights. Int J Sports Med. 2006;27:373–8.

    Article  PubMed  CAS  Google Scholar 

  28. Kemmler W, von Stengel S, Köckritz C, Mayhew J, Wassermann A, Zapf J. Effect of compression stockings on running performance in men runners. J Strength Cond Res. 2009;23:101–5.

    Article  PubMed  Google Scholar 

  29. Rider BC, Coughlin AM, Hew-Butler TD, Goslin BR. Effect of compression stockings on physiological responses and running performance in Division III collegiate cross-country runners during a maximal treadmill test. J Strength Cond Res. 2014;28:1732–8.

    Article  PubMed  Google Scholar 

  30. Scanlan AT, Dascombe BJ, Reaburn PRJ, Osborne M. The effects of wearing lower-body compression garments during endurance cycling. Int J Sports Physiol Perform. 2008;3:424–38.

    Article  PubMed  Google Scholar 

  31. Sperlich B, Haegele M, Achtzehn S, Linville J, Holmberg HC, Mester J. Different types of compression clothing do not increase sub-maximal and maximal endurance performance in well-trained athletes. J Sports Sci. 2010;28:609–14.

    Article  PubMed  Google Scholar 

  32. Wahl P, Bloch W, Mester J, Born DP, Sperlich B. Effects of different levels of compression during sub-maximal and high-intensity exercise on erythrocyte deformability. Eur J Appl Physiol. 2012;112:2163–9.

    Article  PubMed  Google Scholar 

  33. Rivas E, Smith JD, Sherman NW. Leg compressions improve ventilatory efficiency while reducing peak and post exercise blood lactate, but does not improve perceived exertion, exercise economy or aerobic exercise capacity in endurance-trained runners. Respir Physiol Neurobiol. 2017;237:1–6.

    Article  PubMed  Google Scholar 

  34. Lovell DI, Mason DG, Delphinus EM, McLellan CP. Do compression garments enhance the active recovery process after high-intensity running? J Strength Cond Res. 2011;25:3264–8.

    Article  PubMed  Google Scholar 

  35. Varela-Sanz A, España J, Carr N, Boullosa DA, Esteve-Lanao J. Effects of gradual-elastic compression stockings on running economy, kinematics, and performance in runners. J Strength Cond Res. 2011;25:2902–10.

    Article  PubMed  Google Scholar 

  36. Burden RJ, Glaister M. The effects of ionized and nonionized compression garments on sprint and endurance cycling. J Strength Cond Res. 2012;26:2837–43.

    Article  PubMed  Google Scholar 

  37. Driller MW, Halson SL. The effects of wearing lower body compression garments during a cycling performance test. Int J Sports Physiol Perform. 2013;8:300–6.

    Article  PubMed  Google Scholar 

  38. Ali A, Caine MP, Snow BG. Graduated compression stockings: physiological and perceptual responses during and after exercise. J Sports Sci. 2007;25:413–9.

    Article  PubMed  CAS  Google Scholar 

  39. Barwood MJ, Corbett J, Feeney J, Hannaford P, Henderson D, Jones I, et al. Compression garments: no enhancement of high-intensity exercise in hot radiant conditions. Int J Sports Physiol Perform. 2013;8:527–35.

    Article  PubMed  Google Scholar 

  40. Faulkner JA, Gleadon D, McLaren J, Jakeman JR. Effect of lower limb compression clothing on 400-m sprint performance. J Strength Cond Res. 2013;27:669–76.

    Article  PubMed  Google Scholar 

  41. Goh SS, Laursen PB, Dascombe B, Nosaka K. Effect of lower body compression garments on submaximal and maximal running performance in cold (10 °C) and hot (32 °C) environments. Eur J Appl Physiol. 2011;111:819–26.

    Article  PubMed  Google Scholar 

  42. Venckūnas T, Trinkūnas E, Kamandulis S, Poderys J, Grūnovas A, Brazaitis M. Effect of lower body compression garments on hemodynamics in response to running session. Sci World J. 2014;2014:1–10.

    Article  Google Scholar 

  43. Treseler C, Bixby WR, Nepocatych S. The effect of compression stockings on physiological and psychological responses after 5-km performance in recreationally active females. J Strength Cond Res. 2016;30:1985–91.

    Article  PubMed  Google Scholar 

  44. Del Coso J, Areces F, Salinero JJ, González-Millán C, Abián-Vicén J, Soriano L, et al. Compression stockings do not improve muscular performance during a half-ironman triathlon race. Eur J Appl Physiol. 2014;114:587–95.

    Article  PubMed  Google Scholar 

  45. Areces F, Salinero JJ, Abian-Vicen J, González-Millán C, Ruiz-Vicente D, Lara B, et al. The use of compression stockings during a marathon competition to reduce exercise-induced muscle damage: are they really useful? J Orthop Sports Phys Ther. 2015;45:462–70.

    Article  PubMed  Google Scholar 

  46. Ménétrier A, Mourot L, Bouhaddi M, Regnard J, Tordi N. Compression sleeves increase tissue oxygen saturation but not running performance. Int J Sports Med. 2011;32:864–8.

    Article  PubMed  Google Scholar 

  47. Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010;10:28–55.

    Google Scholar 

  48. Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Knicker AJ, Renshaw I, Oldham ARH, Cairns SP. Interactive processes link the multiple symptoms of fatigue in sport competition. Sports Med. 2011;41:307–28.

    Article  PubMed  Google Scholar 

  50. Millet GY, Lepers R. Alterations of neuromuscular function after prolonged running, cycling and skiing exercises. Sports Med. 2004;34:105–16.

    Article  PubMed  Google Scholar 

  51. Lattimer CR, Kalodiki E, Kafeza M, Azzam M, Geroulakos G. Quantifying the degree graduated elastic compression stockings enhance venous emptying. Eur J Vasc Endovasc Surg. 2014;47:75–80.

    Article  PubMed  CAS  Google Scholar 

  52. Ibegbuna V, Delis KT, Nicolaides AN, Aina O. Effect of elastic compression stockings on venous hemodynamics during walking. J Vasc Surg. 2003;37:420–5.

    Article  PubMed  Google Scholar 

  53. Dermont T, Morizot L, Bouhaddi M, Ménétrier A. Changes in tissue oxygen saturation in response to different calf compression sleeves. J Sport Med. 2015;2015:857904.

    Article  CAS  Google Scholar 

  54. Liu R, Lao TT, Kwok YL, Li Y, Ying MTC. Effects of graduated compression stockings with different pressure profiles on lower-limb venous structures and haemodynamics. Adv Ther. 2008;25:465–78.

    Article  PubMed  Google Scholar 

  55. Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000;32:70–84.

    Article  PubMed  Google Scholar 

  56. Poole DC, Jones AM. Oxygen uptake kinetics. Compr Physiol. 2012;2:933–96.

    PubMed  Google Scholar 

  57. Faisal A, Dyson KS, Hughson RL. Prolonged ischaemia impairs muscle blood flow and oxygen uptake dynamics during subsequent heavy exercise. J Physiol. 2010;588:3785–97.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Grassi B, Gladden LB, Stary CM, Wagner PD, Hogan MC. Peripheral O2 diffusion does not affect V(O2) on-kinetics in isolated insitu canine muscle. J Appl Physiol. 1998;85:1404–12.

    Article  PubMed  CAS  Google Scholar 

  59. Grassi B, Gladden LB, Samaja M, Stary CM, Hogan MC. Faster adjustment of O2 delivery does not affect V(O2) on-kinetics in isolated in situ canine muscle. J Appl Physiol. 1998;85:1394–403.

    Article  PubMed  CAS  Google Scholar 

  60. Wilkerson DP, Rittweger J, Berger NJA, Naish PF, Jones AM. Influence of recombinant human erythropoietin treatment on pulmonary O2 uptake kinetics during exercise in humans. J Physiol. 2005;568:639–52.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  61. Ali A, Creasy RH, Edge JA. Physiological effects of wearing graduated compression stockings during running. Eur J Appl Physiol. 2010;109:1017–25.

    Article  PubMed  Google Scholar 

  62. Jones AM, Grassi B, Christensen PM, Krustrup P, Bangsbo J, Poole DC. Slow component of VO2 kinetics: mechanistic bases and practical applications. Med Sci Sports Exerc. 2011;43:2046–62.

    Article  PubMed  Google Scholar 

  63. Berry MJ, McMurray RG. Effects of graduated compression stockings on blood lactate following an exhaustive bout of exercise. Am J Phys Med. 1987;66:121–32.

    Article  PubMed  CAS  Google Scholar 

  64. Nielsen HV. External pressure-blood flow relations during limb compression in man. Acta Physiol Scand. 1983;119:253–60.

    Article  PubMed  CAS  Google Scholar 

  65. Styf J. The influence of external compression on muscle blood flow during exercise. Am J Sports Med. 1990;18:92–5.

    Article  PubMed  CAS  Google Scholar 

  66. Sperlich B, Born DP, Kaskinoro K, Kalliokoski KK, Laaksonen MS. Squeezing the muscle: compression clothing and muscle metabolism during recovery from high intensity exercise. PLoS One. 2013;8:e60923.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  67. Nishiyasu T, Nagashima K, Nadel ER, Mack GW. Human cardiovascular and humoral responses to moderate muscle activation during dynamic exercise. J Appl Physiol. 2000;88:300–7.

    Article  PubMed  CAS  Google Scholar 

  68. Billat LV. Use of blood lactate measurements for prediction of exercise performance and for control of training. recommendations for long-distance running. Sports Med. 1996;22:157–75.

    Article  PubMed  CAS  Google Scholar 

  69. Faude O, Kindermann W, Meyer T. Lactate threshold concepts: how valid are they? Sports Med. 2009;39:469–90.

    Article  PubMed  Google Scholar 

  70. Dittrich N, de Lucas RD, Maioral MF, Diefenthaeler F, Guglielmo LGA. Continuous and intermittent running to exhaustion at maximal lactate steady state: neuromuscular, biochemical and endocrinal responses. J Sci Med Sport. 2013;16:545–9.

    Article  PubMed  Google Scholar 

  71. Marcora SM, Staiano W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol. 2009;106:857–64.

    Article  PubMed  Google Scholar 

  72. Marcora SM, Staiano W. The limit to exercise tolerance in humans: mind over muscle? Eur J Appl Physiol. 2010;109:763–70.

    Article  PubMed  Google Scholar 

  73. Blanchfield AW, Hardy J, De Morree HM, Staiano W, Marcora SM. Talking yourself out of exhaustion: the effects of self-talk on endurance performance. Med Sci Sports Exerc. 2014;46:998–1007.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Graduate Program in Cardiology and Cardiovascular Sciences, School of Medicine, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Térreo, Ramiro Barcelos 2350, Largo Eduardo Zaccaro Faraco, Porto Alegre, RS, CEP 90035-903, Brazil

    César Augusto da Silva, Lucas Helal, Roberto Pacheco da Silva, Karlyse Claudino Belli, Daniel Umpierre & Ricardo Stein

  2. Exercise Cardiology Research Group (CardioEx) HCPA/UFRGS, Porto Alegre, Brazil

    César Augusto da Silva & Ricardo Stein

  3. Exercise Pathophysiology Laboratory (LaFiEx) HCPA/UFRGS, Porto Alegre, Brazil

    Lucas Helal & Daniel Umpierre

  4. Interdisciplinary Laboratory of Research on Sleep (LIPES) HCPA/UFRGS, Porto Alegre, Brazil

    Roberto Pacheco da Silva

  5. Institute for Health Technology Assessment (IATS), HCPA/UFRGS, Porto Alegre, Brazil

    Daniel Umpierre

  6. School of Medicine, HCPA/UFRGS, Porto Alegre, Brazil

    Ricardo Stein

  7. Vitta Centro de Bem-Estar Físico, Porto Alegre, Brazil

    Ricardo Stein

Authors
  1. César Augusto da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lucas Helal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberto Pacheco da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karlyse Claudino Belli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daniel Umpierre
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ricardo Stein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ricardo Stein.

Ethics declarations

Funding

This study was supported by the Fundo de Incentivo à Pesquisa e Eventos from the Hospital de Clínicas de Porto Alegre (FIPE/HCPA). Ricardo Stein and Daniel Umpierre receive research productivity funding from the Brazilian National Council for Scientific and Technological Development (CNPq). Lucas Helal receives PhD funding support from the CAPES (Coordination for the Improvement of Higher Education Personnel) Foundation.

Conflict of interest

César Augusto da Silva, Lucas Helal, Roberto Pacheco da Silva, Karlyse Claudino Belli, Daniel Umpierre, and Ricardo Stein declare that they have no conflicts of interest relevant to the content of this review.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

da Silva, C.A., Helal, L., da Silva, R.P. et al. Association of Lower Limb Compression Garments During High-Intensity Exercise with Performance and Physiological Responses: A Systematic Review and Meta-analysis. Sports Med 48, 1859–1873 (2018). https://doi.org/10.1007/s40279-018-0927-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40279-018-0927-z

Search

Navigation