White Paper: What Is Compression Wear?

You see your favorite athletes wearing compression socks, sleeves, shorts, and shirts as they warm up, train, and play. And then you remember the person next to you on your cross-country flight mentioned she was wearing compression socks.

What exactly is compression wear and should you be using it? Or, is it a buzzword the athletic garment industry invented to increase sales? Is all compression wear equal? What is the right amount of compression? What is the correct compression for your needs?

There are many uses for garments with compression. Compression garments are typically graded by amount of compression or “squeeze,” which is rated in millimeters of Mercury, or mm HG. Medical grade compression often ranges from 20 to 40 mm Hg, where athletic compression is typically less than 30 mm Hg. With graduated compression, the squeeze is higher at the distal end of the limb than at the proximal end (i.e. the foot versus the calf, as with compression socks). It is this graduation that helps to increase venous return (rate of blood flow to the heart), decrease edema (swelling), and prevent varicosities (visible, enlarged veins, common in legs and feet).

According to the former Medical Director of the Carolina Vein and Laser Specialists and Former board member of the American College of Phlebology,  Dr. Michael Krusch, compression socks (also called compression stockings) have been shown to “increase the efficiency of the calf-muscle pump, resulting in improved venous circulation and overall leg health and for those predisposed to varicose veins may delay their onset, possibly for years.” They  can also help reduce the risk of DVT (deep vein thrombosis) by improving venous blood return. Studies in this area have shown that the risk of developing post-thrombotic syndrome including leg swelling, pain, and venous ulcers after DVT is reduced by as much as 50 percent with compression socks (Brandies DP et. Al. Lancet,1997).

In athletes, claims about the benefits of compression garments include faster recovery, better performance during exercise, and improved thermoregulation (the ability of your body to maintain its core internal temperature).

Studying male rugby players, Duffield and Portus concluded that “…the garments as a recovery tool, when worn after exercise, may be beneficial to reduce post-exercise trauma and perceived muscle trauma.” They found that during exercise, players’ skin temperatures increased, and they surmised that those looking to keep their muscles warm during and after exercise might consider compression garments (Duffield and Portus, 2007). A study in 2012 looked at the effects of compression worn for 24 hours continuously after a simulated rugby match.  Hamlin and his team found “delayed onset of muscle soreness was substantially lower in the compression group compared to the placebo group 48 hours after testing” and concluded that “wearing compressive garments during recovery is likely to be worthwhile” (Hamlin et al, 2012).

Compression garments are multifunctional, and there is a body of strong evidence to support these positive claims, both for athletes and the public.  For those who are worried about venous pooling (inadequate blood flow causes the blood to pool) or a DVT, compression socks can be the right solution.

Given the wealth of strong data regarding the benefits of compression, we should all consider wearing at least compression socks on long drives and flights where standing time is limited. Athletes striving for faster recovery times might consider adding compression garments to their post-training regimens. The critical common component, whether you want a pair of compression stockings for your next flight or compression running socks for your next marathon, is high-quality fabric with graduated compression.

Mark Sorrentino MD, MS       
Medical Director, Lily Trotters, Inc.

1. Brandies DP et. Al. Lancet 1997 and the American Public Health Association White Paper
2. Duffield and Portus published in the British Journal of Sports Medicine 2007 
3. Hamlin et al, the Journal of Strength Conditioning Research 2012

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