Do Compression Socks Really Work? The Science Behind The Claims

author : AMSSM

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Over the last several years there has been increasing interest in, and use of, graded compression socks by athletes for training, racing, and recovery. Advertisements for these garments claim much.

By Megan French, M.D.
Member AMSSM

Over the last several years there has been increasing interest in, and use of, graded compression socks by athletes for training, racing, and recovery. Advertisements for these garments claim that wearing them provides more energy, greater endurance, and enhanced performance. Advertisements also report that graded compression socks improve recovery when worn after athletic events. While exciting in theory, in reality there is little evidence behind these claims.

The theory behind graded compression technology:

In modern medicine, compression stockings are used to prevent and minimize edema (swelling of the extremities) from incompetent veins (blood vessels that return deoxygenated blood to the heart), which occur in some medical conditions (e.g. diabetes, advanced age, heart failure, kidney failure). They are also used to prevent blood from stagnating in the veins and forming blood clots when the muscles are not actively contracting to push blood through the veins and back to the heart (e.g. prolonged bed rest and after surgery).

As applied to athletic performance, theories postulate that wearing graded compression technology will help speed blood to the muscles and improve venous return to the heart, thereby improving performance. Other purported benefits of the product include: reducing pain from shin splints by reducing vibration and promoting healing, removing lactic acid from the muscles (lactic acid is a byproduct of intense exercise which can cause muscle aching), increasing blood flow to the Achilles tendon, warming and soothing pulled muscles, and preventing venous reflux and pooling during travel.

The data:

There is very little actual research data addressing the usefulness of compression socks when worn during and after athletic events. The studies that do exist are generally poor in quality and have a small numbers of participants, making it difficult to draw conclusions. In general, the conclusions of these studies are mixed or conflict one another. Furthermore, four of the five studies I investigated demonstrated no significant difference in athletic performance, which is the main selling point for a majority of these socks. There is only one study that specifically addresses post exercise recovery, and this study showed a trend toward slightly decreased recovery time through improved exercise ability 14 days after a marathon. However, it is a small study (only twelve participants), and the study design makes it exceedingly difficult to draw any significant conclusions. Overall, there does not appear to be any consistent physiological benefit to wearing compression socks during, or after, exercise.

There are 'some' benefits though:

Although there does not appear to be much benefit to wearing these socks during or after athletic endeavor, there is overwhelming, good-quality data suggesting that use of compression socks during long plane flights (or long car rides) to your race destination significantly reduces venous pooling in the legs, and as a result, significantly reduces the risk of getting a blood clot. The studies looked at 2800 people who were passengers of flights longer than seven hours. They found that wearing compression stockings on long flights reduces the risk of developing a leg blood clot by a factor of ten-fold. With such little down side in wearing compression socks, you may consider purchasing a pair for a long trip to or from your next race destination.

Wearing compression socks for training or on race day ultimately is a matter of personal preference, as there is no proven evidence they will improve athletic performance or decrease post-race recovery time.

Megan French, M.D.
Member AMSSM
University of Utah
Department of Sports Medicine
Department of Emergency Medicine

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date: May 19, 2015