Do Compression Socks and Ice Baths Work?

author : AMSSM

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Sports doc analyzes usefulness

Question from BT User:

Are ice baths and/or compression socks actually good, from a medical perspective? Are there any studies showing they improve recovery? Do you recommend them for patients? If so, does it make recovery quicker, or actually prevent injury?

Answer from Adae Amoako, MD
Member AMSSM

Do Ice Baths and compression socks improve recovery?

This is a common practice for many athletes, both beginners and elites alike. Especially runners and tri-athletes. In order to understand the theory or reason why this is done, it is important to understand what happens to muscles after intense activity such as running. There is damage or micro-trauma (small tears) in the muscle tissues after intense exercises. Whenever muscle tissues are damaged, a substance called lactic acid is released. The release of lactic acid causes pain. In addition to that, the damage muscles trigger a cascade of events that rebuild muscle. This rebuilding in itself causes pain.

As you may be aware ice slows down metabolism. The theory is that this decreases the damage of muscles which in turn decreases the buildup process and the pain associated with it. It is also thought that it causes lactic acid to get out of the muscle tissues quicker, decreasing pain as well. Ice also causes vasoconstriction (constriction of blood vessels) which is thought to decrease pain and increase circulation. Compression socks are also theorized to cause vasoconstriction and decrease lactic acid production which in turn decreases pain.

Are there any studies that back these theories up?

Several studies have been done looking at ice baths but most have found no benefit or inconclusive results.

For compression socks, there have been benefits shown.

One recent study (2015), looked at swimmers who used ice baths and those that did not and found no difference in the oxidant-antioxidant balance (buildup and catabolic states). In 2011, one study (randomized controlled trial) found no difference between recovery times in rugby players who used ice baths compared to those that use no recovery method. They actually found a negative effect of ice baths when they looked at the phosphate decrement test (a test that shows how fast muscles recover after a sprint). In 2012, a similar study found no difference in performance in games.

Regarding compression socks, in 2015 a study looking at marathon runners found significant beneficial effect of compression socks on recovery compared to placebo. In 2016, another study reconfirmed the benefits of compression socks in performance in runners.

Do I recommend ice baths and compression socks to my patients?

I usually let patients know that most studies show no benefits of ice baths though the theory behind it sounds plausible. However, I do point out that benefits to compression socks have been shown. Some may not be dependent solely on runners, such as; they have been shown medically to decrease swelling, so for marathoners who are on their feet for hours training, it may help with keeping swelling down. They also protect the skin against insect bites, and abrasions while running. So if they think it helps them, I give them the OK to use.

References

1. Sutkowy P, Wozniak A), Boraczynski T, Boraczynski M, Mila-Kierzenkowska C. Oxidation-reduction processes in ice swimmers after ice-cold water bath and aerobic exercise. Cryobiology. 2015 Jun; 70(3):273-7.


2. Crystal NJ, Townson DH, Cook SB, LaRoche DP.Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. Eur J Appl Physiol. 2013; 113(10):2577-86.


3. Higgins T, Cameron M, Climstein M.Evaluation of passive recovery, cold water immersion, and contrast baths for recovery, as measured by game performances markers, between two simulated games of rugby union.J Strength Cond Res. 2012 Jun 11.


4. Armstrong SA, Till ES, Maloney S, Harris G. Compression socks and functional recovery following marathon running: a randomized controlled trial. .J Strength Cond Res. 2015; 29 (2):528-33.


5. Engel FA, Holmberg HC, Sperlich B. Is there evidence that runners can benefit from wearing compression clothing? Sports Med. 2016; 46(12):1939-1952.

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date: February 28, 2017