Sunday, October 28, 2007

Can Your Socks Make You Faster?

This was the Year of the Compression Sock at the Hawaii Ironman. In past years they were evident, but this year they seemed to be every where. The accompanying picture of these elastic stockings was taken in Kona on race day. The users say they improve their performance by…

* improving venous return to the heart,
* preventing muscles from moving unnecessarily as with excess vibration meaning less fatigue, and
* speeding recovery.

They also claim that wearing them on long flights as when going to Hawaii reduces leg and foot swelling due to fluids pooling in legs.

Elastic compression stockings have been around for a long time and used in the treatment of several leg conditions such as blood clotting in deep veins (“thrombosis”) and faulty valves in the veins with weakened vein walls (“varicose veins”). The research generally supports their use for such injuries, but do they improve athletic performance such as the claims made above?

To try to answer that question I scanned more than 700 studies of the stockings looking for any that looked at their benefits during exercise at any level. Nearly all of the studies used subjects suffering from either thrombosis or varicose veins. When it came to exercise benefits in this population the results were mixed. The benefits for athletes may not be the same as for these unhealthy subjects. But there may still be some insights. The following is a typical sample of what I read.

Kahn (1) found that elastic compression stockings did not improve symptoms or increase exercise capacity while walking or running in subjects with thrombosis. Jones’ (2) research appears to support Kahn’s. This study discovered that in subjects with normal leg veins there were negligible benefits from ECS in normal daily activities. Zajkowski reported that the stockings are more effective in controlling reflux (backward flow of blood as in varicose veins) than in improving calf muscle pump function in the normal daily activities of subjects with thrombosis and varicose veins. On the other hand, Ibegbuna (4) showed significantly improved venous blood return in those with chronic venous insufficiency at all walking speeds. As you can see, the answers to such questions aren’t always clear and well-defined by the scientific literature.

I came across only one study using healthy athletes. Ali (5) discovered that after 10km running trials, recreationally active men experienced a reduction in delayed-onset muscle soreness 24 hours after wearing compression stockings. This would certainly indicate a speedier recovery as claimed by some of the stocking users. But until there is more research we will just have to rely on the experiences of athletes who have used them.

If you decide to give them a try you’ll find there is a wide range of prices and reported features. I found them online at $2US a pair and also $50US. That’s a huge difference, especially for one pair of socks. They also come in different models depending on how much pressure they exert on the leg as measured in millimeters of mercury. The most common pressure used in research seemed to be 20-30mmHg, but that is not to say this is the best for athletes. You can find some with greater pressure and also with less. More common when searching the retail websites that cater to athletes is to find no indication of pressure ratings.

I wish I could give you a definitive answer from the research on this matter. And neither I nor the athletes I have coached have ever used them so I can’t speak from experience either. Should you decide to give them a try please feel free to report your experience here with a comment.

1. Kahn SR, et al. 2003. Effect of graduated elastic compression stockings on leg symptoms and signs during exercise in patients with deep venous thrombosis: a randomized crossover trial. J Thromb Haemost 1(3): 494-499.
2. Jones NA, et al. 1980. A physiological study of elastic compression stockings in venous disorders of the leg. Br J Surg 67(8): 569-572.
3. Zajkowski PJ, et al. 2002. Compression stockings and venous function. Arch Surg 137(9): 1064-1068.
4. Ibegbuna V, et al. 2003. Effect of elastic compression stockings on venous hemodynamics during walking. J Vasc Surg 37(2): 420-425.
5. Ali A, et al. 2007. Graduated compression stockings: physiological and perceptual responses during and after exercise. J Sports Sci 25(4): 413-419.


At October 28, 2007 7:28 PM , Blogger Java said...

Never seen or heard from it in athletes. The most I knew about the socks is for pregnant women and in flight treatment. Myself have to wear one on my left leg as I suffer from varicose veins but all internal ones and it makes my leg swell.
They are quite expensive here in WA and I bought some for a fifth less of the price here from the USA over the net too. You wonder why the price is so varied.

At October 29, 2007 1:15 PM , Blogger Dessa said...

Apparently, Popovich is using it al the time, and even was fined 250 swiss francs during Giro 2004 for wearing it during competion.

Walgreens have wide selection of the compression sock at different price level. I'm going to try 3 diffent brands to see what works for me, especially for long flights.

Intereseting, it was mentioned in Cycling Pro articale this month (p.85 Nov 2007), with a note, that it should be custom made to work efficently. "It is around the ankle that the pressure needs to be greates, as this prevents the dilation of certain blood vessels and boosts blood circulation towards the heart", it says.

At November 7, 2007 1:11 AM , Blogger kenny said...

its got to be near impossible to accurately pressure rate socks as everyone's leg is of a different diameter at any given point.

At November 7, 2007 3:56 PM , Blogger privateer said...

It'd be really hard to blind a study comparing performance with and without the socks.

At January 13, 2008 6:52 AM , Blogger Richard said...

This is a huge subject for those of use who have visible varicose veins. What I have always wanted to know is if athletic performance would suffer if any attempt was made to remove/ inject/ reduce surface varicose veins in legs (I'm a cyclist!). I assume it's a bad idea since George Hincapie makes no effort to disguise his. Also interesting that he hasn't started wearing socks - the default position on this subject is, I believe, that the best you can do is have great muscle tone, since they support the veins as well, almost like an internal sock pushing out. Why is there so little info on this subject? Can anyone help re. the surgery route & athletics? I'm still dreaming of smooth cycling legs.

At September 5, 2008 2:55 PM , Blogger tricoachmartin said...

Thanks for your well researched blog. I found an even more recent study in the Medicine & Science in Sports & Exercise on The Effect of Compression Socks during Submaximal and Maximal Exercise on the Treadmill (May 2008). Again, no significant performance results with the socks. There might still be room for an argument that they aid recovery. But making you faster? I don't think so.

At February 18, 2009 10:53 AM , Anonymous Anonymous said...

Hmm... LA is wearing them at the ToC!

At February 28, 2009 10:18 AM , Blogger michaelarnold said...

A vein specialist told me that in addition to hereditary factors and blood pressure strain, cyclist are more prone to getting vericose veins because of the falls. The top tube smashes against the inner thigh destroying the little valves in the surface veins. The outer leg vein valves around the knee also get destroyed. Soccer players too get their veins smashed from being kicked.
I had my vericose veins removed and the veins around them popped out after 7 years. I think stockings are the only hope and I'm 52 now. Drag. Just not my turn to have cycling legs but I still ride.

At March 1, 2009 5:13 PM , Blogger maryka said...

I'm just an n=1, but since buying a pair of 2XU calf guards a few weeks ago and running over 130km with them, my previously very tight calves and sensitive shins are unbelievably better. And I do notice an improvement in fatigue level and recovery times, especially for long runs.

I've gone and picked up some shorts to see if my quads/hamstrings will receive the same positive effects, and also tights for extra recovery benefits. I don't want to sound like a walking advertisement, but this the best performance enhancer I've found since Hammer Nutrition's anti-fatigue caps.

At August 11, 2009 10:29 PM , Blogger Tim Heath said...

I was having terrible shin splints and started wearing compression socks. The pain is definitely mitigated. I would recommend them to others.

When I researched, I saw even greater variance in price $10 - $100+, for socks!!!! I found a great variety at

At September 20, 2009 7:59 AM , Anonymous Jim M said...

I run mostly in the evenings after work. At my age (46) my calves are very tight after sitting at a desk most of the day, and I resort to elevating my legs before running to drain the fluid. I am not only concerned about athletic performance, but I believe running with leg muscles in that condition makes injury more likely, and I can see it increasing damage to veins (a guess on my part). I will be trying the socks in the afternoon before exercise and afterward to reduce post running/riding swelling. I cannot see why using them during running/riding would help unless you already have valve problems and need the help of the graduated support of the surface veins(and this seems to be supported by the research). The best relief from swollen legs is to walk and let the muscles do what they do; pump the blood back up. The same thing happens during exercise, and the pressure of socks in comparison to the squeezing of the muscles is going to be negligible.

At April 20, 2010 6:49 AM , Anonymous Anonymous said...

It should be pointed out that not all compression socks are the same. You want to look for socks that offer true graduated compression to get the true benefits. Some companies claim to make compression socks, but they offer the same level of compression at the calf as the ankle. This does not help you. This Athletic Recoery Sock offers true graduated compresssion. I have tried them and they really do work.


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