Putting the Squeeze on Compression Garments: Current Evidence and Recommendations for Future Research: A Systematic Scoping Review

Fundamentals or Icing on Top of the Cake? A Narrative Review of Recovery Strategies and Devices for Athletes

The sport and athletic performance industry has seen a plethora of new recovery devices and technologies over recent years, and it has become somewhat difficult for athletes, coaches, and practitioners to navigate the efficacy of such devices or whether they are even required at all. With the increase in recovery devices and tools, it has also become commonplace for athletes to overlook more traditional, well-established recovery strategies. In this narrative review, we discuss recovery strategies in relation to the hierarchy of scientific evidence, classifying them based on the strength of the evidence, ranging from meta-analyses through to case studies and reports. We report that foam rolling, compression garments, cryotherapy, photobiomodulation, hydrotherapy, and active recovery have a high level of positive evidence for improved recovery outcomes, while sauna, recovery boots/sleeves, occlusion cuffs, and massage guns currently have a lower level of evidence and mixed results for their efficacy. Finally, we provide guidance for practitioners when deciding on recovery strategies to use with athletes during different phases of the season.

Acute Recovery after a Fatigue Protocol Using a Recovery Sports Legging: An Experimental Study

Enhancing recovery is a fundamental component of high-performance sports training since it enables practitioners to potentiate physical performance and minimise the risk of injuries. Using a new sports legging embedded with an intelligent system for electrostimulation, localised heating and compression (completely embodied into the textile structures), we aimed to analyse acute recovery following a fatigue protocol. Surface electromyography- and torque-related variables were recorded on eight recreational athletes. A fatigue protocol conducted in an isokinetic dynamometer allowed us to examine isometric torque and consequent post-exercise acute recovery after using the sports legging. Regarding peak torque, no differences were found between post-fatigue and post-recovery assessments in any variable; however, pre-fatigue registered a 16% greater peak torque when compared with post-fatigue for localised heating and compression recovery methods. Our data are supported by recent meta-analyses indicating that individual recovery methods, such as localised heating, electrostimulation and compression, are not effective to recover from a fatiguing exercise. In fact, none of the recovery methods available through the sports legging tested was effective in acutely recovering the torque values produced isometrically.

The Effectiveness of Compression Garments for Reducing Pain in Non-Vascular Ehlers-Danlos Syndromes: A Prospective Observational Cohort Study

Patients with Ehlers-Danlos Syndrome (EDS) frequently suffer from severe chronic pain. We carried out an observational cohort study to assess the effectiveness of compression garments (CGs) for reducing this pain. Patients with non-vascular EDS were given custom-made Cerecare^® CGs during a visit to a specialist clinic (visit V0). They were followed up over 2 years with visits every 6 months (V1-V4). At each visit, pain was assessed for the joints treated with CGs using a visual analogue scale (VAS; 0-100 mm). Additional measures were obtained to assess neuropathic pain (painDETECT questionnaire), proprioception/balance (Berg Balance Scale), and functional independence, amongst others. Data were analyzed for 67 patients with EDS (hypermobile: 91%; classical: 6%; kyphoscoliotic: 3%). For the most painful joint, the mean VAS rating was 71.5 ± 22.8 mm at V0; this decreased to 53.5 ± 25.5 mm at V1 and 45.7 ± 29 mm at V4 (t-tests: p < 0.0001). From V0 to V4, improvements were also seen for pain at the other joints, neuropathic pain, functional independence, proprioception/balance, and the incidence of sprains and dislocations/subluxations, although not all comparisons were statistically significant (p < 0.05 level). These results indicate that CGs may effectively reduce the pain and joint instability in non-vascular EDS patients.

Do Sports Compression Garments Alter Measures of Peripheral Blood Flow? A Systematic Review with Meta-Analysis

BACKGROUND

One of the proposed mechanisms underlying the benefits of sports compression garments may be alterations in peripheral blood flow.

OBJECTIVE

We aimed to determine if sports compression garments alter measures of peripheral blood flow at rest, as well as during, immediately after and in recovery from a physiological challenge (i.e. exercise or an orthostatic challenge).

METHODS

We conducted a systematic literature search of databases including Scopus, SPORTDiscus and PubMed/MEDLINE. The criteria for inclusion of studies were: (1) original papers in English and a peer-reviewed journal; (2) assessed effect of compression garments on a measure of peripheral blood flow at rest and/or before, during or after a physiological challenge; (3) participants were healthy and without cardiovascular or metabolic disorders; and (4) a study population including athletes and physically active or healthy participants. The PEDro scale was used to assess the methodological quality of the included studies. A random-effects meta-analysis model was used. Changes in blood flow were quantified by standardised mean difference (SMD) [± 95% confidence interval (CI)].

RESULTS

Of the 899 articles identified, 22 studies were included for the meta-analysis. The results indicated sports compression garments improve overall peripheral blood flow (SMD = 0.32, 95% CI 0.13, 0.51, p = 0.001), venous blood flow (SMD = 0.37, 95% CI 0.14, 0.60, p = 0.002) and arterial blood flow (SMD = 0.30, 95% CI 0.01, 0.59, p = 0.04). At rest, sports compression garments did not improve peripheral blood flow (SMD = 0.18, 95% CI - 0.02, 0.39, p = 0.08). However, subgroup analyses revealed sports compression garments enhance venous (SMD = 0.31 95% CI 0.02, 0.60, p = 0.03), but not arterial (SMD = 0.12, 95% CI - 0.16, 0.40, p = 0.16), blood flow. During a physiological challenge, peripheral blood flow was improved (SMD = 0.44, 95% CI 0.19, 0.69, p = 0.0007), with subgroup analyses revealing sports compression garments enhance venous (SMD = 0.48, 95% CI 0.11, 0.85, p = 0.01) and arterial blood flow (SMD = 0.44, 95% CI 0.03, 0.86, p = 0.04). At immediately after a physiological challenge, there were no changes in peripheral blood flow (SMD = - 0.04, 95% CI - 0.43, 0.34, p = 0.82) or subgroup analyses of venous (SMD = - 0.41, 95% CI - 1.32, 0.47, p = 0.35) and arterial (SMD = 0.12, 95% CI - 0.26, 0.51, p = 0.53) blood flow. In recovery, sports compression garments did not improve peripheral blood flow (SMD = 0.25, 95% CI - 0.45, 0.95, p = 0.49). The subgroup analyses showed enhanced venous (SMD = 0.67, 95% CI 0.17, 1.17, p = 0.009), but not arterial blood flow (SMD = 0.02, 95% CI - 1.06, 1.09, p = 0.98).

CONCLUSIONS

Use of sports compression garments enhances venous blood flow at rest, during and in recovery from, but not immediately after, a physiological challenge. Compression-induced changes in arterial blood flow were only evident during a physiological challenge.

Can Compression Garments Reduce the Deleterious Effects of Physical Exercise on Muscle Strength? A Systematic Review and Meta-Analyses

Background

The use of compression garments (CGs) during or after training and competition has gained popularity in the last few decades. However, the data concerning CGs’ beneficial effects on muscle strength-related outcomes after physical exercise remain inconclusive.

Objective

The aim was to determine whether wearing CGs during or after physical exercise would facilitate the recovery of muscle strength-related outcomes.

Methods

A systematic literature search was conducted across five databases (PubMed, SPORTDiscus, Web of Science, Scopus, and EBSCOhost). Data from 19 randomized controlled trials (RCTs) including 350 healthy participants were extracted and meta-analytically computed. Weighted between-study standardized mean differences (SMDs) with respect to their standard errors (SEs) were aggregated and corrected for sample size to compute overall SMDs. The type of physical exercise, the body area and timing of CG application, and the time interval between the end of the exercise and subsequent testing were assessed.

Results

CGs produced no strength-sparing effects (SMD [95% confidence interval]) at the following time points (t) after physical exercise: immediately ≤ t < 24 h: − 0.02 (− 0.22 to 0.19), p = 0.87; 24 ≤ t < 48 h: − 0.00 (− 0.22 to 0.21), p = 0.98; 48 ≤ t < 72 h: − 0.03 (− 0.43 to 0.37), p = 0.87; 72 ≤ t < 96 h: 0.14 (− 0.21 to 0.49), p = 0.43; 96 h ≤ t: 0.26 (− 0.33 to 0.85), p = 0.38. The body area where the CG was applied had no strength-sparing effects. CGs revealed weak strength-sparing effects after plyometric exercise.

Conclusion

Meta-analytical evidence suggests that wearing a CG during or after training does not seem to facilitate the recovery of muscle strength following physical exercise. Practitioners, athletes, coaches, and trainers should reconsider the use of CG as a tool to reduce the effects of physical exercise on muscle strength.

Trial Registration Number

PROSPERO CRD42021246753.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01681-4.