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Complete Guide to Compression Garments - Part 1January 02, 2014

 

Complete Guide to Compression Garments

DISCLOSURE – I am not a Doctor and statements contained herewith are provided for informational purposes only.

This is the first article of a series that will address the most common topics of discussion and questions surrounding compression garments. In this first article we address the long debated question: What are compression garments and do they really work?

Compression garments are special wear used to exert graduated and controlled pressure over certain areas of the body for medical, sports and body shaping purposes. The use of compression wear has recently become very popular among athletes; however, their utilization dates back more than half a century ago, when they were first applied in the medical field to treat chronic venous insufficiency, edema (accompanying paraplegia, following pregnancy, surgery, fracture, burns or other trauma), lymphedema, prevention of thrombosis in immobilized persons, etc. It is common knowledge that RICE (which stands for rest, ice, compression and elevation) is the protocol applied to manage soft tissue injury involving muscles, tendons or ligaments. Therefore, it is indisputable that compression is widely accepted in the medical field as a means to treat inflammation and circulatory anomalies as well as soft tissue injuries.

Compression garments can come in many shapes and forms, including the following:

  • Inflatable garments, like the one I had to use after my ACL surgery, which combined proven cold and compression therapies (http://www.gameready.com/rehabilitation-equipment). This equipment was recommended to me by Dr. Joe Fernandez, who did surgery on my knee and is one of the best orthopedic surgeons in the United States.
  • Non-elastic binders, which provide static compression but use adjustable Velcro or buckle straps. This type of compression garment is often used after cosmetic and reconstructive surgery. An example would be an abdominal binder used after a tummy tuck.
  • Elastic compression garments, used by most sportswear manufacturers, which provide gradient compression by the use of elastic materials.

What are the benefits? Do compression garments for sports work?

We have already established that the medical field has long recognized the benefits of compression and uses it to treat certain circulatory or inflammatory disorders. It is important to bear in mind that pressure exerted by medicinal compression clothing is typically in the range of 30-40 millimeter of mercury (mmHg), much higher than the level of pressure recommended in sportswear. Keep in mind that this high medical pressure levels should always be used as directed by a Doctor and/or under their supervision.

Commercially available compression clothing rarely applies pressure exceeding 25 mmHg and the recommended level of compression will depend on the area of the body where it will be applied. A compression garment that exerts too much pressure may constrict blood flow, so you must make sure that you are wearing a garment that is the right size for you and that has the technology necessary to apply a GRADIENT and CONTROLLED level of compression. If you are wearing a compression garment and the area under the garment feels numb, starts feeling cold or turns blue, discontinue its use immediately. You are probably using the garment incorrectly, it is the wrong size or it has not been developed by a company without the technology or the means to carefully measure its pressure. On the contrary, a garment that has a level of compression that is too low will simply not provide any of the benefits it should. So once again, do your research and make sure that the company has demonstrated a commitment to R&D and technology over the years.

Many companies are new or have entered the arena of compression clothing given its popularity, yet they have never done the investigation and research to develop such products. A big name does not guaranty the quality of the product either. In essence many companies are better at marketing and creating a brand image that they are at manufacturing a compression garment that will provide you the benefits you are seeking. I have also noticed that some companies make compression shirts or at least market shirts using the term “compression shirt”. In my opinion these companies demonstrate little knowledge about compression and compression garments or they are “purposely” but incorrectly interchanging the term “compression” for “tight-fit”. You can apply compression to the thorax, abdomen, pelvis, back and head and neck, yet this is something that would be done by an individually designed medical compression garment and my recommendation is that it is done under the supervision of a doctor. In sports garments, compression is typically limited to the upper and lower limbs. The upper limb consists of the girdle formed by the clavicles and scapulae, the arm, the forearm, and the hand. The lower limb consists of a girdle formed by the hip bones, the thigh, the leg, and the foot.

The benefits of wearing well designed compression clothing are:

  • Reduction of swelling and inflammatory processes associated with muscle damage. In 2004 Dr. William J. Kraemer et al. published the following in the International SportMed Journal:

Compression therapy represents an economical, cost-effective strategy for the treatment of muscle damage and soft tissue injuries. When applied immediately following injury, compression can promote a faster recovery of function by enhancing the local tissue environment to promote healing processes. In contrast to other therapeutic interventions (e.g. ice, NSAIDs), compression treatment restores the force-producing ability and reduces soreness more quickly following a soft tissue injury. These differences appear to be multifactorial. Firstly, the use of compression bandaging, or a compression sleeve, provides mechanical support to a damaged limb. This additional structural support equates to a “dynamic immobilisation” that enhances neural input to the injured region, thus helping to attenuate the loss of force production. Secondly, and perhaps most importantly, compression has the ability to modulate the inflammatory response that is ubiquitous with soft tissue injury. By reducing the magnitude of swelling associated with inflammation, reducing the space available for swelling to accumulate, and promoting the clearance of myocellular proteins and inflammatory mediators from the injured area, compression can promote the physiological actions of healing. Hydrostatic pressure applied to tissue as a consequence of the pressure gradient created by compression therapies facilitates lymphatic drainage and reduces fluid extravasation from the capillaries.

 

  • Improved blood flow and venous return to the heart. This is accomplished thanks to graded compression. If we were to use the example of a calf sleeve, compression at the ankle is higher than at the widest part of the calf, which facilitates the blood flow through the deep veins back to the heart. This is one of the reasons why not just any compression garment works and you must make sure that the manufacturer is specialized in these types of garments. Lurbel has long studied and researched the optimal pressure gradient for its garments, working together with the University of Valencia, the University of Alicante and Aitex (Textile Industry Research Center). Please see prior post regarding these studies. Notice the collaboration with an internationally recognized Textile Organization in Spain. This is extremely important because, not only must the manufacturer carefully identify and measure the appropriate level of compression, but also carefully select the fabric with the material and geometric properties that will optimize the performance of the garment and add other significant qualities such as durability, breathability, temperature regulation, antibacterial, etc.
  • Lower blood lactate concentrations after exercise. In their publication “Effects of graduated compression stocking on blood lactate following an exhaustive bout of exercise” Berry and McMurray (1987) determined that after the experiments conducted participants that were wearing the compression garment stockings during test and recovery stages exhibited significantly lower lactate values than those participants that wore no compression. You may find the abstract of this clinical trial by visiting the following link to the US National Library of Medicine.
  • Improvement in warm-up in terms of skin temperature attained; reduction of muscle oscillation during exercise and increased vertical jump height (which you may very well interpret as enhanced performance). In 2003, Doan et al. performed a study with 10 male ten female track athletes and concluded that those athletes that wore compression garments had increased skin temperature, reduced muscle oscillation and a higher countermovement vertical jump height. You may find the abstract of this clinical trial by visiting the following link to the US National Library of Medicine.

 

TO BE CONTINUED….