Compression Sleeves

Compression Sleeves: Physiological or Placebo??

Brief History 

In January I went to Africa to climb Mt. Kilimanjaro. It was an amazing experience and by far the coolest thing I’ve ever done. On the down-side, it resulted in two blood clots in the leg (deep vein thrombosis- DVT) and dozens of blood clots in the lungs (pulmonary embolisms- PE). But my body is amazing and kicked those clots ass! My lungs are now clot free and I am allowed to start training again after 5 months of recovery (being a couch potato). The bad news is that my leg has a permanent clot in the calf (small price to pay).

A wonderful side effect of having DVT is chronic pain and swelling called Post-thrombotic syndrome (PTS).

Symptoms include:

-        Chronic swelling

-        Chronic pain, pressure, heaviness, tightness

-        Skin hardening and itching

-        Dark pigmentation

-        Visible spider veins

-        Ulcers and skin breakdown

-        Did I mention pain?

Severity varies from person-to-person, but exercising long periods of time for endurance athletes can greatly increase these symptoms. Lucky me!

PTS can be reduced by using medical-grade special graduated compression stockings which are designed to decrease and prevent swelling. Compression stockings help reduce blood from pooling in the ankle and calf.  The graduated tightness helps the leg muscles squeeze fluid up the leg to improve blood flow back to the heart.

Inactivity is the most important reason to wear them. My heinous deskjob is the absolute worst thing for it. All day I sit and the blood just accumulates. My 2+ hour commute time daily doesn’t help either.  When you’re exercising the muscles in the leg contract, pushing the blood towards the heart. When you are inactive, the muscles aren’t contracting and blood begins to pool.

Types of Compression- It’s all about the Pressure!

Compression stockings come in different grades of tightness. The level of tightness is expressed in millimeters of mercury (mmHg). The most common tightness following a DVT is 30-40 mmHg (come on you remember units of pressure from physics class). It is also referred to as “grade 2.” These are beauties are what I wore for my flight back from Africa. They are tight as hell and my foot swelled up to the size of a football on the airplane. Talk about cankles. However there is no way I could exercise in these, I could barely walk with it on. How do the newly popular athletic compression sleeves compare to the medical grade compression stockings?

Over the past few years runners, cyclists, triathletes, pretty much any endurance athlete has seen the skyrocketing of athletic "compression sleeves". I have researched many companies, read athletes blogs, talked to doctors- but the definitive research is just not there. People claim that they are the best thing since sliced bread, others say it’s complete mumbo jumbo. Compression wear for triathletes comes in all different sizes, for different body parts, companies, and colors… oh the colors. These brands claim that their stuff “improves recovery, increases performance, reduces fatigue, improves circulation, heightens agility, and reduces muscle damage.”

I’ll be honest, when I first saw all these people wearing compression sleeves I thought they looked like the biggest tools, like this guy-

So here comes my experiment:

Compression Sleeves- Physiological or Placebo?

It just so happens that I have a giant blood clotted calf to experiment with!  

This experiment is not an Endurance Athlete vs. Compression study, but more of a Clotted Leg vs. Compression study. So I’m not going to measure my watts, HR, pace, RPE, blah blah blah with and without compression. It’s solely a blood circulation and swelling measurement with and without compression. I measure the circumference of my calves with a measuring tape. Pure and simple.

I chose two brands to study- CEP and Zensah.

CEP claims they are “medical grade” but they don’t list the mmHG pressure.  Other websites claim that these sleeves range from 18-23 mmHg.

I could find nothing on Zensah either. They do state that any compression material over 20 mmHG should only be worn with the advice of a doctor. This leads me to believe that their sleeves are less than 20 mmHg.

I preferred CEP sleeves because they were completely knitted with no elastic at the ends, the fit was much tighter, and they were longer in length. Zensah comes many more ridiculous colors, tie dye, and even argyle. They have elastic on the top and bottom and fit a little looser. I think the quality of CEP trumps Zensah.

Study #1: Running

This study was done doing the same 8 mile course in the same time of the day- HOT. I recorded 5 trials each, all results were consistent. You can really see in this picture how swollen my right calf is.

 ** units = inches

                                               No Sleeves                                            With Sleeves

                                 Left Calf                 Right Calf              Left Calf                 Right Calf

Before:                        14.0                         14.5                           14.0                         14.5

After:                           14.0                         15.75                         14.0                         15.75

Study #2: Biking

This study was done doing the same 40 mile course. I recorded 3 trials for each, all results were consistent.

                                               No Sleeves                                            With Sleeves

                                 Left Calf                 Right Calf              Left Calf                 Right Calf

Before:                          14.0                        14.5                      14.0                            14.5

After:                            14.25                      15.75                    14.25                           16.0

Study #3: Work

Now I’m supposed to wear these every day. But it’s summer in Virginia and 100 degrees outside. I’m not wearing pants, I want to wear dresses and skirts. And compression sleeves just don’t go with my outfit! But I try to wear them every time I do wear pants. I drive about an hour to work each day from North Stafford to Dahlgren Naval Surface Warfare Center, then sit at a desk for 8-9 hours, and drive an hour home. Yuck. Doctor says I am supposed to get up and walk every hour to increase circulation, but that is really hard to do. This study had 5 trials.

                                               No Sleeves                                            With Sleeves

                                 Left Calf                 Right Calf              Left Calf                 Right Calf

Before:                       14.0                             14.25                    14.0                      14.25

After:                          14.25                           16.5                    14.0                       14.5

My Conclusion:

Compression sleeves are most useful when a person is not exercising. The sleeves are very valuable if you have a desk job. Wearing the sleeves while training showed no positive effect (or negative effect). They did not increase performance. But this totally makes sense. When you are running and biking your muscles are contracting powerfully forcing the blood up to the heart. I did find that they are extremely helpful for recovery, because yet again recovery is an inactive process. My leg needed help circulating the blood when I wasn’t using it.

So in conclusion, yes I recommend compression sleeves for athletes for recovery and post-dvt. But I think it’s a bunch of whooey that they increase performance while racing. Never underestimate a psychological effect though, sometimes that’s worth it alone. You will still see many professional racers out there using them. If I was sponsored, got paid, and was given free shit I would wear it to! I will come back to this study when I start seeing the cyclists in the Tour de France wearing them.

But you will still see me wearing my ridiculously colored compression sleeves on long runs and rides. 

Why?

 Because my doctor said so. 

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Agree or disagree?