Welman, K. E., & Terblanche, E. (2010). The effectiveness of compression socks to minimize skeletal muscle damage during and after an ultra-marathon. Presentation 764 at the 2010 Annual Meeting of the American College of Sports Medicine, Baltimore, Maryland; June 2-5.

"Exercise-induced skeletal muscle damage may lead to inflammation, swelling, and slower recovery rates. Therefore rest, recovery, and regeneration are vital to the optimal performance and injury prevention of distance runners. Compression therapy, in particular below-the-knee compression socks, has been suggested as a possible aid for post-exercise recovery. Much of the literature on compression therapy appears to be based on anecdotal claims, while the few available scientific studies are limited to controlled laboratory exercise of short duration." This first field study examined the effect of graded compression socks on selected physiological responses after a long duration running event in competitive runners (N = 62). It determined if graduated compression socks (i) limited skeletal muscle damage during prolonged exercise and (ii) established the optimal timing of wearing graduated compression socks, that is, during or after exercise.

Competitive runners who regularly participated in endurance events volunteered for the study. Following baseline measurements, runners completed a 56 km road race and were followed-up for three consecutive days after the race. The experimental groups wore commercially available below-the-knee graded compression socks (± 20-30 mmHg) either during or after the race. To quantify the recovery rates, changes in lower limb circumference and blood chemistry parameters such as C-reactive protein, plasma Creatine Kinase, and Myoglobin were measured.

Creatine Kinase measures were 37% and 48% lower at 24 and 48 hours post-exercise, respectively, in athletes wearing graduated compression socks during the race compared to those wearing the graduated compression socks in the 72-hour recovery period after the race. More swelling was evident in the lower limbs from 24 to 72 hours post-race in the runners who took the graduated compression socks off after the race compared to those wearing the graduated compression socks throughout the 72-hour recovery period. C-reactive protein and Myoglobin did not differ significantly between the groups. However there was 7% less Myoglobin at 24 hours in the groups that ran with the graduated compression socks than the group that wore the graduated compression socks only during the three consecutive days after the race.

Implication. Wearing graduated compression socks during prolonged exercise may enhance post-race recovery by attenuating skeletal muscle damage.

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