By Jeffery P. Schoonover, M.D., FAAFP, RVT, RPVI
If you have been to any recent races or marathons recently, many runners have begun to wear knee high compression socks or calf sleeves. Why is it beneficial? To understand the benefits of medical grade compression stockings, let’s take a look at the circulatory system. You may recall from biology class that blood circulates through our bodies via a network of vein and arteries. It is a closed system so that blood that is pumped from the heart to the legs must be moved back up the circulatory system to the heart. The calf muscle can actually be considered a “peripheral heart” in that it pumps venous blood against the force of gravity by walking and running.
It is well known that compression stockings improve blood flow by helping the calf muscle pump more effectively, which helps keep blood from pooling in the legs. Stockings have been used for years with patients after surgery, to treat leg swelling and for varicose and spider veins.
Now, there is growing evidence that athletic compression stockings may reduce muscle pain in the recovery phase (post-event soreness) after a race. Post-event muscle pain can occur for several reasons: lactic acid build-up, micro trauma at the muscle fiber (myofibril) level, electrolyte depletion and a release of prostaglandins (inflammatory chemicals released during and after exercise). Compression is believed to reduce the muscle pain because they can reduce the myofibril micro trauma and increase the calf muscle pump efficiency, which clears out lactic acid and prostaglandins more effectively.
What is less clear is the benefit of wearing them during a race. It is well documented that venous insufficiency is associated with swelling, inflammation, and pain but there are no definitive studies yet that show the benefit of use during the event. We do advise athletes with varicose vein disease to wear compression stockings during events to increase the calf muscle pump function while reducing swelling and venous pooling. For athletes without varicose vein disease, there may be a benefit to wearing athletic compression stockings after an event to help with recovery.