Compression Garments Reduce Muscle Movement and Activation during Submaximal Running

Influence of compression garments on proprioception: A systematic review and meta-analysis

Compression garments (CGs) are commonly used in rehabilitation and sports contexts to enhance performance and speed up recovery. Despite the growing use of CGs in recent decades, there is no unanimous consensus on their overall influence on joint proprioception. In this current meta-analysis, we aim to fill this knowledge gap by assessing the impact of CGs on joint proprioception. We conducted a literature search across seven databases and one registry. Ultimately, we included 27 studies with 671 participants. The meta-analysis revealed that wearing CGs resulted in a significant reduction in absolute error during joint position sensing (Hedges' g: -0.64, p = 0.006) as compared to no CGs. However, further analyses of variables such as constant error (p = 0.308), variable error (p = 0.541) during joint position sense tests, threshold to detect passive motion (p = 0.757), and active movement extent discrimination (p = 0.842) did not show a significant impact of CGs. The review also identified gaps in the reporting of certain outcomes, such as parameters of CGs, reporting of performance, individual-reported outcomes, and lack of placebo comparators. Consequently, this review provides guidelines for future studies that may facilitate evidence-based synthesis and ultimately contribute to a better understanding of the overall influence of CGs on joint proprioception.

Whole leg compression garments influence lower limb kinematics and associated muscle synergies during running

The utilization of compression garments (CGs) has demonstrated the potential to improve athletic performance; however, the specific mechanisms underlying this enhancement remain a subject of further investigation. This study aimed to examine the impact of CGs on running mechanics and muscle synergies from a neuromuscular control perspective. Twelve adult males ran on a treadmill at 12 km/h, while data pertaining to lower limb kinematics, kinetics, and electromyography were collected under two clothing conditions: whole leg compression garments and control. The Non-negative matrix factorization algorithm was employed to extract muscle synergy during running, subsequently followed by cluster analysis and correlation analysis. The findings revealed that the CGs increased knee extension and reduced hip flexion at foot strike compared with the control condition. Moreover, CGs were found to enhance stance-phase peak knee extension, while diminishing hip flexion and maximal hip extension during the stance-phase, and the ankle kinematics remained unaltered. We extracted and classified six synergies (SYN1-6) during running and found that only five SYNs were observed after wearing CGs. CGs altered the structure of the synergies and changed muscle activation weights and durations. The current study is the first to apply muscle synergy to discuss the effect of CGs on running biomechanics. Our findings provide neuromuscular evidence for the idea of previous studies that CGs alter the coordination of muscle groups, thereby affecting kinematic characteristics during running.

Evaluating the effect of sports compression tights on balance, sprinting, jumping and change of direction tasks

Compression garments are commonly used during athletic tasks. However, the effect of compression garments on balance, sprinting, jumping and change of direction performance requires further investigation. In the current study, 24 recreationally active participants (12 males, 12 females, age 27 ± 3 years) completed single-leg balance tasks, countermovement jumps, drop jumps, 10 m straight line sprints and change of direction tasks wearing either compression tights (COMP) or regular exercise tights (CON). There was a significant main effect of the condition for 10 m sprint time (p = 0.03, d = -0.18) and change of direction time (p = 0.03, d = -0.20) in favour of COMP. In addition, there was a significant, small difference (p = 0.05, d = -0.30) in ellipse area and a small (p = 0.16, d = 0.21) difference in balance time in favour of COMP during a single-leg balance task. There were no significant differences between trials for any of the other balance or jump tests (p > 0.05). The application of compression tights during exercise may offer small benefits to the performance of balance and change of direction tasks, though these benefits are likely within the typical error of measurement for the tests used.

The Effects of Wearing a Portable Media Armband on Muscle Activation of the Biceps Brachii

Portable media armbands are commonly used among the physically active population. Their effect on muscle function has not been established. The purpose of this study was to determine if muscle activation of the biceps brachii is influenced by wearing a portable media armband during an elbow flexion exercise. Eighteen participants (11 males: age = 22.5 ± 2.1 years, height = 178.3 ± 5.2 cm, mass = 85.0 ± 6.5 kg; 7 females: age = 22.9 ± 2.5 years, height = 168.3 ± 5.7 cm, mass = 72.3 ± 12.2 kg) with no history of upper extremity injury volunteered for the study. Participants performed elbow flexion trials with a hand-held dumbbell with and without wearing a portable media armband. Dumbbell weight was determined by an 8-10 repetition maximum, and the condition was counterbalanced. The average concentric and eccentric phases for five trials for each condition were normalized to a maximum voluntary isometric contraction using electromyography. The independent variable was condition (with-PMAB and without-PMAB). The dependent variable was the muscle activation of the biceps brachii. Mean data for each condition were analyzed using separate paired-samples t-tests for the concentric and eccentric phases (p < 0.05). Statistical analysis revealed a significant difference for the concentric phase (t17 = 2.905; p = 0.010). The with-PMAB condition elicited greater muscle activation (72.57 ± 36.31%) compared to the without-PMAB (63.67 ± 26.2%), with a medium effect size (d = 0.69). There was no statistical difference for the eccentric phase (t17 = 1.964; p = 0.066), and a small effect size (d = 0.46). The increase in muscle activation during the concentric phase is likely due to a change in the muscle properties due to the compressive force applied to the muscle fibers by the portable media armband.

Feasibility of mitigating out-toeing gait using compression tights with inward-directing taping lines

Out-toeing gait may cause alterations in lower limb biomechanics that could lead to an increased risk of overuse injuries. Surgery and physical therapy are conventional methods for mitigating such gait, but they are costly and time-consuming. Wearable devices like braces and orthoses are used as affordable alternatives, but they apply non-negligible stress on the skin. Haptic feedback-delivering shoes were also recently developed, but they require actuators and power sources. The purpose of our study is to develop compression tights with inward directing taping lines that apply compression to lower limb muscles and segments to facilitate inward rotation of the foot, overcoming the drawbacks of previous methods. These compression tights were manufactured to fit the average height, leg length, hip girth, and waist girth of South Korean females in their twenties. The efficacy of these compression tights was evaluated by comparing walking kinematics and user satisfaction of 12 female dancers with an out-toeing gait under three conditions: wearing tights with taping lines, tights without taping lines, and basic bicycle shorts. The foot rotation angles and joint kinematics were recorded using a pressure-pad treadmill and motion capture system, respectively. Multiple pairwise comparisons revealed that the compression tights with inward-directing lines significantly reduced foot rotation angles (up to an average of 20.1%) compared with the bicycle shorts (p = 0.002 and 0.001 for dominant and non-dominant foot, respectively) or the compression tights without taping lines (p = 0.005 and p = 0.001 for dominant and non-dominant foot, respectively). Statistical parametric mapping revealed significant main effects of the tight type on joint kinematics. Also, t-tests revealed that the participants reported significantly higher ratings of perceived functionality and usability on the compression tights with inward-directing taping lines. In conclusion, we developed a comfortable and practical apparel-type wearable and demonstrated its short-term efficacy in mitigating out-toeing gait.

Effects of compression running pants and treadmill running stages on knee proprioception and fatigue-related physiological responses in half-marathon runners

Background: Knee injury is common in half-marathon runners, however, the effect of compression running pants on fatigue and knee proprioception remains unclear. Objectives: The study aims to investigate whether wearing compression running pants (CRP) and treadmill running stages affect knee proprioception and fatigue-related physiological responses during half-marathon running. Methods: Eighteen half-marathon runners completed two self-paced 21 km treadmill running trials, once wearing CRP and once wearing loose running shorts (LRS). For each 21 km run, RPE, heart rate, blood lactic acid, and knee flexion proprioception were assessed before starting, and after each 7 km stage. Results: Data analysis revealed no difference between CRP and LRS conditions in heart rate, RPE, or blood lactic acid. Repeated measures ANOVA showed a significant garment condition main effect whereby wearing CRP was associated with higher knee proprioceptive acuity (p = 0.006). Polynomial trend analysis showed a significant linear downwards trend in proprioceptive acuity across the four measurement occasions (p = 0.048). Stage analysis showed that wearing CRP was associated with better knee proprioception at running distances of 14 km (p = 0.007, 95%CI = -0.054, -0.010) and 21 km (p = 0.016, 95%CI = -0.051, -0.006). Conclusion: Compression running pants provide an overall positive effect on knee proprioception, particularly after 14 km and 21km, which may reduce the probability of knee injury. CRP had no significant effect on physiological measures in half-marathon running.

Soft Tissue Vibrations in Running: A Narrative Review

During running, the human body is subjected to impacts generating repetitive soft tissue vibrations (STV). They have been frequently discussed to be harmful for the musculoskeletal system and may alter running gait. The aims of this narrative review were to: (1) provide a comprehensive overview of the literature on STV during running, especially why and how STV occurs; (2) present the various approaches and output parameters used for quantifying STV with their strengths and limitations; (3) summarise the factors that affect STV. A wide set of parameters are employed in the literature to characterise STV. Amplitude of STV used to quantify the mechanical stress should be completed by time-frequency approaches to better characterise neuromuscular adaptations. Regarding sports gear, compression apparels seem to be effective in reducing STV. In contrast, the effects of footwear are heterogeneous and responses to footwear interventions are highly individual. The creation of functional groups has recently been suggested as a promising way to better adapt the characteristics of the shoes to the runners' anthropometrics. Finally, fatigue was found to increase vibration amplitude but should be investigated for prolonged running exercises and completed by an evaluation of neuromuscular fatigue. Future research needs to examine the individual responses, particularly in fatigued conditions, in order to better characterise neuromuscular adaptations to STV.

Compression-induced improvements in post-exercise recovery are associated with enhanced blood flow, and are not due to the placebo effect

The aim of this study was to investigate the physiological effects of compression tights on blood flow following exercise and to assess if the placebo effect is responsible for any acute performance or psychological benefits. Twenty-two resistance-trained participants completed a lower-body resistance exercise session followed by a 4 h recovery period. Participants were assigned a post-exercise recovery intervention of either compression tights applied for 4 h (COMP), placebo tablet consumed every hour for 4 h (PLA) or control (CON). Physiological (markers of venous return, muscle blood flow, blood metabolites, thigh girth), performance (countermovement jump, isometric mid-thigh pull), and psychological measures (perceived muscle soreness, total quality of recovery) were collected pre-exercise, immediately post-exercise, at 30 (markers of venous return and muscle blood flow) and 60 min (blood metabolites, thigh girth and psychological measures) intervals during 4 h of recovery, and at 4 h, 24 h and 48 h post-exercise. No significant (P > 0.05) differences were observed between interventions. However, effect size analysis revealed COMP enhanced markers of venous return, muscle blood flow, recovery of performance measures, psychological measures and reduced thigh girth compared to PLA and CON. There were no group differences in blood metabolites. These findings suggest compression tights worn after resistance exercise enhance blood flow and indices of exercise recovery, and that these benefits were not due to a placebo effect.

Influence of Altered Knee Angle on Electromyographic Activity of Hamstring Muscles Between Nordic Hamstring Exercise and Nordic Hamstring Exercise with Incline Slope Lower Leg Board

Background

Previous studies have shown that performing the Nordic hamstring exercise (NHE) with different board slope angles can affect hamstring activation. However, changes in muscle length with different board slopes can alter joint angles leading to the moment arm (MA) at the knee changing during the NHE.

Purpose

This study aimed to investigate the influence of changing muscle length on hamstring electromyographic activity during an isometric NHE, while maintaining an equal moment arm.

Study Design

A crossover study design.

Methods

Sixteen male volunteers performed two types of conventional NHE, one with knees on the floor (NHE) and one with the legs placed upon an incline slope of a lower leg board (NHEB). To compare between the conventional and inclined NHE, the moment arm at the knee was calculated to be equal by an examiner holding the lower legs at points marked at 77% and 94% of the length of the lower leg. The four sub-groups comprised of: 1) NHE-77%, 2) NHE-94%, 3) NHEB-77%, and 4) NHEB-94%. The hamstring EMG activity was measured at the biceps femoris long head (BFlh) and at the semitendinosus (ST) and related compensatory muscles. The RMS data were normalized as a percentage of the maximum isometric values (normalized EMG [nEMG]). Significant main effects findings were followed up with Tukey's post-hoc test using SPSS software and statistical significance was set at the p < 0.05 level.

Results

The BFlh EMG activity values for NHE-77% were significantly higher than those for NHE-94% (p= 0.036) and NHEB-77% (p < 0.001), respectively, while ST during NHE-77% was significantly higher only in NHEB-77% (p < 0.001). In addition, NHEB-94% was significantly greater than NHEB-77% for both BFlh (p < 0.001) and ST (p < 0.001).

Conclusion

These results indicate that hamstring electromyographic activity is decreased when the hamstring muscle is lengthened during the Nordic hamstring exercise.

Level of Evidence

3.

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

Background

Compression garments are regularly worn during exercise to improve physical performance, mitigate fatigue responses, and enhance recovery. However, evidence for their efficacy is varied and the methodological approaches and outcome measures used within the scientific literature are diverse.

Objectives

The aim of this scoping review is to provide a comprehensive overview of the effects of compression garments on commonly assessed outcome measures in response to exercise, including: performance, biomechanical, neuromuscular, cardiovascular, cardiorespiratory, muscle damage, thermoregulatory, and perceptual responses.

Methods

A systematic search of electronic databases (PubMed, SPORTDiscus, Web of Science and CINAHL Complete) was performed from the earliest record to 27 December, 2020.

Results

In total, 183 studies were identified for qualitative analysis with the following breakdown: performance and muscle function outcomes: 115 studies (63%), biomechanical and neuromuscular: 59 (32%), blood and saliva markers: 85 (46%), cardiovascular: 76 (42%), cardiorespiratory: 39 (21%), thermoregulatory: 19 (10%) and perceptual: 98 (54%). Approximately 85% (n = 156) of studies were published between 2010 and 2020.

Conclusions

Evidence is equivocal as to whether garments improve physical performance, with little evidence supporting improvements in kinetic or kinematic outcomes. Compression likely reduces muscle oscillatory properties and has a positive effect on sensorimotor systems. Findings suggest potential increases in arterial blood flow; however, it is unlikely that compression garments meaningfully change metabolic responses, blood pressure, heart rate, and cardiorespiratory measures. Compression garments increase localised skin temperature and may reduce perceptions of muscle soreness and pain following exercise; however, rating of perceived exertion during exercise is likely unchanged. It is unlikely that compression garments negatively influence exercise-related outcomes. Future research should assess wearer belief in compression garments, report pressure ranges at multiple sites as well as garment material, and finally examine individual responses and varying compression coverage areas.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01604-9.

Compression Garments Reduce Soft Tissue Vibrations and Muscle Activations during Drop Jumps: An Accelerometry Evaluation

Objectives: To explore the effects of wearing compression garments on joint mechanics, soft tissue vibration and muscle activities during drop jumps. Methods: Twelve healthy male athletes were recruited to execute drop jumps from heights of 30, 45 and 60 cm whilst wearing compression shorts (CS) and control shorts (CON). Sagittal plane kinematics, ground reaction forces, accelerations of the quadriceps femoris (QF), hamstrings (HM) and shoe heel-cup, and electromyography images of the rectus femoris (RF) and biceps femoris (BF) were collected. Results: Compared with wearing CON, wearing CS significantly reduced the QF peak acceleration at 45 and 60 cm and the HM peak acceleration at 30 cm. Wearing CS significantly increased the damping coefficient for QF and HM at 60 cm compared with wearing CON. Moreover, the peak transmissibility when wearing CS was significantly lower than that when wearing CON for all soft tissue compartments and heights, except for QF at 30 cm. Wearing CS reduced the RF activity during the pre-, post-, and eccentric activations for all heights and concentric activations at 45 cm; it also reduced the BF activity during post- and eccentric activations at 30 and 60 cm, respectively. The hip and knee joint moments and power or jump height were unaffected by the garment type. Conclusion: Applying external compression can reduce soft tissue vibrations without compromising neuromuscular performance during strenuous physical activities that involve exposure to impact-induced vibrations.

Downhill Running: What Are The Effects and How Can We Adapt? A Narrative Review

Downhill running (DR) is a whole-body exercise model that is used to investigate the physiological consequences of eccentric muscle actions and/or exercise-induced muscle damage (EIMD). In a sporting context, DR sections can be part of running disciplines (off-road and road running) and can accentuate EIMD, leading to a reduction in performance. The purpose of this narrative review is to: (1) better inform on the acute and delayed physiological effects of DR; (2) identify and discuss, using a comprehensive approach, the DR characteristics that affect the physiological responses to DR and their potential interactions; (3) provide the current state of evidence on preventive and in-situ strategies to better adapt to DR. Key findings of this review show that DR may have an impact on exercise performance by altering muscle structure and function due to EIMD. In the majority of studies, EIMD are assessed through isometric maximal voluntary contraction, blood creatine kinase and delayed onset muscle soreness, with DR characteristics (slope, exercise duration, and running speed) acting as the main influencing factors. In previous studies, the median (25th percentile, Q1; 75th percentile, Q3) slope, exercise duration, and running speed were - 12% (- 15%; - 10%), 40 min (30 min; 45 min) and 11.3 km h-1 (9.8 km h-1; 12.9 km h-1), respectively. Regardless of DR characteristics, people the least accustomed to DR generally experienced the most EIMD. There is growing evidence to suggest that preventive strategies that consist of prior exposure to DR are the most effective to better tolerate DR. The effectiveness of in-situ strategies such as lower limb compression garments and specific footwear remains to be confirmed. Our review finally highlights important discrepancies between studies in the assessment of EIMD, DR protocols and populations, which prevent drawing firm conclusions on factors that most influence the response to DR, and adaptive strategies to DR.

Enhanced Cycling Time-Trial Performance During Multiday Exercise With Higher-Pressure Compression Garment Wear

PURPOSE

Compression garments are widely used as a tool to accelerate recovery from intense exercise and have also gained traction as a performance aid, particularly during periods of limited recovery. This study tested the hypothesis that increased pressure levels applied via high-pressure compression garments would enhance "multiday" exercise performance.

METHODS

A single-blind crossover design, incorporating 3 experimental conditions-loose-fitting gym attire (CON), low-compression (LC), and high-compression (HC) garments-was adopted. A total of 10 trained male cyclists reported to the laboratory on 6 occasions, collated into 3 blocks of 2 consecutive visits. Each "block" consisted of 3 parts, an initial high-intensity protocol, a 24-hour period of controlled rest while wearing the applied condition/garment (CON, LC, and HC), and a subsequent 8-km cycling time trial, while wearing the respective garment. Subjective discomfort questionnaires and blood pressure were assessed prior to each exercise bout. Power output, oxygen consumption, and heart rate were continuously measured throughout exercise, with plasma lactate, creatine kinase, and myoglobin concentrations assessed at baseline and the end of exercise, as well as 30 and 60 minutes postexercise.

RESULTS

Time-trial performance was significantly improved during HC compared with both CON and LC (HC = 277 [83], CON = 266 [89], and LC = 265 [77] W; P < .05). In addition, plasma lactate was significantly lower at 30 and 60 minutes postexercise on day 1 in HC compared with CON. No significant differences were observed for oxygen consumption, heart rate, creatine kinase, or subjective markers of discomfort.

CONCLUSION

The pressure levels exerted via lower-limb compression garments influence their effectiveness for cycling performance, particularly in the face of limited recovery.

Effectiveness of Using Compression Garments in Winter Racing Sports: A Narrative Review

Nowadays, compression garments (CGs) are widely used in winter racing sports, such as speed skating, short-track speed skating, alpine skiing, and cross-country skiing. However, the effect of wearing CGs on athletic performance in these specific sports is still not fully examined. Thus, the aim of this narrative review is to summarize the research and application of CGs in winter racing sports and to discuss how the CGs help athletes improve their performance in an integrative manner (i.e., physiology, aerodynamics, and biomechanics). A total of 18 experimental studies dedicated to CGs in winter racing sports were identified from the peer-review scientific literature. The main findings are as follows. (1) Currently, CG studies have mainly focused on drag reduction, metabolism, muscle function, strength performance, and fatigue recovery. (2) The results of most studies conducted in wind tunnels showed that, for cylindrical structures similar to the human body, clothing with rough surfaces can reduce air drag. Notably, the effect of CGs on drag reduction in real competition has not been fully explored in the literature. (3) Compression can reduce muscle vibrations at high impact and help athletes control the center of pressure movement, a function that is important for alpine skiing. Future studies are needed to improve current understanding of the effects of compression clothing microstructure on drag reduction and their stretching in different parts of the body. Furthermore, the design of experimental protocol must be consistent with those during the competition, thus providing a full discussion on energy metabolism, fatigue, and recovery affected by CGs.