By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
- A recently published scientific study showed no improvements in race performance, pain rating, or muscle architecture in a group of healthy endurance runners wearing compression socks vs. those who ran in normal socks
- Other studies have shown benefits to the compression socks, but many published studies have problems with their study design
- There is no harm in wearing the socks and there are benefits if you’re returning after lower extremity injury or surgery
Calf compression socks are reported to improve leg endurance during running, speed recovery after a long distance run, and possibly lead to better performance. Do they actually do these things or is something else happening?
A recent scientific study evaluated the pain levels, performance, and muscle architecture during a six-week training period prior to an ultramarathon and in the immediate period after the race. In this group of healthy experienced runners with no prior issues of leg pain, the study authors found no improvements in the compression sock group. In fact, their runners with compression socks actually reported more pain than the runners who trained and competed without the socks.
The conclusion in this well-performed study of healthy runners is that there is no benefit to wearing the compression socks. Still, I find there are good reasons to wear them, especially if you’re recovering from an injury.
What Compression Socks Are Supposed To Do
Calf compression socks worn by healthy athletes with no leg issues are reported to improve venous circulation, improve lymph fluid drainage to reduce swelling, and to make runners feel better than without the socks. Many runners truly believe in their benefits and never run without them.
There is also a belief that the compression socks reduce muscle damage, improve the metabolic recovery of the muscle and speed the recovery time. Unfortunately, there are not many properly conducted scientific studies available to back up these claims.
What One Recent Study Shows
This recently published study evaluated the pain levels, race performance, and muscle architecture (using ultrasound imaging) in two groups of experienced healthy long distance runners. The study was unique in that it started evaluations during a six-week training period prior to an ultramarathon, and then had final evaluations two days after the ultramarathon.
Their results showed no differences in the group of runners training with the compression socks vs. those training and competing without compression socks. Interestingly, pain ratings were worse in the compression group, even though post race swelling was less.
What’s going on here? First, their results could certainly be taken at face value- namely, if you’re a healthy long distance runner you’re getting no benefit from wearing compression socks. But there are other possibilities. Other studies (cited in the study References) have shown benefits in several areas. This study might be a victim of a “type 2 statistical error” in which a larger number of study participants would lead to a different result. There may be metabolic benefits present, which were not measured here. Results in shorter race distances common to recreational runners (such as a 10k) could be different.
I Recommend Compression Socks When Returning From An Injury
I like compression socks for any of our athletes with some conditions, such as coming back to sport after a prior injury to the calf or Achilles. I’ve also found that athletes with a tendency to swell after ACL or other knee surgery will benefit from compression socks during return to sport. And finally, there’s no harm in wearing them.
If you think they work, you will definitely feel better about wearing them. Pick a style that makes you look really fast!