Compression Leg Sleeves & Socks Discussion

Contrived Contraptions or Decisive Devices? A Compression Leg Sleeves/ Socks Discussion and Zensah Compression Leg Sleeves Review

The medical community has long utilized compression socks for the treatment of an array of lower leg conditions caused by circulatory and/or lymphatic systems malfunction (e.g., lower leg swelling, blood clots, and varicose veins). The full story of how compression socks treat these conditions is fairly complex, but can be boiled down into two research-proven categories:

  1. A specific degree of graduated compression of the lower leg (compression that is a bit tighter around the ankles than the calves) helps to maintain static pressure, necessary for circulatory and lymphatic systems function, among all of the lower legs’ veins and cell walls.
  2. A specific degree of graduated compression of the lower leg enhances calf muscles’ contractions, which is one of the physical mechanisms that pushes blood and lymph out of the lower leg and back towards the body’s core.

If the medical community has documented the effectiveness of compression socks in treating lower leg ailments in sick people, then it makes logical sense that they might serve similar function in healthy people. I don’t know exactly when compression socks were co-opted by athletes, but Paula Radcliffe made a big splash among the running community when she world-recorded the marathon distance while wearing them during the 2003 London Marathon.

Since then, the compression leg sleeves/socks industry has blossomed, and we runners can acquire them in every color of the rainbow. Green compression socks? Check. Striped knee-highs with some compression? Oh yeah. Chicken wire-patterned calf sleeves? Got ‘em, too. … and this stuff ain’t cheap. Forking out $40 for a pair of sleeves or socks might be considered a miser’s purchase in this industry. The big question, though, for all of the funny-looking stuff with which we adorn our lower legs, and for all the hard-earned cash we spend, does this stuff really work?

The Science
Here’s brief snippet of what’s out there regarding the use of lower leg compression by healthy individuals. In no particular order:

Results
Smith et al. [1] showed no statistically significant physiological (VO2 max and blood lactate level) or perceptual (rate of perceived exertion) differences between subjects who wore or did not wear compression socks after an anaerobic workout (30-second Wingate test).

In a 1997 study of Dutch factory workers [2], those that wore compression socks reported less leg pain and were measured to have less leg volume than their co-workers without compression socks. This study measured 114 workers on a daily basis for 3 months.

Layman et al. [3] measured running economy and mechanics in well-trained distance runners and found no statistically significant change in either variable by runners when wearing or not wearing Zensah Compression Leg Sleeves.

Ali et al. [4] observed that runners who wore graduated compression socks during and after a 10-kilometer run reported decreased muscle soreness 24 hours after the compression socks run. The subjects of this study were recreationally active men.

Kemmler et al. [5] showed that a group of moderately active male runners wearing compression socks with constant compression around the calf muscle experienced statistically significant improved running performance (measured in work performed) at different metabolic thresholds than when those same men ran without compression socks.

Research by Berry et al. [6] on 12 well-trained male runners indicated that blood lactate levels were lower after a maximal treadmill test while wearing graduated compression socks than by men not wearing the socks.

Discussion
As I perused the scientific literature on compression leg sleeves/socks, I noticed several emergent trends:

  1. The verdict remains out within the sports science research community with regards to the effectiveness of using compression sleeves and socks among healthy human beings both during exercise of variable types and for recovery afterward.
  2. Subjects who were asked to report how they felt during and after exercise while wearing compression leg sleeves/socks largely reported feeling a bit better than subjects who weren’t wearing sleeves/socks.
  3. The studies vary widely in their independent variables. For example, in some research, the subjects are elite athletes, while, in others, they are self-described recreational athletes. For another example, the medical research community has learned that aiding circulatory and lymphatic systems malfunction requires a specific degree of compression. Very few sports science studies measured the amount of compression exerted upon subjects’ lower legs by the sleeves/socks.

My Zensah Compression Leg Sleeve Experience
Zensah Compression Leg SleevesFor this article, I tested the Zensah Compression Leg Sleeves in black. Zensah’s website says that, “The Calf/Shin Recovery Sleeves are made with gradient compression which provides wide ribbing in the front for shin support and tight ribbing in the back for calf support. The sleeves are made with Zensah Fabric which has silver helping to regulate skin temperature and fight bacteria.” The sleeves come in three sizes, but it’s not clear what the “calf size” categories denote, perhaps calf circumference or lower leg length? In any case, Zensah gave iRunFar a men’s medium to test, and, while a bit long, they created a fine degree of compressive pressure around my legs.

My lower legs swell after physical effort, and I have the same problem during air travel. I’ve experienced great success in minimizing swelling in both circumstances with the Zensah Compression Leg Sleeves. For example, in 2009, I took a three-flight, 24-hour, transcontinental and trans-Atlantic trip without compression socks, and I arrived with cankles and elephant-sized feet. This year, I made the same journey while wearing the Zensah sleeves, and I arrived with lower legs and feet of normal, happy size.

I previously wore $5, drug store bought, granny compression socks instead of the leg sleeves for recovery, because I reasoned that compression over my feet was also helpful. (Let’s face it, I also wear granny socks because they’re darn cheap!) Since I’ve started wearing the Zensah Compression Leg Sleeves for recovery, I haven’t noticed my feet swelling any more or less than with my granny socks.

The Zensah sleeves are fairly thick, and I’ve occasionally found them to be a bit warm while wearing them under a pair of pants. While I don’t doubt the moisture-wicking and heat-transferring properties of their material because I’ve experienced them on a hot day’s run, it’s simple a thick fabric to put underneath another fabric.

I’ve heavily tested the Zensah Compression Leg Sleeves during running, and I have no positive or negative feedback to share. If I experience an improvement or degradation of my running performance as a result of them, or if I recover from a running effort a bit better or worse because I wear them during the effort, I cannot detect these differences.

Zensah Compression Sleeves Meghan

The author training with Zensah Compression Sleeves.

The Conclusion Is That There Is No Conclusion
If you’re sick person at risk for a deep vein thrombosis, research has conclusively proven that compression socks, sleeves, and other compressive leg garments can help prevent this serious condition.

If you’re an active to really active person, we don’t yet conclusively know if compression sleeves and socks are going to help you perform or recover from your performance better.

My personal conclusion? I’ll continue to wear my Zensah Compression Leg Sleeves as a recovery tool and when I’m making long airplane or car journeys. For running, my experiment of one will continue, as well.

What Do You Think?
Calling all runners with good compression sleeves or socks anecdotes! Have you ever been either applauded or teased for your unique on-trail sense of style? Have you experienced personal success, or a lack thereof, with them?

References
[1] Smith, et al. (2009). The effect of compression socks on recovery after a 30-sec Wingate Test. Medicine and Science in Sports and Exercise (41)5.

[2] University Academic Hospital in Amsterdam, Netherlands. (1997). Compression stockings help aching legs. Journal of Occupational and Environmental Medicine (31)9.

[3] Layman et al. (2010). Lower leg compression sleeves: influence on running mechanics and economy in highly trained distance runners. Medicine and Science in Sports and Exercise (42)5.

[4] Ali et al. (2007). Graduated compression stockings: physiological and perceptual responses during and after exercise. Journal of Sports Science (25)4.

[5] Kemmler et al. (2009). Effects of compression stockings on running performance in men runners. Journal of Strength Conditioning and Research (23)1.

[6] Berry et al. (1987). Effects of graduated compression stockings on blood lactate following an exhaustive bout of exercise. American Journal of Physical Medicine 66(3).

Meghan Hicks

is iRunFar.com’s Senior Editor, the author of ‘Where the Road Ends: A Guide to Trail Running,’ and a Contributing Editor at Trail Runner magazine. The converted road runner finished her first ultramarathon in 2006 and loves using running to visit the world’s wildest places. For more information on Meghan and her adventures, please visit her personal website.

There are 44 comments

  1. adam

    If you don't recieve any benefit from them physically while running but they don't do any harm either and if you feel better with them on then why not wear them. They say ultra running is 90% mental so if you feel like you get a benefit from wearing them I say go for it.

    adam

  2. Blaine Moore

    I don't know if they help performance at all, and don't really care.

    I usually wear them during races and some of my long runs because I've found that I often recover faster when I do.

    When I ran my first 50 miler, I didn't wear the leg sleeves during the race (having just gotten them a few days earlier and never used them.) Instead, I finished the race, took a shower, and put them on right before taking a 2 hour nap. When I woke up from the nap, my calves felt fine. I left them on for about 30 hours, which included the rest of race day, plus getting up early the next morning to fly across the country and then take a bus back home. No calf pain whatsoever at any point after the race.

    Since my calves were sore before the nap, I attribute that to the calf sleeves and have used them ever since.

    If they do offer some performance benefit, well, that's just a bonus.

  3. Travis

    I'm still up in the air with these things. While I do think that added compression helps, I almost feel like it is the warmth created by the garment that helps more. What I can say is that improperly fitting compressions sleeves can cause an issue. Having ones that are too tight can really cause some discomfort. I had a pair on during Leadville that seemed to be constricting my calf muscles and I quickly shed them at Fish Hatchery outbound and almost immediately noticed a relaxing of my tight calves. I did put on a different pair that was less tight at Winfield but mostly for the warmth factor during the night.

  4. Roy

    I have recently started wearing the swiftwick 12" socks on my long runs and I am still undecided if they are helping. I have however found them to be great for recovery after long runs and I often wear them to work. I do like the compression and even the protection in some cases. As of now they don't seem to

    make anything worse and they do seem to help with soreness after a race or long run so why not, they look a little goofy but positive thinking can go a long ways.

  5. Jacob

    I have been on the fence about getting a pair of compression socks. The scientist in me looks at the various experiments that have been performed and says, there's no way they can eliminate the placebo effect. I mean, you can't exactly do a double-blind test with these things. On the other hand, as others have pointed out, whether it's placebo or something real, if they seem to work then that's all that matters, and anecdotal evidence counts for something in this regard. I suspect I'll eventually cave in and pick up a pair.

  6. Kovas Palubinskas

    Might be a placebo, might be a coincidence, but since I started running with socks and sleeves (I use both depending on the shoes I wear) I have not had a single lower leg issue and my runs have been quite abit faster as well. I'm a beginner runner, just lost enough weight o not be a Clydesdale, so the impace might be greater on someone like myself. Good honest review, thanks.

  7. Kim Neill

    I like and use compression sleeves mostly for post workout recovery (sometimes all night and the next day). I also use them for running (mostly in the winter under tights, because I haven't gotten over the geek factor and they are a bit hot for summer running). The difficulty is getting the proper size–they seem to either be too loose for proper compression, or too tight to wear for any length of time. Brands I wear are: Zensah, Recofit, CEP. I like them all, but still seem to be between sizes (size M). The Recofit seem to be just the right tightness; Zensah a bit looser but taller–great for long legs. I also have some Footsmart & Jobst support sleeves that have a much firmer fit (more compression) that are best for post workout. Since I do have hereditary circulation issues, I will wear all of these for the rest of my life.

    1. Paige T.

      I am a RecoFit girl…love those things! They hold their shape and compression really well (as they should).

      I wore Zensah for awhile, but found that they ended up stretching out and being nothing more than modern leg warmers. I have skinny calves so that was surprising, and now they just take up room in my drawer. I wear my sleeves a lot, so I needed something that would hold up and not slip down my legs (as my Zensahs did during a race!). Not sure how common this is.

      The Zensahs do come in fun colors, though :)

  8. Anonymous

    I swear my cep compression socks stopped a leg cramp in process during the finger lakes 50. Extremly comfortable and I find them to greatly improve my long runs and races.

  9. Anthony

    I wear my CEP socks after all my long runs and when I have to stand a lot at work. As a recovery tool they work for me. I've tried various brands, be aware that not all "compression" is the same. Zoot and CEP had the most compression to me.

    AB

  10. Brad

    I love my Zensahs — they really seemed to help with calf-cramping problems. I agree that they do make me hotter than running without them. With respect to the placebo effect, my observation is that running in sleeves on a hot day slows me down due to the increased heat build-up, but my legs feel better the next day. Placebo for recovery but not for speed / perceived exertion?

  11. Jerry Cagle

    I don't think there's either a measurable or perceived improvement in my running performance, but I've been wearing both compression tights (CW-X Ventilators or Salomon 3/4 Exo's) and socks (both Zensah and Sugoi) for all of my long runs in building up to a mid-October marathon, and I absolutely love them. I did a 12 miler on Saturday, and didn't wear them. It felt like the 20 miler I did the weekend before.

    I also wear them post-long run/ice bath, and have slept in them for their purported recovery benefits. There is a palpable difference with/without, i.e. I think they speed recovery and reduce DOMS.

    Anecdotal? Yes! Placebo? Maybe… but (is there an echo in here?) – who cares? It's not called the Placebo "Effect" for nothin'…!

  12. Will T.

    I love the tingly, massage feeling I get when I slip on my compression socks after a good run. Like most of the other comments, no new PR's or outstanding performances wearing compression gear during activity. I get all the joy in using compression during recovery.

  13. Judie

    I use the Skins pants and long sleeve shirt. Thwey make a difference in how my legs feel while I run and are a tremednous benefit with recovery. I have run several significant downhill runs with them and I was fine the next day-no real muscle tightness or any problems. I think they are great.

  14. Ken

    I've tried the Zensahs and full CW-X tights in some longer training runs but didn't notice any difference. Next, used the Zensahs in a cold-ish very mountainous 50 race and my calves didn't hurt at all the entire race or afterward. That ALMOST convinced me… until I then did a hilly 50 race on pavement (ouch) without them, and my calves still didn't hurt. So, for me, jury's still out. I'll continue to use the CW-X tights for recovery, but doubt I'll use either in a race or run unless it's cold and I want the warmth anyway.

    Oh, and I also got the Under Armour recovery tights. They initially seemed as good as the CW-X, but the stitching has started to come unraveled in numerous areas so they're a 'don't buy' due to poor manufacturing.

  15. Meghan

    Thanks everyone for your thoughts, opinions, and comments.

    I think I'm seeing a trend here, that the "placebo effect," or whatever you would like to call it, is thought to be meaningful to many of you. We all know how closely tied our minds and bodies are!

    I'm also glad to see a theme towards an analytical perspective, not just "buying in" because of trend or popularity. We all have to use our heads to find out what's right for us!

    Thanks again.

    1. Blaine Moore

      Actually, Steve Magnass at Science of Running went through all the research he could find as of a few months ago to see if compression socks were worth using, and his conclusions weren't much different.

      There's no research to say that there's anything but a placebo effect in terms of performance gains, but the research seems to indicate that there's improved lactate clearance and recovery, although it's hard to be sure since so many of the studies use different levels of compression and athletes of different levels of fitness.

      You can read his article here:
      http://www.scienceofrunning.com/2010/07/compressi

      1. Meghan

        Hi Blaine,

        Thanks for your note and the link!

        If, when you peruse the annals of research on leg compression technology (We're talking compression tights, knee-length shorts, calf sleeves, socks, everything. Including stuff made for healthy athletes and sick people. Probably 5 dozen studies, total.), a placebo effect if probably the most prevalent data trend that emerges.

        Both the "Science and Running" and I have referenced Berry et al (1987)'s correlation between lower blood lactate levels and the use of compression on the lower legs. Neither "Science of Running" nor I mentioned that:

        1. There is research out there that reports to the contrary; and

        2. Researchers are yet to understand where the lactate went during the workout. That is, was it not produced at all (Unlikely, we're talking about a sprint test.)? Did it not squeeze out from the muscles to the blood stream, where lactate levels were measured? (Possible. We don't know how good or bad this is, if so.) Was the lactate pressed into the bloodstream and into other muscles before bloodstream lactate measurement occurred? (Also possible. We don't know how good or bad this is, either.)

        What I'm trying to say is that Berry et al (1987) themselves stated they don't know if their results were good, bad, or ugly. And further, the data from all of the research that's so far occurred are truly inconclusive about the effectiveness of compression technology.

        Thanks again!

  16. Roger (Sydney)

    A new study raises questions over the value of any compression that only starts below the knee for DVT – http://www.usyd.edu.au/news/84.html?newscategoryi
    I don't know about DVT because it's never been an issue for me but I've used heaps of different compression running distances up to 100km – Zoot, X-Bionic, CW-X, 2XU, Zensah, etc.

    I'd say that the 2XU compression is a joke because it easily pinches together between the fingers and lifts off the skin. Zensah and Zoot do the exact opposite, generally providing heavier compression than you need for active wear but being just awesome afterward or during recovery betwee a morning session and an evening session.

    I've been using the X-Socks for ages and they're really durable and reliable. A nice trick with the long ones is to leave them down around your ankles for the first 15km or so then pull them up for a refreshing difference.

    And the new CW-X Ventilator socks have just become available in Australia and I'm loving those. Have only just been using them the last few weeks so can't yet say anything about their durability, but so far they seem to provide an ideal level of active compression while being lighter and more breathable than other full length socks – which is a big plus.

    One thing that really does seem to go missing in these discussions of compression socks is that there really is no benefit in compression over any distance under 10km. Also, a big part of the benefit for endurance is simply the reduction of shudder from impact. Over a decent distance, even a 2-3% reduction in muscle fatigue is worth the extra spend.

    To really get a good benefit from compression, leave it off for training unless your muscles are feeling very tired or injured, but make sure to use it in recovery. If you then save it for race day, it becomes an advantage over what you are used to, rather than just essential kit that you run worse without. ; )

  17. joe

    I am new to compression socks and cannot feel any real benefit during along race and never considered using them later for recovery but it sounds like a good idea. Fill me in, thnaks

  18. Claudia

    I'm a big fan of CEP compression socks. Before discovering these socks i would get shin pain on longer or faster runs. Since i began using them I noticed an instant change, shin pain has disapeared over time and lower legs take less time to recover.

  19. Claudia

    Thanks for posting this. I just bought CW-X conditioning tights and I was wondering if they could be worn with my CEP compression socks or if it would be overkill.

  20. Ross

    Likewise, I have ben running in CEP compression wear for about a month now and really have noticed the difference in recovery time between long runs. It might just be a result of me getting fitter though lol

  21. Carly D. @ CarlyBana

    Zensah sleeves made a huge difference in my running. As a beginning runner I had terrible shin splints. The Zensah compression sleeves provided relief while I wasn't running and pretty much stopped the shin splints from returning.

  22. Nathan

    I need opinions as to which compression is best for knees when playing tennis.

    Besides the placebo effect, all research I've read points to the conclusion that wearing copper for arthritis is a placebo effect at best. Therefore, I'm quite skeptical that Tommie Copper (for knees) would have much benefit other than providing some compression. If anyone who can dispute this with proof or experience, I'm open to listen (or read). I'd like to buy compression sleeves for my arthritic knees but I'm trying to decide between Tommie Copper, Zensah, CEP Running Compression, McDavid or some other brand. Since I need TWO (1 for each leg), I'd like some advice so I don't make a mistake. Any recommendations??

  23. Sally Portafekas

    I have a Baker's cyst behind my left knee and would like some adice as to what stockings I should purchase for the knee and calf area. My calf measures about 13inches when not standing long and 13 1/2" when swollen. Also fell on right knee and fractured the knee back in July 2011. I would like a knee support for that leg. Please advise what I can purchase. Thanks

  24. Willy

    Those who are older or have undiagnosed circulation issues will benefit more from compression. If legs swell on flights or during the day then there are medical issues present regardless of age or physical condition. To be helpful the studies need to target the populations.

  25. Lill

    I have tried Zensah and CEP, and CEP are defineltey the way to go. They help the pain in my Achilles and they have helped prevent my recurring shin splints. I am a believer! Zensah helped me mentally, but CEP actually got the job done.

  26. @LostinAngeles

    thought i'd get an answer to this here, but haven't, so i'll give you feedback on the effect of wearing both tape and a sleeve to support my strained calf muscle while i continued my 60min run on it (right, i know…don't).

    amazingly it helped me get through the run, but until the endorphins kicked in at the last half of the run, along with being able to run on my injured calf (strained at the top of the calf) i noticed a LOT more pressure on my shins on that leg…i had both elastic taped it (proper wide tape meant for support) AND used a compression sleeve.

    my question is whether all the shin pressure (i normally have never had shin issues my entire life) was caused by wrapping my calf too tightly, or is simply the result of the injury transferring work to the shin until the calf recovers more…if you can answer that i'd appreciate it.

    hopefully you won't gasp when i also point out i'm a minimalist runner, so my runs are on the front portion of my foot, putting more strain on the calf. this whole mess happened AFTER i had spent 2 years adjusting to full minimalist running in the NB minimus zero and was strong and healthy. i experimented with going back to zero drop shoes that had more padding than my zeros, which allowed my calfs to decondition over the 3 weeks i did this, so when i went back to the minimally padded NB zeros, my calf strained.

    anyway, thanks for any light you can shed on the issue of added pressure on my shins from, 1. the injury?, or 2. from tight wrapping of the injury while training on it.

  27. Running Blog

    2xu Compression Performance Run Socks

    […] me in three sizes, but it’s not clear what the “calf size” categories deno […]

  28. Relief Blog

    Copper Compression Socksblackladies Size

    […] , but it’s not clear what the “calf size” categories denote, perhaps calf […]

Post Your Thoughts