Overview

The usage of compression garments over the past three decades has increased specifically during exercise, to alleviate fatigue responses and enhance recovery. Compression garments act by providing mechanical pressure to the body. This may influence physiological and/or biomechanical performance and have a positive effect on individuals exercising. There has been increasing attention on these garments for their potential ergogenic effects on performance and recovery. It is common for athletes to wear them before, during and/or following a regime of physical activity. 

These garments can be used in a variety of ways, which include upper, lower and whole-body garments. However, the most used and researched are lower-body compression garments. Clinically, they promote blood flow from superficial veins into deep veins, preventing cutaneous venous stasis. However, there is less research conducted on circulatory changes in settings when compression garments have been worn during exercise.    

Compression garments are typically a tight-fitting type of clothing. Leabeater and colleagues tested two types of full-length compression tights on a sample of 24 recreationally trained participants. These waist to ankle exercise tights were either made of 80% nylon and 20% elastane or  92% polyester and 8% elastane.¹  

Overview of a contusion

A muscle contusion is a bruise that some athletes may experience due to engaging in sports. Contusions are the second most common injury in athletes followed by strains. In the majority of cases, contusions are minor and heal quickly. However, severe contusions can cause deeper tissue damage, which can result in complications that prevent athletes from engaging in sports for a long period of time.  

Contusions occur when a certain part of the body is affected either by a repeated or a direct blow by a blunt object. This causes underlying muscle fibres and connective tissue to be crushed without breaking the outer layer of the skin. Similarly, a contusion can also be a result of a fall or something hitting the body with a hard surface. 

Symptoms

• Swelling and pain and reduced movement near the injury
• A blue discolouration (due to a torn blood vessel)
• The injured muscle may weaken or stiffen
• A blood clot may form within the damaged tissue, forming a lump over the injury (hematoma)
• In extensive cases, if the tissue damage is severe there may be a broken bone, dislocation of a joint or a torn muscle² 

Role of Compression Garments in Preventing Contusion Complications

Performance and Muscle Function

Weakley et al evaluated 115 studies on wearing compression garments and their effects on exercise performance as well as muscle function outcomes. Gradual exercise test performance was improved when wearing compression garments. However, there were also reports that there were no effects or a decreased effect on gradual exercise test performance. Researchers highlighted increased compression in improving running speed and the distance travelled during netball, team sports and circuits. However, there was no effect on triathlon discipline speed or the distance travelled whilst in a football match.³          

The most used markers to measure muscle function and strength were isometric and isokinetic. Despite the wide range of measures on the effects of compression, the results obtained are unclear. This is due to a large amount of studies reporting either a beneficial effect or no effect. Only one study was identified to report a detrimental effect of compression on performance. This result represents a small percentage of data (-1%) of studies. This suggests it is not likely that wearing a compression garment can have a negative effect on performance and muscle function.³  

Cardiovascular and Haemodynamic Outcomes

Research from 74 studies reported cardiovascular and haemodynamic measures. The cardiovascular measures include heart rate, blood pressure, cardiac output, stroke volume, and mean arterial pressure.   

Haemodynamic measures that were assessed (whilst compression garments were worn) are changes in muscle oxygenation, arterial blood flow and venous blood flow.  Most studies showed no effect of compression on heart rate. However, 12 studies reported positive effects of compression and three studies reported negative effects. Blood pressure was documented as no change due to compression in seven studies and a positive result in two studies.³  

Contrastingly, there is some data suggesting wearing compression garments to positively influence cardiac output. Three studies documented a positive effect and two studies with no effect. 

Similarly, three studies showed stroke volume to have no effect on compression and one study to have a positive effect on compression. No studies reported negative effects of compression whilst blood pressure, cardiac output and stroke volume were measured. Weakley et al also discussed literature that investigated changes in mean arterial pressure and total vascular conductance to have no effect due to compression.    

Research is limited in assessing the effects of compression on venous blood flow (two studies available) which hold conflicting findings of positive and no-effect results. Weakley suggested future research to focus on incorporating measures that investigate alterations in peripheral blood flow. These will allow a greater understanding of muscle and venous blood flow which are a major contributor to the effectiveness of compression (in exercise and recovery).³   

Summary

Compression garments are commonly worn by athletes to improve physical performance and during exercise by non-professional competitors. They are also known to be used in the healthcare industry to enhance recovery, specifically post-surgery. Over the past few decades, these garments have been increasing attention due to their potential ergogenic effects on the body. Compression garments function by providing mechanical pressure to the body. Which in turn influences physiological and/or biomechanical performance allowing a positive effect to be achieved.        

On the other hand, the efficacy of utilising compression garments is variable. The methods, approaches and outcome measures that are used in the literature are varied. Although it is unlikely compression garments would have a negative effect on the desired outcome. Future research could investigate individual opinions of the garments. Report pressure at multiple sites, different garment materials and most importantly varying compression coverage areas (e.g., knees, elbows, wrists).³     

FAQs

Do compression garments help with bruising?

Minimise bruising:

By wearing a compression garment the formation of a bruise can be reduced. This is due to limiting the blood flow in blood vessels and capillaries. Which can lead to rupturing and ultimately causing discolouration in certain parts of the body e.g. joints and on operated areas.

Protects the Incisions:

Compression garments can add an extra layer, protecting incisions.

Can compression garments be worn to prevent injury? 

Wearing a compression garment (such as a sleeve, leggings and/or socks) before, during and after exercise can improve bodily fluids to move freely in the body. This will also aim to remove waste products that have built up during exercise. This will result in muscles to gain further oxygen with a quicker recovery time.     

This will allow muscles to gain further oxygen with a quicker recovery time.   

Is compression good for contusion?

Soon after an injury occurs, it is best to follow the RICE method (rest, ice, compression and elevation) to minimise inflammation. Reducing movement and stretching the injured muscle will also help.   

How can contusion be prevented?

There are some basic steps that an individual can take to prevent the risk of muscle contusion. 

• Ensure good training and exercise practices are in place, this will prevent overworking the muscles
• Ensure warm-up and cool-down exercises are done before and after sports
• Ensure protective clothing (e.g., compression garments) is worn during competitive and extreme activities

How does compression help injuries?

A compression bandage is a long strip of stretchable cloth that can be wrapped around a sprain or strain. The gentle pressure from the bandage will aid in reducing swelling. 

How does compression prevent bruising?

Compression aims to decrease bruising that may occur. When blood vessels rupture, The blood flow is disrupted and leaks into the surrounding tissue. This may result in bruising around the injury. By wearing a compression garment blood cells are prevented from moving towards the skin’s surface. This will minimise the appearance of bruising after surgery.