Medically reviewed by Dr. Michael Darder OBGYN — Written by Kari Johnson
Published October 31, 2020
As the founder and CEO of Comrad, I field a lot of questions about socks. Here's one that I've heard many times before: what's the difference between high-tech running socks and the compression stockings that you wear on a plane ride? My answer is simple. There's really no difference. The same socks you wear to improve your performance during a marathon can also be worn during a long work shift. All compression socks and stockings promote venous return. No matter the material composition of the garment, you should look at the millimeters of mercury (mmHg) rating to determine the compression level. In other words, once you find the optimal compression sock for exercise, you can also wear it for other activities, such as flying, standing, and sitting. There's no reason to wear an old-fashioned medical stocking. A well-designed compression sock provides medical benefits, even after your workout is complete.
Both men and women can benefit from compression therapy. With dozens of published studies about the efficacy of compression garments, scientists have investigated how compression affects subjects of both genders. For example, some studies examine the impact of compression on women during pregnancy. Other studies explore the benefits of compression for men. In this article, my goal is to analyze several studies that have shown how compression therapy improves athletic performance and recovery for men. Armed with the information from these studies, I'll give some advice for how men should select the best compression socks for performance and recovery. Luckily, a great athletic compression sock will support you through work, leisure, and travel, as well as physical exertion.
40-km Cycling Test for Multisport Male Athletes
A 2012 study in the Journal of Strength and Conditioning Research evaluated the effect of wearing graduated compression garments during recovery on a subsequent cycling performance. In the experiment, fourteen trained multisport male athletes wore either a graduated full-leg compression garment or a similar-looking placebo garment (polyester and spandex). After performing a 40-km time trial in normal cycling gear, the test subjects wore the graduated compression garments continuously for 24 hours. After the 24-hour recovery period, they participated in another 40-km trial. Following a one-week break, the groups were reversed, and the experimenters repeated the procedures. For the group that wore compression garments, the results showed significant improvements in both average power output and performance time for the second 40-km trial. (de Glanville Abstract) This study indicates that healthy males may be able to optimize recovery time by wearing graduated compression on the legs. Better muscle recovery may lead to stronger athletic performance in subsequent activities. Although this experiment evaluated full-leg-length garments, graduated compression is also available in the form of compression sleeves, socks, and stockings.
Elite Wheelchair Rugby Athletes
You might assume that wearing compression socks on your lower legs only impacts your performance and recovery as it relates to your legs and feet. A 2016 study published in The Journal of Spinal Cord Medicine suggests that the opposite is true. At the National Sports Training Centre in Queensland, Australia, researchers set out to study ten male wheelchair rugby athletes with cervical spinal cord injuries. For the experiment, the athletes did wheelchair sprints and laps while wearing medical grade compression socks on both legs. The researchers compared the results to the same exercises performed without compression. Interestingly, they found several measurements improved with the use of compression socks. Not only was average lap time better maintained with the use of compression socks, but there were also greater increases in upper limb blood flow pre- to post-exercise with the use of compression. (Vaile et al.) This indicates that compression increased endurance and improved full-body blood circulation in the men studied. Although these athletes did not use their lower legs (which were paralyzed), they still experienced measurable benefits from the use of compression socks.
Functional Recovery for Marathon Runners
Perhaps the strongest evidence that compression socks can improve functional recovery comes from a 2015 study, which evaluated Melbourne, Canberra, and Gold Coast marathon participants older than 18 years. The study included twenty-three male and ten female participants. The researchers put half the participants in graduated compression socks and half in placebo garments for the 48-hour period after a marathon. The study evaluated pre-marathon and post-marathon treadmill tests, performed 2 weeks before and 2 weeks after each study participant's marathon. During timed tests, the researchers added incremental incline and speed until the study participants reached exhaustion. The compression group showed a 5.9% improvement in time to exhaustion, compared to the placebo group. The compression group improved by an average of 52.4 seconds, compared to a decrease of 61.7 seconds for the placebo group. The study shows significant differences in post-marathon recovery between the two groups. Notably, the time score decreased for the placebo group, whereas the compression group significantly improved their pre-marathon scores.
What Leads to Better Performance and Recovery?
The studies above suggest that compression therapy leads to more efficient recovery and better subsequent athletic performance, but the experiments still leave us with some important questions. What are the physiological factors that contribute to performance and recovery? In truth, researchers still have some unanswered questions regarding the reasons that compression therapy works so well for athletes. We know that compression garments narrow the circumference of the blood vessels, improving the velocity to blood flow. This leads to better circulation throughout the body, as evidenced by the improved upper limb blood flow of the elite wheelchair rugby athletes. Better blood flow means that high-quality oxygenated blood reaches your muscles and, more importantly, that deoxygenated blood and waste materials are cleared away more efficiently. Graduated compression further reduces swelling in the lower limbs by pushing fluids from the ankle towards the calf. Graduated compression leg sleeves, socks, and stockings all work by exerting more pressure on the ankle and less as the garment moves up the leg. The upward pressure supports venous return, helping the body work against gravity.
One theory for why compression therapy helps to reduce muscle soreness and damage has to do with waste materials, such as lactic acid dehydrogenase and creatine kinase. Scientists sometimes use these enzymes to measure recovery, since lower levels are associated with better recovery. These waste materials are also thought to accumulate with stress fractures, plantar fasciitis, and shin splints. (Miyamoto 3) Graduated compression garments may aid in the elimination of such waste materials from the bloodstream during functional recovery, preventing muscle damage and increasing comfort for athletes. In an analysis of all available medical literature, scientists found a large body of evidence to support the use of compression therapy to reduce post-exercise leg soreness and delay the onset of muscle fatigue. The same analysis found small beneficial effects for the markers of muscle damage and inflammation, such as lactic acid dehydrogenase and creatine kinase, across all 32 experiments analyzed. (Engel 940) It may be that these small beneficial effects would be more pronounced with consistent application of compression therapy in the days after exercise, especially if the maximum benefits of compression come from long-term use.
Selecting the Best Sock
The best athletic compression socks have features that allow you to wear them more than once between each wash. Because all compression garments eventually lose their shape after multiple washes, it's important to look for socks with moisture-wicking fabric and anti-odor technology. This will keep your gym bag smelling fresh and maximize the life of each pair of socks. For example, at Comrad, we offer knee-high compression socks, Companions, made with a breathable SmartSilver material. With these socks, silver binds with the thread at a molecular level, protecting you from odor-causing bacteria. Companions eliminate odor and regulate temperature, making them excellent compression socks for recovery, whether you're a triathlete, a CrossFit fanatic, or a marathon runner. With a number of unisex sock styles to choose from, every man can find the perfect Comrad sock to go with his running shoes or cross trainers.
When looking for a sock, remember that graduated compression socks do the most to improve oxygen flow and reduce fluid retention in the lower legs. Look for socks that advertise a gradient of compression, measured in mmHg. For example, Companions measure 25 mmHg at the ankle and 15 mmHg at the calf. If you see socks with a label that doesn't show a compression range, such 15-20mmHg, 15-25mmHg, or 20-30mmHg, it's likely that you're looking at a uniform compression sock rather than a graduated compression sock. Uniform compression socks do not provide the same proven medical benefits as graduated compression. For fans of ankle socks and crew socks, it's possible to buy shorter styles with targeted compression. These socks are designed to provide arch support and prevent swelling and blisters, but they lack the additional benefits of graduated pressure.
Look for socks that have extra cushioning in the heel and toe, like our Allies and Companions, since extra padding ensures optimal comfort. You should also be sure to buy a compression sock in the correct size. For men with wider calves, be sure that extended sizing options are available. Take a look at our size chart to learn more about how to select the right socks for you. To ensure you get the most out of your high-performance sports compression socks, you need to make sure that they fit snugly without any bunching or sagging. Lastly, always be sure to check the reviews when you shop for compression socks online. Whether you buy from Amazon or directly from the manufacturer, be sure that the seller has a return policy that will enable you to exchange your socks for another size.
Check out our website, and learn why 99% of our customers would recommend Comrad socks to a friend. You can return your socks for a full refund or exchange them for a different size within 30 days of purchase. We'll even give you a $20 gift card when your friends try Comrad, and they'll get 25% off their first order. You may want to get started with a variety pack that features both ankle and knee-length socks, all made with antimicrobial SmartSilver fabric. Many customers feel a difference in their athletic performance and recovery after just a few workouts. If you do notice an improvement, be sure to spread the word. Join the lineup of athletes who understand that compression gives them a competitive edge, both on and off the field.
Sources:
Armstrong, Stuart A., Till, Eloise S., Maloney, Stephen, & Harris, Gregory A. "Compression Socks and Functional Recovery Following Marathon Running," The Journal of Strength & Conditioning Research, Vol. 29, Iss. 2, 2015, pp. 528-533, https://journals.lww.com/nsca-jscr/Fulltext/2015/02000/Compression_Socks_and_Functional_Recovery.30.aspx.
de Glanville, Kieran M., and Michael J. Hamlin. “Positive effect of lower body compression garments on subsequent 40-kM cycling time trial performance.” Journal of Strength and Conditioning Research, vol. 26, iss. 2, 2012, pp. 480-486, https://pubmed.ncbi.nlm.nih.gov/22240553/.
Engel FA, Holmberg HC, Sperlich B. "Is There Evidence that Runners can Benefit from Wearing Compression Clothing?" Sports Med, vol. 46, iss. 12, 2016, pp. 939-952, https://www.researchgate.net/publication/301581402_Is_There_Evidence_that_Runners_can_Benefit_from_Wearing_Compression_Clothing.
Miyamoto, T., Oguma, Y., Sato, Y., et al. "Elevated Creatine Kinase and Lactic Acid Dehydrogenase and Decreased Osteocalcin and Uncarboxylated Osteocalcin are Associated with Bone Stress Injuries in Young Female Athletes." Scientific Reports, Vol. 8, 2018, https://doi.org/10.1038/s41598-018-36982-0.
Vaile, Joanna, Stefanovic, Brad & Askew, Christopher D. "Effect of lower limb compression on blood flow and performance in elite wheelchair rugby athletes," The Journal of Spinal Cord Medicine, vol. 39, iss. 2, 2016, pp. 206-211, https://www.tandfonline.com/doi/full/10.1179/2045772314Y.0000000287