Effect of compression garment on recovery from exercise or sport induced muscle fatigue: Literary Review

The purpose of this literary review was to present a comprehensive overview of the effects of compression garments in recovery from micro-trauma exercise induced muscle damage (EIMD).? The sensation of soreness is described as delayed onset muscle soreness (DOMS). Exercise induced muscle damage is associated with higher levels of fatigue, lower muscular power outputs, and reduced strength levels. Treatment modalities are common in the recovery process from exercise induced muscle damage. The goal of the treatments is to increase the rate of recovery from exercise or sport induced muscle damage. Compression garments are used widely for the clinical treatment of pathologies. The same principles of compression garments in clinical treatments are now being presented as supportive for the treatment of exercise induced muscle soreness.

KEYWORDS: Muscle soreness, recovery, regeneration, muscle damage

INTRODUCTION

Athletes and individuals involved in structured exercise programs are always looking for processes to improve performance. One component of improving performance is recovery from exercise, practices, or competition (Hamlin et al., 2012). Repetitive exercise or athletic actions results in fatigue, micro-trauma to the musculature, and sensations of soreness (Upton, Brown, & Hill, 2017).

The sensation of soreness is described as delayed onset of muscle soreness (DOMS). Micro-trauma is referred to as exercise induced muscle damage (EIMD) and is characterized by mechanical damage to muscle fibers producing inflammatory responses (Clarkson & Hubal, 2002). Exercise induced muscle damage is associated with fatigue, reductions in strength, increased levels of creatine kinase (CK), and lower power outputs (Clarkson & Hubal, 2002). These physiological components impair subsequent performances in competition or training (Upton, Brown, & Hill 2017). Several modalities are commonplace in the recovery from exercise induced muscle damage including cold therapy, contrast treatments, massage, and macro-micro nutrient supplementation (Kato, Nakamura, & Takahashi 2017). The goal of these treatments is to improve the rate of recovery from exercise or sport induced muscle damage.

Compression garments have been used widely for the clinical treatment of pathologies such as deep vein thrombosis and chronic venous insufficiencies (Kato et al., 2017). Due to their external compression increases in venous return, blood flow velocity, and tissue oxygenation occur (Kato et al., 2017). These same principles are the basis by which compression garments are thought to assist in recovery from exercise induced muscle damage. The compression garment has now become a modality in the recovery from exercise induced muscle damage from sporting activities and exercise (Kato et al., 2017).

PROBLEM STATEMENT

The purpose of the research is to determine compression garment benefits on recovery after exercise or sport induced muscle damage. One group will be utilizing a compression garment post exercise or sporting activity. A second group will not be fitted with a compression garment after exercise or sporting activity. The independent variable will be the use of compression garments on the body after resistance training exercise or sport activity. The independent variable contains two levels: compression garment and control. The dependent variables are measurements of improvement from exercise or sport induced muscle fatigue.

The subjects are healthy adults participating in structured resistance training, team sports, or exercise programs with no reported orthopedic injuries or dysfunction. The demographics are both male and females. Measurement of improvements from exercise or sport induced fatigue are to include maximum voluntary isometric contraction via EMG surface data, counter movement jump performance, perceived muscle soreness via a physiological questionnaire, and serum concentrations of creatine kinase with blood samples within this study (Shimokochi et al., 2017; Kramer et al., 2010). Compression garments in this study will include full body, lower, and upper extremity garments. The compression garments in this study vary in terms of construction with a minimum of 8% spandex and maximum 92% nylon as the acceptable fabric range. The author thus seeks to determine if compression garment usage is beneficial in recovery from exercise or sporting activity induced muscle fatigue.

DATA SOURCES

The references selected provide information on the usage of compression garments on recovery from exercise induced muscles damage from sporting or exercise related activities. The peer reviewed articles were located via the PubMed online database and the University of Texas Permian Basin library. The initial keyword searches were ‘compression garment’, ‘exercise induced muscle damage’, ‘compression garment recovery mechanism’, and ‘compression garment delayed onset muscle soreness’. The date range of the peer reviewed articles for this review was from 2010 to the present.

ANNOTATED BIBLIOGRAPHY

Hamlin, M. Mitchell, C. Ward, F. Draper, N., Shearman, J. Kimber, N. (2012) Effect of

compression garments on short-term recovery of repeated sprint and 3-km running performance in rugby union players. Journal of Strength and Conditioning Research, 26 (1). 2975 - 2982.

The aim of the study was to determine whether wearing a compression garment during recovery improved subsequent sprint and 3-km run performance (Hamlin et al., 2012). A randomized single blind cross over study of 22 male union level rugby level players participated in the study (Hamlin et al., 2012). Participants were randomly placed into a full-length compression garment group and similar looking non-compression placebo group to wear for 24 hours after performance of a rugby centric circuit program (Hamlin et al., 2012). After 24 hours garments were removed, and the circuit program was repeated. One week after initial testing groups were reversed, and testing procedures repeated (Hamlin et al., 2012).

Results of the study indicated the compression garment group improved both the 3 km run and sprint times relative to control group (Hamlin et al., 2012). Delayed onset of muscle soreness was substantially lower in the compression group compared to the placebo group (Hamlin et al., 2012). The intended audience of this study are participants in rugby, coaches, and instructors of sports with repeated sprint and endurance run characteristics. The results of this study support the use of compression garments for recovery in the areas of delayed onset of muscle soreness and improved sprint times. Authors of this study are faculty from the departments of social science, school of science and physical education, and applied sciences at Lincoln University, University of Canterbury, and Christchurch Polytechnic Institute of Technology.

Hill, J. Howatson, G. Someren, K. Gaze, D. Legg, H. Lineham, J. Pedlar, C. (2017) The effects

of compression garment pressure on recovery after strenuous exercise. International Journal of Sports Physiology and Performance, 12. 1078-1084.

The study was performed to identify the effects of two different grades of compression garments on recovery after strenuous exercise (Hill el at., 2017). The study involved the use of a high-compression, low-compression, and non-compression garment on 45 participants after the completion of eccentric base exercise program. Garments were worn for 72 hours post exercise. Measurements of perceived muscle soreness, maximal voluntary contraction, counter movement jump height, creatine kinase, reactive protein, and myoglobin were assessed pre-exercise and again at 24-, 48-, and 72-hours post exercise (Hill el at., 2017).

The results of the study indicated a significant recovery in maximal voluntary contraction and counter movement jump in the high compression garment subjects (Hill el at., 2017). No significant differences were observed pertaining to soreness, creatine kinase, reactive protein, and myoglobin (Hill el at., 2017). Review of the results indicates a benefit of high-compression garments having a positive influence on muscular performance though no effect on physiological parameters on the conditions of exercise induced muscle fatigue. The results of this study are in-line with studies on compression garments benefitting performance parameters though in direct conflict with research indicating physiological benefits to the use of compression garments in areas such as reductions in creatine kinase levels.

?The intended audience of this study are individuals participating in structured exercise programming. A portion of the authors for this study are faculty from St. Mary’s University and Northumbria University. Additional authors of the study are associated with GlaxoSmithKline performance laboratory and Saint George’s Healthcare.

Hooper, D. Dulkis, L. Secola, P. Holtzum, G. Harper, S. Kalwowski, R. Comstock, B. Szivak,

T. Flanagan, S. Looney, D. DuPont, W. Maresh, C. Volek, J. Culley, K. Kraemer, W. (2015) Roles of an upper body compression garment on athletic performance. Journal of Strength and Conditioning Research, 29 (9). 2655-2660.

The purpose of this study was to assess whether compression garments enhanced proprioception and improved sports performance in high level athletes (Hooper el at., 2015). The study involved collegiate level pitchers and golfers performing their respected pitching or golfing athletic actions. The subjects were randomly selected to perform their athletic protocols wearing a compression garment (CG) or non-compression garment (Hooper el at., 2015).

The results of the study indicated an improvement in fastball accuracy in the pitchers though no increase in velocity with the use of a compression garment (Hooper el at., 2015). The compression garment golfers showed significant improvement in driving, approach, and chipping accuracy with no improvement in distance (Hooper el at., 2015).

The study provides a positive benefit of compression garments on repetitive athletic actions in terms of accuracy. Though analysis in the areas of physiological or performance was not a collective part of this research study. Recognizing the repetitive nature of these athletic actions and the potential of a compression garment to impede the fatigue from these motor patterns. A direct correlation can be made from this study and the benefits of compression garments on recovery from exercise induced muscle fatigue. The intended audience of this study are the athletic and instructional populations associated with these sports. The authors of this study were faculty and students of the department of human sciences at Ohio State University.

Kato, E. Nakamura, M. Takahashi, H. (2017) Effect of compression garments on controlled

force output after heel-rise exercise. Journal of Strength and Conditioning Research, 32(4). 1174-1179.

The purpose of the study was to determine the effects of compression garment on controlled force outputs after strenuous exercise (Kato, Nakamura, & Takahashi 2017). The study included 16 individuals completing trials with a compression garment and without on two separate days at least 30 days apart. Pre and post heel rise exercise mechanical stiffness, architectural properties, and isometric maximal voluntary contraction of the gastrocnemius medialis was tested. (Kato et al., 2017).

The study indicated no change in maximal voluntary contraction between the compression garment and control group (Kato et al., 2017). Muscle stiffness and steadiness declined less in the compression garment group (Kate et al., 2017). The study correlated positively with additional studies reviewed on physiological benefits of the compression garment though inclusive on performance benefits as no change occurred in maximum isometric voluntary contraction. The study was intended for individuals involved or associated with exercise or sporting activities. The authors of this study were the faculty of sociology and department of sports sciences at Kyoto Sangyo University and Japan Institute of Sport.

Kraemer, W. Flanagan S. Comstock, B. Fragala, M. Earp, Lewis, C. Ho, J. Thomas, G.

Hill, G. Penwell, Z. Powell, M. Wolf, M. Volek, J. Denegar, C. Maresh, C. (2010) Effects of a whole-body compression garment on markers of recovery after a heavy resistance workout in men and women. Journal of Strength and Conditioning Research, 24 (3). 804-814.

The primary goal of this study was to evaluate the influence of a whole-body compression garment on recovery from heavy resistance training exercises (Kramer et al., 2010). The study involved highly resistance trained subjects randomly assigned to a compression garment and control group. After a strenuous whole-body resistance training program subjects were fitted immediately after showering with a full body compression garment or his/her normal garments (Kramer et al., 2010). Subjects were tested 24 hours post workout with dependent measures including sleep quality, vitality rating, resting fatigue rating, muscle soreness, power outputs, ultrasound analysis, and serum concentrations of creatine kinase (Kramer et al., 2010). The primary findings of the study indicated the use of a whole-body compression garment did produce more rapid recovery in select psychological, physiological, and performance variables. The results correlated positively with additional research on both physiological and performance induced improvements from exercise induced muscle damage. Both physiological and performance improvements occurred in areas such as creatine kinase and power outputs.

The authors of the study were faculty and students from the department of physiology and neurobiology and physical therapy program at the University of Connecticut. The intended audience of this study was populations in need of recovery from sport and resistance training including athletes and individuals. The extensive resistance training program performed separated this study from others reviewed where one to three modalities were implemented to induce fatigue.

Sambaher, N. Abbodarda, S. Silvey, D. Button, D. Behm, D. (2016) Effect of an ankle

compression garment of fatigue and performance. Journal of Strength and Conditioning Research, 30 (2). 326-335.

The aim of the study was to examine the effects of an ankle compression garment on performance and physiological measures associated with recovery from fatigue (Sambaher et al., 2016). Subjects participated in a randomized crossover study with the experimental conditions of ankle compression garment and control group. The dependent variables of drop jump performance, skin temperature, maximum voluntary contraction, electromyography, and blood lactate concentrations were measured pre - and post-warmup and post fatigue (Sambaher et al., 2016). Results suggested ankle compression garment increased skin temperature, no effects occurred in improvement of maximal voluntary contractile force, ground reaction force, and blood lactate levels post fatigue in the compression garment subjects.

The results showed no positive effects from the use of compression garments on muscle performance and recovery immediately after exercise. Additional studies reviewed implemented post exercise testing at times of 24 to 72 hours after exercise. This study did not perform testing at these post-exercise intervals, and as a result may not be conclusive in determining the effects of compression garment on delayed onset muscle soreness. The authors of this study were students and faculty at the school of human kinetics and recreation at Memorial University of Newfoundland. The intended audience of this study are individuals seeking information on the compression garment benefit on muscle performance and immediate physiological recovery from exercise induced fatigue.

Sear, J. Hoare, T. Scanlan, A. Abt, G. Dascombe, B. (2010) The effects of whole-body

compression garments on prolonged high-intensity intermittent exercise. Journal of Strength and Conditioning Research, 24 (7). 1901 1910.

The study investigated the effects of wearing a compression garment on prolonged high intensity interval training (Sear, Hoare, Abt, & Dascombe 2010). The study entailed eight male team sport athletes completing a prescribed 45 minutes of team specific high intensity bouts of exercise with a full body compression garment and a second control group clothed in typical soccer apparel (Sear et al., 2010). Heart rate, Vo2, tissue oxygenation, tissue hemoglobin index, and blood lactate level were monitored over the course of the exercise (Sear et al., 2010).

Results suggested the wearing of a full compression body garment provided moderate increases in strength and total distance covered (Sear et al., 2010). The likely increases in performance were based upon improvements associated with muscle oxygenation and associated metabolic benefits (Sear et al., 2010). The study utilized a compression garment during the actual exercise activity. The use of the garment during exercise and not post exercise was incongruent with most of the research studies reviewed. The results for the use of a compression garment on immediate fatigue benefits are positive though are inclusive on exercise induced muscle damage, delayed onset muscle soreness, and performance benefits as the study did not utilize the garment post exercise.

The study was intended for individuals participating in high intensity interval orientate sports such as soccer. General population individuals involved in interval-based exercise programming would find this study correlating to their programming. The authors of this study are faculty and administrators from the department of health and human services of Central Queensland University, Department of Sport, Exercise, and Heath at the University of Hull, and the School of Environmental and Life Sciences at the University of Newcastle.

Shimokochi, Y. Kuwano, S. Yamaguchi, T. Abutani, H. Shima, N. (2017) Effects of wearing a

compression garment during night sleep on recovery from high-intensity eccentric-concentric quadriceps muscle fatigue. Journal of Strength and Conditioning Research, 31 (10). 2816-2824.

The purpose of the research was to determine the effects of wearing a compression garment during night sleep on recovery from high intensity eccentric-concentric quadriceps muscles fatigue. The methodology of the study incorporated subjects performing a muscular fatigue protocol with one set of subjects wearing a compression garment for night sleep post exercise. Immediately before, after, and 24 hours after the exercise induced muscle fatigue protocol maximum voluntary isometric contraction (MVIC) was measured with surface electromyography. The results of the study indicated the maximum voluntary isometric contraction 24 hours post exercise was approximately 10% greater in the compression group (CG) than in the non-compression group (NCG).

The study correlated positively relative to additional studies reviewed on the benefits of compression garments on improving exercise induced muscle damage. The study did not test any specific physiological markers such as creatine kinase. As a result, this study only provided a suggested performance benefit measured as maximum voluntary isometric contraction.

The authors of this study were comprised of graduate degree students at the Osaka University of Health and Sport Science. The intended audience of this study are individuals seeking information on the viability of compression garments for recovery from exercise induced muscle fatigued. This study provided a positive marker in performance improvement which contrasts with some of studies reviewed where only physiological benefits were a result from the use of a compression garment.?

Upton, C. Brown, F. Hill, J. (2017) Efficacy of compression garments on recovery from a

simulated rugby protocol. Journal of Strength and Conditioning Research, 31 (11). 2977 - 2982.

The study was to examine the efficacy of lower limb compression garment on recovery in club level rugby players (Upton, Brown, & Hill 2017). The study involved 19 participants completing a muscle damaging protocol prior to random assignment to a compression garment or recovery drink group. Compression group wore garment for 48 hours post exercise and recovery group consumed beverage immediately after exercise (Upton et al., 2017). Perceived muscle soreness, creatine kinase, maximal voluntary isometric contraction, and counter movement jump were measured baseline, post 24 and 48 hours after exercise.

Results of the study indicated perceived muscle soreness and creatine kinase were lower in the compression garment group (Upton et al., 2017). Performance parameters of countermovement jump height and maximum voluntary isometric contraction showed no significant effect through use of a compression garment (Upton et al., 2107).? The parameters of improvement in perceived muscle soreness and lower levels of creatine kinase are in-line with other studies reviewed where physiological recovery factors occurred. In addition, the performance tests of maximum voluntary isometric contraction and counter movement jump height was in-line with findings in some of the studies reviewed though not for all the results of the tests.

This study provided support for the use of compression garments on physiological recovery from exercise induced muscle damage. Though this study did not support performance improvements of maximum voluntary isometric contraction and countermovement jump performance with the use of a compression garment. The intended audience of this study are participants and coaches in the sport of rugby. The authors of this study are faculty and students from the School or Sport, Health, and Applied Science at St. Mary’s University in Twickenham, United Kingdom.

CLINICAL APPLICATIONS

The clinical implications of the research studies reviewed indicate a positive correlation in terms of the use of compression garments in the process of recovery from exercise induced muscle damage. The findings point to a more substantial effect on the physiological components of recovery such as improvements in creatine kinase and muscle stiffness relative to performance improvements such as the counter movement jump. The research additionally points to increased grades of compression are of greater benefit relative to lower compression garments. Finally, the compression garment may have implications on improving performance during competition.

The use of a compression garment will be included in the suggested recovery techniques for these athletes. The research studies definitively show a positive effect of the use of compression garments in the process of recovery and potentially in certain performance parameters which are both very important components to this population of individuals.

CONCLUSION

The use of compression garment for recovery from exercise induced muscle damage showed a positive effect pertaining to reduced levels of creatine kinase and perceived levels of muscle soreness in most of the studies reviewed. Benefits of the compression garment usage on the performance parameters maximum voluntary isometric contraction and counter movement jump was inclusive as results were varied. The grade of compression garment appears to have a direct effect on the physiological recovery from exercise induced muscle damage, where a higher-grade compression has an invariably improved effect. The process by which the compression garment may benefit recovery is through increases in venous return, tissue oxygenation, and tissue oxygenation (Kato et al., 2017).?

Physiological recovery appears to be the greatest benefit from the usage of a compression garment improving recovery affecting microtrauma and muscle soreness. The inclusion of the compression garment with treatments such as massage, cold therapy, and micro-macro supplementation to assist in the recovery from exercise induced muscle damage and perceived muscle soreness appears to be a viable recovery tool. Individuals involved in structured exercise or sporting activities seeking improved performance recognize the importance of physical recovery and may implement the compression garment as part of their recovery techniques.

FUTURE RESEARCH

The overall findings of this research indicate a positive effect on the usage of compression garments on recovery from exercise induced muscle damage. Future research on the use of compression garments could be focused on the grade of compression garment as a large variance in terms of fabric construction existed in the studies reviewed. One study did indicate increased physiological recovery from a high-grade garment construction compared lower grade compression garments (Hill et al., 2017). A second area of future research is on the comparison of a full -body compression garment relative to lower extremity, upper extremity, or single muscle garments (Hamlin et al., 2012; Kato et al., 2017; Upton et al., 2017). The studies in which a full body compression garment was incorporated appeared to show a higher percentage of recovery pertaining to both physiological and performance parameters (Hamlin et al., 2012; Kraemer et al., 2010). A final area of future research would be the time comparisons in terms of recovery level. Most of the compression garment studies performed a pre-test, post-test, and recurring analysis at time stamps of 24, 48, and 72 hours after the initial testing (Kramer et al., 2010; Upton et al., 2017) Research on the determination on the percentage amount of physiological and performance recovery at specified post exercise time intervals would be beneficial. These three areas of future research would provide additional information on the use of compression garments for recovery from exercise induced muscle damage.

REFERENCES

1. Clarkson, P. Hubal, M. (2002) Exercise induced muscle damage in humans. American Journal

of Physical Rehabilitation and Medicine, (81) 11. 52-69.

2. Hamlin, M. Mitchell, C. Ward, F. Draper, N., Shearman, J. Kimber, N. (2012) Effect of

compression garments on short-term recovery of repeated sprint and 3-km running performance in rugby union players. Journal of Strength and Conditioning Research, 26 (1). 2975 - 2982.

3. Hill, J. Howatson, G. Someren, K. Gaze, D. Legg, H. Lineham, J. Pedlar, C. (2017) The

effects of compression garment pressure on recovery after strenuous exercise. International Journal of Sports Physiology and Performance, 12. 1078-1084.

4. Hooper, D. Dulkis, L. Secola, P. Holtzum, G. Harper, S. Kalwowski, R. Comstock, B. Szivak,

T. Flanagan, S. Looney, D. DuPont, W. Maresh, C. Volek, J. Culley, K. Kraemer, W. (2015) Roles of an upper body compression garment on athletic performance. Journal of Strength and Conditioning Research, 29 (9). 2655-2660.

5. Kato, E. Nakamura, M. Takahashi, H. (2017) Effect of compression garments on controlled

force output after heel-rise exercise. Journal of Strength and Conditioning Research, 32(4). 1174-1179.

6. Kraemer, W. Flanagan S. Comstock, B. Fragala, M. Earp, Lewis, C. Ho, J. Thomas, G. Hill,

G. Penwell, Z. Powell, M. Wolf, M. Volek, J. Denegar, C. Maresh, C. (2010) Effects of a whole-body compression garment on markers of recovery after a heavy resistance workout in men and women. Journal of Strength and Conditioning Research, 24 (3). 804-814.

7. Sambaher, N. Abbodarda, S. Silvey, D. Button, D. Behm, D. (2016) Effect of an ankle

compression garment of fatigue and performance. Journal of Strength and Conditioning Research, 30 (2). 326-335.

8. Sear, J. Hoare, T. Scanlan, A. Abt, G. Dascombe, B. (2010) The effects of whole-body

compression garments on prolonged high-intensity intermittent exercise. Journal of Strength and Conditioning Research, 24 (7). 1901 1910.

9. Shimokochi, Y. Kuwano, S. Yamaguchi, T. Abutani, H. Shima, N. (2017) Effects of wearing a

compression garment during night sleep on recovery from high-intensity eccentric-concentric quadriceps muscle fatigue. Journal of Strength and Conditioning Research, 31 (10). 2816-2824.

10. Stade, Makenzie., (2017). The physiological effects of wearing a compression garment

during resistance exercise. (Master’s dissertation). California State University, Long Beach. ProQuest Number 10638611

11. Thomas, J. Nelson, J. Silverman, S. (2015) Research methods in physical activity.

?Champaign, IL: Human Kinetics.

12. Upton, C. Brown, F. Hill, J. (2017) Efficacy of compression garments on recovery from a

simulated rugby protocol. Journal of Strength and Conditioning Research, 31 (11). 2977 - 2982.

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