Compression boots seem to be everywhere these days. Everyone from professional sports teams and fitness influencers to weekend warriors tout the benefits of full-leg compression therapy.
Compression therapy is not new. Compression devices have been used in medical settings for decades, but wide access to compression systems is a relatively recent development. But are they really as magical as they seem?
Don’t get me wrong– I love a session in a pair of recovery compression boots… but inquiring minds want to know what science says about compression therapy for endurance athletes.
What is Intermittent Pneumatic Compression?
Intermittent pneumatic compression(IPC) is the fancy name for compression sleeves. The sleeves usually go around the arms or legs and fill with air to create graduated pressure around the limbs. The goal is to stimulate blood flow. Many IPC devices can also be programmed to apply different amounts of pressure to help drain flued or boost circulation in certain regions.
There are loads of different IPC devices in the medical field, and they are often used to treat conditions like arterial and venous diseases or lymphedema and prevent deep vein thrombosis or pulmonary embolism.
Some physical therapists incorporate IPC treatments as an alternative or alongside compression wraps or manual therapy techniques.
Compression Boots for Endurance Athletes
Our bodies constantly produce metabolic waste. When we work out, our bodies produce even more waste byproducts, like lactate, that our lymphatic system must clear out of our muscles. Because our legs are below our heart, it’s more difficult for the heart to pump the waste from our legs to our lymph system to get rid of it.
Compression therapy's goal for endurance athletes is to increase blood flow to the legs, which helps circulate waste more efficiently, speed recovery, and reduce swelling so athletes can get back to training faster and with less muscle fatigue and soreness.
What does the science say about compression therapy for athletes?
No matter what kind of runner you are, whether you finish a 5K or a 100K, your muscles experience microtears from all that stress. You may not even notice it, but swelling occurs when your body starts repairing those microtears.
If you recover appropriately—stay off your feet, elevate your legs, and take the appropriate amount of rest—your body will repair itself naturally, and the swelling will go away. Compression therapy can help your body work more efficiently during that recovery time.
Overall, studies indicate that compression therapy does offer some benefits in recovering after hard workouts. While the studies are usually small, they have found benefits for cardiovascular recovery, heart rate variability, and perceptual muscle soreness, swelling, and range of motion.
Other studies indicate there may be some placebo effect. A 2021 study found that compression therapy only provided short-term relief of DOMS (delayed-onset muscle soreness).
On the other hand, a 2016 clinical trial involving 72 ultramarathon runners found that using compression therapy after exercise offered similar benefits as post-exercise massages, especially when it came to reducing overall muscle fatigue immediately after a run.
Another small 2018 study concluded that daily pneumatic compression therapy (like with Normatec boots) reduced recovery time from DOMS compared to athletes wearing compression sleeves.
In short, we need larger and more comprehensive studies. Most of the scientific studies are very small or focus on elite athletes, so we need more data.
Should Amateur Athletes Invest In Recovery Boots?
With mixed results in the studies, where does that leave endurance athletes who are considering whether to invest in compression boots? The data that we do have indicates that serious athletes can experience recovery benefits from using compression therapy.
However, recovery boots cannot combat overtraining.
More training requires more and better recovery and there’s no real way to cheat that. If recovery boots help you take the time your body needs to recover, then that’s a win! But, recovery boots generally can’t help you cheat the system and avoid proper recovery that includes eating healthy, sleeping well, and giving your body appropriate amounts of rest.
Are there any risks to using recovery boots?
The obvious risk is that you invest in a fairly costly recovery product that feels great but isn’t used much. If you have the pressure setting too high, you may experience temporary numbness in your legs. Other than that, there’s very little downside to investing in recovery boots.
Endurance athletes will likely experience the most benefits from compression therapy compared to other types of athletes. The more training and racing you do, the more recovery your body needs. Compression boots might incentivize you to sit down and give your body the proper rest.
When to use compression boots?
You’ll likely experience the most benefit from compression therapy after the workouts that are the most taxing on your legs (assuming we’re talking about recovery boots). They can also be helpful when you have two fairly hard efforts in a short period of time.
Generally, recovery boots should be used three to four times per week. A ratio of one to two workouts for every recovery session seems to produce more positive results.
While some recovery boots offer “pre-workout” settings, it’s best to use them after your workouts. Compression therapy boots help your nervous system switch to a “rest and digest” response. You want your nervous system primed and excited before your workouts, not ready to rest!
There is an exception to this–if you have a job that requires you to be on your feet a lot, then a short 10-15 minute compression boot session before your workout can help flush your legs and make you feel fresher.
Typically, 30-35 minutes after your workout is enough compression therapy to help your body clear things out and begin the recovery process.
In summary, compression therapy seems to have enough potential benefits that serious athletes will likely experience some positive outcomes from incorporating it into their training and recovery programs. We are still waiting for the science to determine exactly how much benefit we can expect. Also, they just feel great – so if you’re eyeing a pair of those Normatec boots, go for it!
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