Sock It To Me - Where Should I Use Compression Wear?

"...don't criticize what you can't understand..." - "The Times, They Are A-Changin'" - Bob Dylan (1964)

I am a late adopter. I hold a particularly wary attitude toward the newest, brightest, & latest. It's not that I prefer to be the grouchy curmudgeon who "just won't get with the program." More often than not I'm the guy who calmly stares at the smoldering ruin of the next "greatest thing since the invention of sliced bread" & like the young man in Rudyard Kipling's "If," 'stoops to build them using worn-out tools.' When it comes to technology I wait for the second model year, the 2.0, the next version. That second year is always a plus; the (inevitable) "bugs" from the initial release have been worked out & the degree of sticker shock is often much lower and less painful.

I first saw compression stockings, sleeves & hosiery during my initial fling with triathlon. I couldn't wrap my head around the idea of people running 13.1 miles in the 90-degree heat of Panama City, FL, in black knee-length stockings immediately after riding 56 miles, immediately after swimming 2215 yards. I didn't know anybody who could explain the benefits; none of my closest (Ironman) triathlon-participating friends wore the stockings (but, after reading the research, I'm wondering whether I needlessly endured post-race trauma). Therefore, I made the conscious decision to speak neither well nor ill of wearer or garment until I had ample opportunity to try them out for myself.

Thank you, Road Runners Club of America. Thank you, Sigvaris. The Sigvaris/RRCA study was simple enough: Receive a pair of compression socks, run a 10k, wear the socks as part of the recovery protocol, write down your findings. In return I'd receive a second pair of compression socks.

Amazingly enough, as bad as I felt after the 10K (a week after Ironman 70.3 New Orleans), my legs did not feel all the worse for wear while I wore the socks. I now wear the socks during Sunday afternoons sitting around the house, or under a pair of jeans or slacks if I go out on Sunday. Sorry, I draw the line at tackiness during recovery, so no long socks with shorts (unless a pair of German "lederhosen" & I'm going to beer fest) in public. In fact, with a couple of weeks left in my training cycle for a target half-marathon, I've pulled the socks out for workplace wear. Everything feels good this afternoon.

My gosh, I've become my grandfather.

But the jury is still out - at best inconclusive - on running in compression stockings. One of my athletes, a 28 year-old male, started to wear his 2XU calf compression sleeves at track workouts. Again, the "speak neither well nor ill" tactic works best when one wears the "Coach" hat. If they work for Allan, then so be it. It appears that many runners who wear compression sleeves or socks while running feel more comfortable with them on, even if there are few notable benefits during the run.

But researchers in Europe & the US have seen the benefits of compression clothing once they are worn during recovery. The compressive wear decreased the amount of exercise-induced muscle damage, which probably continues during the immediate post-exercise period. Garment wearers were less likely to complain of perceived muscle soreness, & there was less incidence of creatine kinase in the blood (a marker of muscle damage) during the 48-hour period following a run. While there was only one study which alluded to improved run performance with compression socks, the majority of studies did find an improvement in follow-on run performance after recovering with the socks.

So, I've come to see the light about compression wear, but it's going to take a little bit of time before I'm brave enough to be seen in public in a pair of compression socks. Perhaps they won't be so easily noticed if I wear them with a pair of long tights instead of shorts.

The Run - The Smallest Part Of Training

Two evenings. Ninety minutes. As a coach that's how much time a week on the average I have to influence the training of my athletes. I have to trust them to do the right things on the other five days of the week; run a long run, run a semi-long run, run some easy runs, rest, listen to their body, and so on. The training regimen of every athlete, whether elite or amateur, boils down to two states: The Run, and The Recovery.

When you're not running you're recovering. It's that simple. Even if you're busy at your "real job", if you're not running it's recovery time. Simply put, recovery begins the moment you finish the run. Some of the smartest things you can do to aid in the recovery process has to start within the first 30 minutes of the finish.

FUEL:

First things first: let's refill the tank. A blend of carbohydrates & protein (3-to-1 or to 4-to-1 is optimal) will help to repair micro-torn muscles & jump-start the process of glycolysis (simply put, the making of glycogen, the fuel muscles use to burn for energy). You can either take this in solid or liquid form; your body will accept it either way. If you don't like to eat soon after a hard run or a race, then you can use a commercial recovery drink, like (Pacific Health Labs') Accelerade, (Aijinomoto's) Amino Vital, or (Cytosport's) Muscle Milk to get those necessary elements in that 30-minute window. Why 30 minutes? Physiological research finds muscles are more ready to accept those elements during that first 30-minute period. Besides, I can think of few things better after a hot, sweaty long run than a nice cool drink.

Low-fat chocolate milk has been the latest recovery hero; an almost perfect blend of carbohydrates & protein, and without the hassle of measuring and mixing; every little local convenience store (no matter where you are) has 16 ounce or half-liter bottles of the stuff in stock. If you can eat during that half-hour window, low-fat yogurt, a sandwich or pasta with meat sauce will also do the trick. Does it have to be both carbohydrates & protein? While carbohydrate-only refueling is better than no refueling at all, a recent study concluded runners taking carbohydrates & protein together reported less soreness compared to runners who took only carbohydrates.

HYDRATION:

At the finish of my ten-miler this morning I stepped into the porta-potty near my car. I felt like I needed to void my bladder, but all I could void was a small amount of dark yellow urine. Yes, I was definitely dehydrated; probably even before I started the run. The eight-to-ten ounces of water I took in at the halfway point of the run was a weak holding action at best in the struggle to remain hydrated. I wrung out more than that amount from my technical shirt at a mile-and-a-half to go. There are multiple schools of thought on rehydration:

Weight change - weigh yourself naked before & after the run. Rehydrate with the same amount of water or sports drink you lost in weight.

Weight change/150-percent - weigh yourself naked before & after the run. Rehydrate with 150 percent - one-and-a-half times - the amount of water or sports drink you lost in weight.

Weight - weigh yourself . Divide the number (pounds) by two. That number is the amount of water (in ounces) you should take in. This school of thought is good for those no training run days.

Urine color - drink enough water/sports drink to ensure the color of your urine is straw-colored/light yellow. The problem with this method is it's subjectivity; one person might consider their urine to be sufficiently light in color, also, vitamin supplements can color urine a bright yellow.

ALCOHOL:

I run with several friends who consider beer to be a beverage with multiple benefits; post-run carb replenishment, post-run analgesic, lubricant. One out of three is correct. Apart from killing pain (and brain cells!), alcohol affects reaction time, accuracy, balance, eye-hand coordination, & endurance. Even the night-before "barley pop carbo load" can screw up sleep cycles & hurt the next day's performance.

A 12-ounce can of beer has only 14 grams of carbohydrates, as compared to 40 grams in a can of soft drink. Athletes who drink regular beer end up running - to the bathroom - more than those who drink low-alcohol beer or alcohol-free beer. And drinking alcohol forces your liver to focus on breaking down alcohol rather than on glycolysis. So one 12-ounce can of beer can delay your body's recovery & refueling by an hour. When you have real life to accomplish outside of the run or the workout every hour counts.

If you're trying to drop a pound or few (one pound of excess weight can add two seconds per mile to a race performance) calories in alcohol pile on top of regular caloric intake. Alcohol also stimulates the appetite & makes it harder to feel full. So if you like alcohol, limit the drinks to two per day (for men; one for women). And don't forget to swap between one glass of non-alcoholic beverage for every drink.

(SELF-)MASSAGE:

I know several local massage therapists; I train one of them. I'd use their services on a weekly basis if I didn't have a real daytime job. My employer understands my occasional training & coaching-related absences to a certain degree, but I'm not willing to push the envelope on this account. So, outside of the occasional weekend "fit into the schedule" visit, my use of massage as a means of recovery is a do-it-yourself project. Some massage therapists teach self-massage to their clients as a value-added service: A smart LMT will have to work less hard on an athlete who keeps their muscles & tendons happy in between visits. The founder of Trigger Point Performance Therapy considers self-massage like tooth-brushing; you still go to the professional (like a dentist) for a thorough job or an emergency situation. Some popular self-massage items include foam rollers, therapy & sports balls for pinpoint massage, knobs; there are also at least half a dozen books on athletic & therapeutic self-massage. Check with your local health club, therapy spa, massage therapist, or athletic specialty store - not necessarily in that order - for lessons, items & recommendations on what works...and what should be avoided like the plague.

YOGA:

Yoga can be used as a cross-training or therapy tool - the core strengthening, relaxation & flexibility aspects can be used either after or in between workouts; even on those days when you're beat up or injured. There are stretches & positions which will work on the legs, core & balance.

COMPRESSION:

Lastly, compression wear - tops, tights, & socks - can help ensure blood flows from the extremities back to the heart, lungs and digestive system. They provide gentle pressure and support to the muscles, as well as retain warmth, which will allow the muscles to remain supple for a longer period of time. There are several companies which produce compression clothing, at varying levels of affordability, so every runner can take advantage of their benefits. Oh, and while there are many runners who swear by the use of compression sleeves or compression socks while racing or training, the jury is still out on the benefits; so far all they seem to do is make runners look a little geeky.

So, the best way to prepare for the next workout is to aggressively approach the recovery process immediately after the present run is completed.

The End Of Sports Fashion As We Know It

I'm certain there are people who will disagree with me, but in many cases, I believe more textile is not always a good thing. Take triathlon, for instance. The first triathletes competed in little more than a Speedo & an itty bitty singlet, with maybe a pair of high-cut running shorts for the run leg of the event; this might have been because the first really good tri-geeks were swimmers or lifeguards. Then came the first compression wear, an offshoot of cycling shorts. These have been a blessing & a curse. It seems the compressive nylon lycra cycling shorts decreases the amount of muscle vibration on the run, thus decreasing the amount of fatigue & perhaps even thwarts the onset of muscle cramps in the later stages of the run.
But the next thing you know, there are athletes participating in triathlon in full tights, near-full tights, calf sleeves, arm warmers, & so on, & so on. My heavens, whatever happened to the travel light, travel fast dictum? Okay, so the compression wear is light, but it sure as hell doesn't seem all that fast to me. In many cases I'd worry like mad about the chance of heat stroke from all that coverage. I don't care about the fact Paula Radcliffe wears compression stockings when she races marathons; she looks like a dork, or whatever the female version of dork is. FloJo is dead, ladies (& gentlemen); get past it.

But, in much the same way I am with technical stuff - a semi-late adopter - I took the time to try & read some of the research on the benefits & drawbacks of using compression clothing; when, why, how long, & so on. Most of the researchers who have written for triathlon magazines say the jury is still out on the overall benefits, but believe there's a place for compression tops, tights, & stockings in the recovery from hard workout efforts. They don't see much benefit to racing in them, however.

Still, I am a (cheap) skeptic. I almost picked up some 2XU compression wear while at the IM 70.3 expo, but there was still the little bit of sticker shock; what if this stuff was all bupkus? When Sigvaris, an RRCA corporate sponsor, was looking for a population at the recent national convention who would be willing to try a pair of their athletic recovery socks, I figured this would be the perfect time to give stockings a shot. Sigvaris is in the medical compression wear field, but their latest stuff is a far cry from the TED hose or the Jobst stockings I encountered when working at the VA hospital.

First, the stockings I was given for the study are for athletic recovery. They went up to just below the knees & provided anywhere from 20-to-30 millimeters of pressure. But I have to admit the eight hours I spent in the stockings were a fairly comfortable experience. What's more, I didn't feel (too) beat up in the evening, or the next morning when I awakened after the evening's banquetizing & socializing. My right achilles tendon was a two-to-three on a one-to-ten scale of soreness, with ten being "shoot me now." But that's pretty much par for the course, especially the week after riding 56 miles, then running 13.1 miles in succession.

I wasn't looking for miracles from the Sigvaris stockings, so feeling good the next morning was definitely a positive outcome. My response to the use of the stockings seems to align with the referenced studies (Ali, Caine, & Snow, 2007; Engineering of Sport, 2009) on the Sigvaris website (http://www.athleticrecoverysock.com/medicalstudies.php). And naturally, you get what you pay for...as a thank you for participating in the study I'll receive another pair of stockings for personal use.

But don't expect to see me wearing them on the road during one of my long training runs. I'm not ready to become uber-geek. Or would that be uber-dork?