Compression Wear Is Key to Sports and Surgical Recovery

Though you might most commonly associate it with sports, compression gear began as a medical device used for recovery from surgery or injury. "As you're removing tissue from the body, the body sends signals to fill that void with fluid," says Linda Burhance, chief product officer for Marena, a compression garment company that specializes in surgical recovery.

Compression garments are designed to prevent this from happening. The theory behind this is simple: If you prevent fluid buildup around a wound, then the area can heal quicker and with a lower risk of forming blood clots.

This idea is nothing new: People have employed compression in a medical context for a long time. The earliest known record of compression therapy comes to us from the ancient Greek "Hippocratic Corpus," a fifth-century B.C.E. medical text that recommends using tightly wound bandages to prevent swelling around lower leg wounds. The practice fell in and out of fashion over the next several centuries, eventually becoming a fairly standard treatment for swelling during the Renaissance.

Most sources agree that modern compression garments were invented sometime around 1950 by a German engineer named Conrad Jobst. Jobst had varicose veins; in an effort to wrangle his bulbous blood vessels back into shape, he developed a pair of super snug, knee-high socks designed to squeeze excess fluid out of his lower legs.

Jobst's socks were a success. It wasn't long before compression garments were being tailored for all different body parts. Today, companies like Marena work with doctors to custom-fit compression garments for patients' post-surgical needs.

"For example, if it's a facial support wrap, we work with a doctor who specializes in facial plastic surgery," Burhance explains. "If it's a liposuction garment, we would work with a doctor, or several doctors, who focus on liposuction."

Compression garments are generally considered helpful for certain medical conditions — like varicose veins and deep-vein thrombosis — as well as post-surgical recovery, provided that they're properly fitted (i.e., not too tight) per U.S. Food and Drug Administration guidelines.

But what about sports? How useful is compression gear for athletic recovery?

When Philadelphia 76ers Allen Iverson first donned a makeshift shooting sleeve to stave off elbow bursitis in 2001, he unleashed a trend that would echo throughout the NBA for the next two decades. During that crucial game, Iverson scored 51 points. A few months later, Under Armour sent him a specially designed sleeve, which he wore for the rest of the season. By 2015, 65 percent of NBA players were wearing at least one sleeve per game.

The trend caught on in other sports as well. Olympians like Allyson Felix and Meb Keflezighi helped popularize compression socks and sleeves in the running world.

In my own competitive running career, I sometimes pull on a pair of compression socks after a hard workout or race to (ostensibly) squeeze the lactic acid out of my throbbing limbs. The gear certainly makes me feel like I'm maximizing recovery; while wearing the socks, I can feel my pulse through my lower legs. The sensation is not unlike getting an intense sports massage.

However, research into the actual benefits of compression gear for athletic performance is a mixed bag. In a 2021 systematic review of 183 studies on the effect of compression garments in athletes, scientists found negligible benefit when the gear was worn during competition, though it did appear to aid slightly in recovery. Another study, published in 2012 in The Journal of Strength and Conditioning Research, found that rugby players recovered better while wearing compression tights after competition, but only if they left them on for a full 24 hours. Based on other evidence, wearing them at least 24 hours seems inadvisable.

In fairness, researchers trying to conduct these types of studies have a major hurdle to overcome: Compression is virtually impossible to "blind" (the scientific practice of randomizing treatment and placebo). Scientists can't just put a cotton tube sock on an athlete and expect them to believe it's squeezing their leg. This has led some scientists to conclude that any benefit athletes report from wearing compression gear is strictly placebo effect.

Other scientists point out that placebo gains during competition can translate to real results; if an athlete believes they have an advantage, they'll be more confident and relaxed, and may perform better in competition.

So unfortunately, that compression sleeve probably won't make you shoot like Allen Iverson. But it might just give you the confidence and swagger to intimidate your opponents on the basketball court — and if you play so hard you injure your elbow, it'll help you recover later.