by Richard Ellin, MD, FACP
Question: It seems compression gear is everywhere these days. I’m reading more about it, including John Marsh’s product review of compression sleeves and socks. But I’m wondering if, medically, it really is an effective tool for cyclists? – Kirk G.
Dr. Richard Ellin Responds: What follows is a summary of what compression hose does and how it is used medically. I have not found any evidence that it is helpful to cyclists, unless they have an underlying problem with leg swelling (edema) or venous insufficiency (for example, from moderate or severe varicose veins).
However, I have used compression socks for years and, like John and many other cyclists, derive at least the psychological benefit of believing they make my legs and knees feel better after, especially, hard rides – and that they benefit my recovery. (I wear them when I bike to work, too, as a matter of convenience, but don’t notice any benefit from wearing them while riding.)
So, compression may be lumped in with such cycling gear as carbon wheels and 13-pound bikes in that their positive effects may be more in the realm of the feeling of improvement or benefit than in the hard scientific evidence of benefit. But there are innumerable studies showing that if such things actually make you feel better, then there’s benefit in that.
There’s no harm in trying compression gear to see if it makes you feel better after a ride, or enhances your feeling of recovery. If it does, great! If not, move on – and maybe invest in that 13-pound bike or some new carbon hoops!
Here’s How Compression Works Medically
Lower extremity graduated compression stockings are commonly used, and are effective, for counteracting swelling of the legs.
These prescriptions vary depending on the symptoms and signs of venous disease and patient factors. The grade of compression, length (i.e. knee-high vs. thigh-high or pantyhose type), and type of stocking must be specified on the prescription written by the physician.
If one has a reason to use compression hose, they should be instructed to schedule a morning appointment shortly after waking to minimize accumulation of edema. If this is not possible, some clinicians and fitting technicians have patients elevate their legs for 30 to 90 minutes prior to leg measurements to get a more accurate fit. Alternatively, if edema is severe, compression bandages can be applied to gradually reduce edema over a period of several weeks prior to fitting compression stockings.
Compression stockings should exert a minimum of 20 to 30 mmHg pressure at the ankle to be effective. The white “anti-embolism” stockings commonly given to patients in the hospital exert only 8 to 10 mmHg pressure at the ankle, which may be effective for the prevention of deep venous thrombosis (blood clots) in someone who has never had a clot, but is not an adequate treatment of venous insufficiency.
A higher grade of compression stockings (30 to 40 mmHg) is prescribed when symptoms and signs are more severe. Higher grade compression garments (in the range of 40 to 50 mmHg or 50 to 60 mmHg) are available but are usually reserved for patients with chronic lymphedema or in the management of burn scars.
Richard Ellin, MD, FACP, is a board-certified specialist in Internal Medicine who practices in Alpharetta, Georgia. He received his medical degree and completed residency at Emory University, and has been in practice with Kaiser Permanente for more than 26 years. He is also an avid cyclist.