Why marathon run­ners should give it socks . . .

Re­search sug­gests com­pres­sion socks may be es­sen­tial in aiding re­cov­ery

The Irish Times - Tuesday - Health - - Fitness - Ge­orge Win­ter

In 2016 Sam­sung re­ported on why socks go miss­ing. Its sur­vey of 2,000 Bri­tish adults found that a per­son loses an av­er­age of 1.3 socks per month in the wash­ing cy­cle, equalling – in Sam­sung’s prose – “a whop­ping 1,264 socks lost over their life­time!”

This sock hor­ror find­ing is rel­e­vant to those pre­par­ing for this year’s SSE Air­tric­ity Dublin Marathon, be­cause next to good train­ers should be match­ing high-qual­ity socks. A fur­ther as­pect to con­sider is that an in­creas­ingly pop­u­lar item of spe­cial­ist hosiery – com­pres­sion socks – might even en­hance per­for­mance.

Ivor O’Sul­li­van of Dublin-based Com­pres­sion Socks told The Ir­ish Times that the socks are “de­signed to im­prove blood cir­cu­la­tion and re­duce swelling to the lower legs. When cir­cu­la­tion is im­proved, de­oxy­genated blood is cleansed of lac­tates, al­low­ing for in­creased mus­cu­lar power, less fa­tigue dur­ing per­for­mance and quicker re­cov­ery time. I have had pos­i­tive feed­back from Le­in­ster Rugby . . . the head physio ex­plained they use them post-ex­er­cise to aid re­cov­ery.”

The re­lease of the enzyme cre­a­tine ki­nase (CK) into the blood­stream fol­lows mus­cle-dam­ag­ing ex­er­cise such as marathon run­ning, and fol­low­ing en­durance ex­er­cise ve­nous blood tends to pool in the lower limbs, ex­tend­ing the ex­cre­tion time of mus­cle dam­age waste prod­ucts like CK and lac­tate. How­ever, as an “old school” run­ner, I’ve never worn com­pres­sion socks. But does pub­lished peer-re­viewed ev­i­dence lend sup­port to claims favour­ing their use?


In 2015, New Zea­land re­searchers in­ves­ti­gated whether wear­ing com­pres­sion socks for 48 hours af­ter a marathon would re­duce ve­nous pool­ing and im­prove func­tional re­cov­ery, as mea­sured by a timed tread­mill test a fort­night af­ter the race. In the ran­domised con­trol trial, 33 adult ath­letes were as­signed to a com­pres­sion sock or placebo group.

Writ­ing in the Jour­nal of Strength & Con­di­tion­ing Re­search, the re­searchers re­ported: “In the com­pres­sion group, av­er­age tread­mill run to ex­haus­tion time two weeks af­ter the marathon in­creased by 2.6 per cent . . . In the placebo group, run to ex­haus­tion time de­creased by 3.4 per cent . . . This shows a sig­nif­i­cant ben­e­fi­cial ef­fect of com­pres­sion socks on re­cov­ery com­pared with placebo.”

And com­pres­sion socks ap­pear to have a role to play in re­duc­ing the risk of deep vein throm­bo­sis (DVT).

Ex­pe­ri­ences such as pro­longed air travel can ac­ti­vate the body’s co­ag­u­la­tion sys­tem, rais­ing the blood con­cen­tra­tion of fac­tors such as the throm­bin/anti-throm­bin com­plex (TAT), which can in­crease the risk of de­vel­op­ing DVT, which is a blood clot, typ­i­cally in the leg. A clot break­ing loose could cause a stroke, heart at­tack or pul­monary em­bolism.

En­durance ex­er­cise ac­ti­vates not only the co­ag­u­la­tion sys­tem but also the so-called fib­ri­nolytic sys­tem. Fib­ri­nol­y­sis is a nor­mal process pre­vent­ing nat­u­rally oc­cur­ring blood clots from de­vel­op­ing, and en­durance ex­er­cise al­lows a bal­ance be­tween co­ag­u­la­tion and fib­ri­nol­y­sis to de­velop, and thus helps pro­tect against DVT.

But in July this year Aus­tralian re­searchers – led by Dr Emma Zadow of the Uni­ver­sity of Tas­ma­nia – cited ev­i­dence demon­strat­ing that although phys­i­cal ex­er­cise ap­pears to pro­tect against DVT “the risk

This shows a sig­nif­i­cant ben­e­fi­cial ef­fect of com­pres­sion socks on re­cov­ery

of an ad­verse event is com­pounded by un­der­ly­ing and ac­quired risk fac­tors as­so­ci­ated with hy­per­co­ag­u­la­bil­ity such as oral con­tra­cep­tive use, long-haul travel [and] de­hy­dra­tion”.

In ad­di­tion, they pointed out, marathon run­ners are “ex­posed to ‘run­ning-spe­cific’ risk fac­tors in­creas­ing the risk for ve­nous throm­bo­sis gen­er­a­tion through repet­i­tive mi­cro­trauma re­sult­ing in foot strike haemol­y­sis, de­hy­dra­tion, and en­dothe­lial dam­age, which could pro­mote an in­creased con­cen­tra­tion of TAT com­plexes”.

So, might com­pres­sion socks help? Dr Zadow’s team – writ­ing in the Euro­pean Jour­nal of Ap­plied Phys­i­ol­ogy – re­ported on “com­pres­sion socks and the ef­fects on co­ag­u­la­tion and fib­ri­nolytic ac­ti­va­tion dur­ing marathon run­ning”.

On the prac­ti­cal ap­pli­ca­tions of their re­search, Dr Zadow’s team stated: “While com­pres­sion socks are fre­quently used within the sport­ing in­dus­try to en­hance ex­er­cise per­for­mance and aid re­cov­ery, the use of com­pres­sion socks within en­durance-based ex­er­cise may re­duce the po­ten­tial for throm­bo­sis de­vel­op­ment . . . There­fore, the use of com­pres­sion socks when com­plet­ing a marathon run may ben­e­fit en­durance-based ath­letes.”

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