Can Compression Socks Make You Run Faster?

Podiatrists have been prescribing compression socks for years to treat things like chronic edema, lymphedema, varicose veins, and to prevent deep venous thrombosis; but recently they have started showing up on perfectly healthy runners. Yes, sometimes compression socks are used to treat shin splints, but do they make you faster? Can you run longer in compression socks? Many runners and triathletes swear by wearing compression they feel faster and recover better. Do they really work? Is there any scientific evidence that they really work? Or is this just more running lore?

In 2007, one study showed no increase in endurance or speed, but they were shown to stimulate blood flow, helping legs recover faster from a hard run. OK, so they help recovery, but can they make me faster? That early study didn’t think so, but that’s why we kept looking.

Most theories about how compression socks improve running performance focus on the physiological and biomechanical support of the lower legs.

It is assumed that compression socks may enhance venous return to the heart through a more efficient calf muscle pump, leading to increased endurance capacity. And there is the notion that because muscles are kept more compact, balance and proprioception are improved and muscle fatigue is minimized. Sounds reasonable, but again, what does the research show?

It wasn’t until 2009 that a German study clearly showed that they enhance performance during hard runs. And research done in South Africa and New Zealand both show that knee-highs also improve recovery by boosting blood flow in the extremities. In fact, even compression socks (not your Grandma’s TED hose) have been shown to increase resting arterial circulation by 30% and 40% under physical strain. Many compression sock companies even tout that they have studies that shoe an increase in running efficiency by 5%, which can equate to taking 12 minutes off a four-hour marathon. Crazy? Maybe not?

Yet they still aren't for everyone. One German study conducted on super-fit elite athletes (not most of us in the back of the pack) reported no performance payoffs from compression. According to the study, the socks work better when they're squeezing more performance out of non-elites (you and me).

Lots more studies to come, but if donning some hot pink knee socks will take 12 minutes off my marathon time, bring them on!

Should Diabetic Runners Use Sports Drinks?

I get a lot of questions from diabetic runners about the use of sports drinks during exercise. Should they drink straight water or a “diet electrolyte solution”? Can they mix in or use a regular carbohydrate-electrolyte solution for carbohydrate replacement and energy?

Great question! Drilling down a title further, most diabetics are truly concerned about spikes in blood sugar and bottoming out during exercise, which may cause fatigue symptoms and decreased endurance. There is some validity to these concerns, but studies show the benefits out weigh the risks as long as you are utilizing 5-8% carbohydrate solution. Higher concentrations will delay gastric emptying an actually slow rehydration which can lead to dehydration especially in our hot climates. A recent article actually explains this well: “Drinking carbohydrate-electrolyte solutions before exercise does produce, during exercise, rapid rises in blood glucose and insulin concentrations, followed by a sharp fall in blood glucose. However, as exercise continues, blood glucose concentrations normally return to pre-exercise values. It is interesting to note that, even on the occasions when blood glucose concentrations fall to hypoglycemic values during the early part of prolonged exercise, the subjects in these studies do not report any adverse sensations.”

Interested in learning more? Click here to take you to the original article.

New Study: Foot Orthotics Can Prevent Running Injuries

The top three questions runners ask about custom foot orthotics are:
1. Should they use orthotics in their shoes while running if they don’t have an injury?
2. If they have fatigue in their legs while running or a jacked up gait, they often wonder of orthotics will help?
3. Should they wear orthotics forever after an overuse injury?

The answers are yes, yes and yes!! A new study showed that orthotics have a significant benefit in reducing running injuries as prophylaxis. It makes common sense, that if you have an underlying biomechanical deficit, orthotics give you better alignment so therefore should reduce overall abnormal stressors and subsequently injuries. Now there is a new study that shows just that! Piggy-back that on years of biomechanics research and the answers get much more clear.

This study demonstrated that the subjects who wore orthotics had "a significantly reduced rate of exercise-related lower limb injury across the training period". The authors emphasized that participants were not treated for an injury with orthotics, but were prescribed orthotics to prospectively reduce the risk of injury. In addition, they believe that these "preventative results can be cautiously extrapolated to a recreational running setting and should be considered by sports and exercise medicine professionals."

We generally prescribe foot orthotics to treat specific injuries. This study indicates that orthotics can be a valuable prophylactic tool for injury prevention, supporting orthotic use in at-risk populations (e.g. runners) for medial stress syndrome, iliotibial band syndrome and Achilles tendinopathy. Considering the results of this study and the results of a previous study on the use of orthotics in runners by Mundermann, it is recommended to use at least a pre-fabricated Powerstep orthotic which incorporate a medial heel skive and rearfoot post, as a cost-effective means of providing prophylaxis with corrections proven effective in runners. Runners with a previous history of these injuries and/or those that develop symptoms would be good candidates for custom orthoses based on the results of these two studies.

Franklyn-Miller A, Wilson C, Bilzon J, et al. Foot orthoses in the prevention of injury in initial military training: a randomized controlled trial. Am J Sports Med 39(1):30-37, 2011

Mundermann A, Nigg BM, Humble RN, et al. Foot orthotics affect lower extremity kinematics and kinetics during running. Clin Biomech 18(3):254-262, 2003