Do compression garments enhance running performance? An updated systematic review and meta-analysis

Abstract

Background: Despite the wide use of compression garments to enhance athletic running performance, evidence supporting improvements has not been conclusive. This updated systematic review and meta-analysis of randomized controlled trials (RCTs) compared the effects of compression garment wearing with those of non-compression garment wearing (controls) during running on improving running performance.

Methods: A comprehensive search was conducted in the electronic databases (Web of Science, EBSCOhost, PubMed, Embase, Scopus, and Cochrane) for RCTs comparing running performance between runners wearing compression garments and controls during running, from inception to September 2024. Independent reviewers screened studies, extracted data, appraised risk of bias (RoB 2) and certainty of evidence (Grading of Recommendations Assessments, Development and Evaluation (GRADE)). Primary outcomes were race time and time to exhaustion. Secondary outcomes covered running speed and race pace, submaximal oxygen uptake, tissue oxygenation, and soft tissue vibration. Random-effects meta-analyses were conducted to generate pooled estimates, expressed in standardized mean difference (SMD). Subgroup differences of garment, race type, and contact surface were tested in moderator analyses.

Results: The search yielded 51 eligible studies comprising 899 participants, of which 33 studies were available for meta-analysis of primary outcomes. Runners wearing compression garments during running showed no significant improvement in race time (SMD = -0.07, 95%CI: -0.22 to 0.09; p = 0.40) or time to exhaustion (SMD = 0.04, 95%CI: -0.20 to 0.29; p = 0.72). Moderator analyses indicated no effects from garment type, race type, or surface. Secondary outcomes also showed no performance benefits, although compression garments significantly reduced soft tissue vibration (SMD = -0.43, 95%CI: -0.70 to -0.15; p < 0.01). Certainty of evidence was rated low to very low.

Conclusion: Data synthesis of current RCTs offers no updated evidence favoring the support of wearing compression garments during running as a viable strategy for improving running and endurance performance among runners of varying performance levels and types of running races.

Keywords: Endurance; Performance enhancement; Runners; Sprint.

Graphical abstract

Fig. 1

Preferred reporting items for systematic reviews and meta-analysis (PRISMA) flow diagram of the literature screening and selection process.

Fig. 2

Characteristics of study outcomes included in this systematic review and meta-analysis. Performance = performance level; Pressure1 = pressure characteristics; Pressure2 = pressure measurement method. G = gradual; NM = not mentioned; RG = reverse gradual. Percentages may not add up to 100% due to rounding.

Fig. 3

The forest plot showing the effect of compression garment wearing on race time, as compared with controls. The black square represents the pooled SMD and its 95%CI. Estimates were calculated using a random-effects model meta-analysis. 95%CI = 95% confidence interval; NM = not mentioned; SMD = standardized mean difference.

Fig. 4

The forest plot showing the effect of compression garment wearing on time to exhaustion, as compared with controls. The black square represents the pooled SMD and its 95%CI. Estimates were calculated using a random-effects model meta-analysis. 95%CI = 95% confidence interval; SMD = standardized mean difference.