Recovery Part 3- Compression and Cold Therapy

In our previous posts on recovery, we have highlighted the importance of a good night’s sleep and the value of optimizing post-workout nutrition. While those two categories are the giants in the recovery arena, there are several other areas that can enhance the recovery process. In this article we will discuss the use of compression garments and cold therapy. The mechanisms of action for the two therapies are different, however they each have the ability to reduce exercise-induced swelling.

It is now commonplace to see recreational exercisers and athletes wearing compression socks, pants, tops, or even suits. Because gravity is always acting upon our body, a common phenomenon during a prolonged bout of exercise that occurs is the pooling of blood in our extremities. The same phenomenon happens during air travel, where our feet and hands become swollen. The use of compression garments during and after training or air travel can assist our venous system in returning blood back to the heart thus minimizing the resulting swelling. Compression has been shown to reduce swelling, blood lactate concentration during maximal exercise, improve lactate clearance, reduce muscle vibration and oscillation, reduce effects of delayed onset muscle soreness, and improve perceptions of recovery status.

Cold Therapy in the form of cold water immersion (aka ice bath, cold tub) has been involved in athletics for a very long time. Many sports medicine facilities are equipped with tubs and whirlpools filled with ice that athletes can hop into following a hard practice, game, or training session. The efficacy of cold water immersion has been mixed in research but some benefits include a decrease in metabolic activity and tissue breakdown, improved lymphatic drainage, reduced inflammation, and an improved perception of recovery status.

If you choose to give compression garments a try, make sure that you purchase a product that has graduated compression. Research is clear that a compression gradient, where compression is greater lower on the extremity and is reduced further up the limb is ideal in improving venous return. Levels of compression necessary for a therapeutic effect can vary per individual but should be in the area of 20-25mmHg. A garment may only hold its optimal compression properties for several months under regular use, so replace or rotate your garments frequently.

Water temperature is critical to cold water immersion to elicit a therapeutic effect. The ideal water temperature for water immersion has been shown to be in the area of 50-59 degrees. Exposure time during cold water immersion is similar to ice pack treatments following an injury, which should be 15-20 minutes immediately following the game, practice, or training session.

Compression garments are best worn during a prolonged endurance event, following any exercise session, during sleep, and during air travel. The only caution to wearing compression garments during an event or training session comes in the presence of extreme heat. Compression garments can interfere with the body’s ability to cool itself during exercise. Socks are likely a better garment choice under these conditions, while a pant, or full suit is better suited for post-workout recovery and air travel.

Cold therapy should be initiated immediately following an event or training session to optimize the treatment. Neoprene socks can be worn in the tub to take the edge off of the intense cold on the feet, and allow for a slightly more pleasant experience. Cold water immersion is sometimes used in conjunction with hot water plunges. This is known as a contrast bath and helps to create a pumping action from the constriction and dilation of blood vessels. If contrast baths are being performed remember to always end with a cold treatment, as the body will naturally re-warm itself.

Next up in the Recovery Series, Part 4- Soft Tissue Mobilizations