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Original Research

Graduated Compression Sleeves

Effects on Metabolic Removal and Neuromuscular Performance

Martorelli, Saulo S.1; Martorelli, André S.1; Pereira, Maria C.1; Rocha-Junior, Valdinar A.1; Tan, Jeremy G.2; Alvarenga, José G.1; Brown, Lee E.2; Bottaro, Martim1

Author Information
The Journal of Strength & Conditioning Research: May 2015 - Volume 29 - Issue 5 - p 1273-1278
doi: 10.1519/JSC.0000000000000401
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Athletes have used numerous strategies in an attempt to improve their performance in training and competition. Recently, compression garments have become popular as an attempt to improve sport performance (2,25) including volleyball, basketball, and track and field which all rely on muscle power (26).

Previous studies have found recovery benefits from the use of compression garments following exercise-induced muscle damage (1,10,14,15,29,31) and performance during continuous exercise (2,11,19). However, few studies have examined their effects on performance during predominantly anaerobic exercise (15,16,26,29,30,35).

It has been previously shown that the external pressure applied by compression sleeves (CS) increases forearm blood flow (4). This change in blood flow may provide quicker lactate clearance leading to increased performance, especially during high-intensity intermittent exercise (5). Furthermore, compression garments seem to increase sensory feedback and muscle proprioception while decreasing muscle vibration (2,5,12,26,27). The combination of these mechanisms might improve power, strength, and fatigue resistance, as well as metabolic removal.

Chatard et al. (6) found lower lactate levels ([La]) and an improvement in power maintenance when performing 2 consecutive maximal cycle ergometer tests while wearing compression socks. Lovel et al. (33) conducted a high-intensity running protocol and found lower [La] when waist-to-ankle compression garments were used. Furthermore, Doan et al. (12) found increases in jump height and decreased muscle oscillation without improvement in running performance while wearing compression shorts. However, Dascombe et al. (9) demonstrated that wearing upper-body compression garments did not improve cardiorespiratory, oxygenation measures or performance during flat-water kayaking.

The use of compression garments seems beneficial in athletes during training by increasing muscle power (27). Wearing compression garments may allow training at a higher physiological intensity, which results in completion of a greater training volume (16). This may prove to be beneficial chronically as improvements of 1.3% seem to influence success in competition (13).

A majority of previous studies have investigated the use of lower-body compression garments; however, upper-body compression garments have become increasingly popular among recreational and professional athletes. Thus, because of the controversies between lower-body compressions garments on lactate clearance and neuromuscular performance, as well as the lack of studies on upper-body compression garments, the aim of this study was to examine the effects of upper-body graduated CS on neuromuscular and metabolic responses during power training. We hypothesized that the use of the CS will improve power, strength, exercise time to failure, and lactate removal.


Experimental Approach to the Problem

Each subject attended 4 training sessions. In the first 2 sessions, they performed familiarization and a bench press 1 repetition maximum (1RM) test. In the 2 subsequent sessions, they performed identical resistance training protocols under 2 different conditions: with CS and with placebo sleeves (PS) in a counterbalanced fashion. In accordance with the manufacturer's instructions, arm circumference was used to select the size of the sleeves (Skins, Sydney, Australia). The PS were visually similar to the graduated CS, but did not have the capacity for compression. Sleeves were worn for the entire duration of the protocol.

All sessions were separated by a minimum of 72 hours. The power training protocol consisted of 6 sets of 6 repetitions with a load of 50% 1RM. A 1-minute rest was given between the sets. Before and after the protocol, they performed a maximal voluntary isometric contraction (MVIC) test. After resting for 30 minutes in a seated position, they performed a bench press test for repetitions to failure with 50% 1RM.


Fifteen resistance trained men (age: 23.07 ± 3.92 years; body mass: 76.13 ± 7.62 kg; height: 177 ± 6 cm) voluntarily participated in this study. No subjects were under 18 years old. Inclusion criteria included 6 months experience resistance training and a bench press 1RM equal to at least their own body mass. All subjects were tested at the same time of the day during the 4 visits. They were also asked to maintain their drinking and eating habits and refrain from any physical activity. Subjects were properly informed of the study's purpose, procedures, risks and benefits before reading and signing an informed consent form approved by the Institutional Ethics Committee. Exclusion criteria included any history of cardiovascular disease or orthopedic limitations.

One Repetition Maximum

The bench press 1RM was assessed in a Smith machine (Rotech Fitness, Goiânia, Brazil) by determining the highest load that could be lifted in 1 single repetition using a protocol previously published (32). After performing a specific warm-up (using submaximal loads according to the subject's training log), resistance was adjusted to estimate the 1RM. Volunteers were instructed to lift the load once, while maintaining proper technique and completing the full range of motion. Each successive lift was attempted after 5-minute rest. The load was progressively increased until failure, with no more than 5 attempts performed. The greatest load completed with proper technique was deemed to be the 1RM.

Muscle Power

Mean and peak power were measured during the bench press exercise in sessions 3 and 4 by a linear power control device (Peak Power; Cefise, Sao Paulo, Brazil) connected to the Smith machine (Figure 1). During the tests, average velocity (m·s−1) and power (W) were recorded by a rotary encoder. Mean power was the average power achieved during each set while peak power was the highest power achieved during the set. The calculation of instantaneous velocity and power was performed, and it has been described elsewhere (22,23). Power (W) was assessed at 50% of the 1RM.

Figure 1
Figure 1:
Power test setup.

Isometric Strength Test

Bench press isometric strength was measured by a load cell using the Miotool 400 system (Miotec, Rio Grande do Sul, Brazil). Two MVICs (3 seconds long, separated by 1 minute of rest) were collected using Miograph 2.0.20 software (Miotec). Measurement was made with the elbow at an angle of 90° of flexion. The highest value obtained for the 2 MVICs was considered their maximal isometric strength. Measurements were made before (PRE) and 2 minutes after (POST) each resistance training session.

Muscle Activation

Muscle activity of the triceps brachii, anterior deltoid, and pectoralis major muscles was assessed with a bipolar electrode configuration (Mini Medi-Trace 100; Tyco Healthcare, Cork, Ireland). Surface electromyography data were collected on the right side of the body during the MVIC test using a multichannel amplifier (Miotool 400; Miotec, Porto Alegre, Brazil). The signal was filtered (−3 dB bandwidth = 10–500 Hz, fourth order Bessel filter), sampled at 2000 Hz, and converted to digital data by a 14-bit A/D converter board. For the triceps brachii and anterior deltoid muscles, the electrodes were positioned in previously detected zones, as defined by the SENIAM project (Surface ElectroMyography for the Non-Invasive Assessment of Muscles). For the pectoralis major muscle, electrodes were positioned according to Clemons and Aaron (7). A reference electrode was placed on the spinous process at C7. Root mean square (RMS) values from the electromyographical signal were calculated with a specific routine written in Matlab 6.5 (Mathworks, Natick, MA, USA).

Repetitions to Failure Test

The repetitions to failure test were performed with 50% of 1RM. Participants were instructed to perform repetitions to the speed of a metronome (1.5 seconds each for concentric and eccentric actions) (20,21,36). The test was concluded when they were unable to maintain the pace of the metronome. The maximal number of repetitions performed was recorded for analysis.

Blood Lactate Concentration

Blood lactate concentration was determined from a capillary blood sample (25 ml) from the earlobe. Blood samples were taken before (PRE), 3 minutes post (POST), and 30 minutes post (30 POST) the bench press resistance session. Samples were collected with a heparinized capillary tube and then added to a labeled Eppendorf tube filled with buffer (1% sodium fluoride) at a ratio of 1:3 (blood to buffer). All samples were placed in refrigeration at approximately 4° C. Samples were analyzed using a YSI 1500 Lactate Analyzer (Yellow Springs Instrument, Yellow Springs, OH, USA).

Statistical Analyses

Data are reported as mean ± SD. The test-retest reliability was p = 0.994. DataTwo 2 × 6 (condition × sets) repeated-measures analyses of variance (ANOVAs) were used to determine significant differences in mean power and peak power. A 2 × 3 (condition × time) repeated-measures ANOVA was used to determine significant differences in blood lactate concentration. A 2 × 2 (condition × time) repeated-measures ANOVA was used to determine significant differences in maximal isometric strength. A paired t-test was used to determine significant differences in repetitions to failure. Statistical significance was set a priori at p ≤ 0.05. All statistical procedures were performed using the statistical software package SPSS 17 (SPSS Inc., Chicago, IL, USA).


For mean power and peak power, there was no significant interaction or main effect for condition. However, there was a significant main effect for sets with values decreasing across sets (Figure 2). The mean power was significantly greater in set 1 compared with sets 3, 4, 5, and 6, and significantly greater in sets 2, 3, and 4 compared with set 6. Peak power was significantly greater in set 1 compared with sets 3, 4, 5, and 6.

Figure 2
Figure 2:
Values for mean power (A) and peak power (B) across sets. * = significantly greater than sets 3, 4, 5, and 6. + = significantly greater than set 6.

For isometric strength, there was no significant interaction or main effect for condition. However, there was a significant main effect for time. POST values were significantly less than PRE values (Table 1).

Table 1
Table 1:
Isometric strength values (mean ±SD) by condition and time.*

For repetitions to failure, there were no significant interactions or main effects for condition or time. Subjects performed similar number of repetitions (CS 17.69 ± 3.68 and PS 17.81 ± 2.81). For muscle activation of the triceps brachii, anterior deltoid, and pectoralis major muscles, there were no significant interactions or main effects for condition or time (Table 2).

Table 2
Table 2:
Surface electromyography root mean square values (mean ±SD) by time (PRE and POST) and condition (CS and PS) for PM, AD, and TB muscles.*

For blood lactate concentration, there was no significant interaction or main effect for condition. However, there was a main effect for time. Blood lactate concentration was significantly greater at POST compared with PRE and 30 POST (Figure 3).

Figure 3
Figure 3:
Blood lactate values by time. * = significantly greater than PRE and 30 POST.


The purpose of this study was to examine the effects of upper-body graduated CS on neuromuscular and metabolic responses during power training in the bench press exercise. The main results suggest that there is no effect of wearing graduated CS on neuromuscular performance or metabolic responses. These results rejected our hypothesis. Possible explanations for this might be an insufficient amount of compression by the sleeves to cause changes in blood flow. Consequently, there was no improvement in metabolite removal.

This study confirms previous research that found no positive effects on muscle power with the use of upper-body compressive garments during a kayak exercise (9). Conversely, studies involving jump performance have demonstrated increased performance with compression garment use (2,26). One possible mechanism that could explain performance gains is increased proprioception in the compressed limb. In this study, exercise was performed on a machine. This type of equipment reduces the proprioceptive requirements (skin, muscle, and joint receptors) essential for optimal performance, as the machine provides guidance to maintain the movement pattern (8).

The same mechanism could explain why no differences were found in repetitions to failure. This finding supports previous research that has reported no differences in repetitions performed in a squat test performed with 70% 1RM while wearing compression shorts (28). Unlike this study, in which we wanted to examine acute changes resulting from wearing compression garments during power training, other studies have found quicker muscle recovery 24 hours after the experimental protocol (24,29,30). In these cases, the compressive garments were worn only after the experimental protocol, for periods of 12–120 hours.

Our analysis of muscle activation showed no significant differences between protocols. Also, no differences were found between PRE and POST time points confirming a previous study where EMG from the pectoralis major and anterior deltoid was analyzed during the bench press (17). The authors reported no differences in performance or activation, even when the muscles were fatigued. During sustained submaximal isometric actions to fatigue (50% of maximal isometric force), the number of motor units recruited increases, which causes an increase in RMS values (34). However, in maximum effort situations, a large proportion of motor units are recruited at the beginning of the activity. Therefore, there is a limited amount of increase in the number of motor units recruited in fatigue situations. In this situation, RMS values can remain constant (17) or even decrease (34) while maintaining the same performance level.

We also found no difference in blood lactate concentration between conditions, but it did increase significantly at POST. These results corroborate previous studies that found no differences in blood lactate concentration between test protocols in rugby players (15) or following different running protocols (2,37). In one of the few studies that used upper-body compression garments, they tested 6 types of CS to assess differences in forearm blood flow (4). They found that compression increased blood flow for 3 minutes, reaching a plateau at 115% and returning to baseline 1 minute after removal of the sleeves. The lower blood lactate concentration found when wearing compression garments may be associated with enhanced venous return and increased lactate removal during exercise (3,6). In addition, upper limbs do not experience the same pronounced venous hydrostatic pressure as do the lower limbs (4). Therefore, doubts remain regarding the systemic mechanisms and pressure required to cause changes in blood flow of the upper limbs. Moreover, a previous study reported that the elasticity of compressive garments increased flexion and extension torque resulting in greater power output of the specific muscular action (12). This effect was not observed in this study, possibly because of the small surface area that was compressed by the sleeves (from wrist to shoulder), thereby exerting no compression on the primary movers (anterior deltoid and pectoralis major). However, this justification needs more investigation because the definition of prime movers and accessory muscles during multijoint exercises is controversial (18). Studies have shown that small muscle groups are recruited at an equal or greater extent than the prime movers (7,38). Clemons and Aaron (7) reported that during bench press exercise, triceps brachii percent of MVIC was greater than the pectoralis major. In addition, the results from this study reported the same muscle activation between triceps brachii and pectoralis major. In summary, the results of this study suggest that wearing upper-body CS during power training in the bench press exercise does not elicit positive effects in neuromuscular performance or metabolic responses in young trained men.

Practical Applications

Although graduated CS did not enhance muscle performance during power training, they also did not hinder it. Therefore, coaches and athletes may use graduated CS at their preference for other purposes. Compression clothing use during resistance training should be further investigated, including studying their effects at different levels and areas of compression, with higher intensities and with different power exercises or activities (i.e., squat jump, bench press throw, and plyometric exercises).


This study was partially supported by the Brazilian Council for the Research Development (CNPq) and by the Coordination for the Improvement of Higher Level Personnel (Capes).


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compressive garment; muscle power; blood lactate; resistance training; muscle activation

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