Abstract
Purpose
Compression socks are frequently used in the treatment and prevention of lower-limb pathologies; however, when combined with endurance-based exercise, the impact of compression socks on haemostatic activation remains unclear.
Objectives
To investigate the effect of wearing compression socks on coagulation and fibrinolysis following a marathon.
Methods
Sixty-seven participants [43 males (mean ± SD: age: 46.7 ± 10.3 year) and 24 females (age: 40.0 ± 11.0 year)] were allocated into a compression (SOCK, n = 34) or control (CONTROL, n = 33) group. Venous blood samples were obtained 24 h prior to and immediately POST-marathon, and were analyzed for thrombin–anti-thrombin complex (TAT), tissue factor (TF), tissue factor pathway inhibitor (TFPI), and D-Dimer.
Results
Compression significantly attenuated the post-exercise increase in D-Dimer compared to the control group [median (range) SOCK: + 9.02 (− 0.34 to 60.7) ng/mL, CONTROL: + 25.48 (0.95–73.24) ng/mL]. TF increased following the marathon run [median (range), SOCK: + 1.19 (− 7.47 to 9.11) pg/mL, CONTROL: + 3.47 (− 5.01 to 38.56) pg/mL] in all runners. No significant post-exercise changes were observed for TAT and TFPI.
Conclusions
While activation of coagulation and fibrinolysis was apparent in all runners POST-marathon, wearing compression socks was shown to reduce fibrinolytic activity, as demonstrated by lower D-Dimer concentrations. Compression may reduce exercise-associated haemostatic activation when completing prolonged exercise.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- DVT:
-
Deep vein thrombosis
- ELISA:
-
Enzyme-linked immunosorbent assay
- TAT:
-
Thrombin–anti-thrombin complex
- TF:
-
Tissue factor
- TFPI:
-
Tissue factor pathway inhibitor
References
Bartsch P, Welsch B, Albert M, Friedmann B, Levi M, Kruithof EK (1995) Balanced activation of coagulation and fibrinolysis after a 2-h triathlon. Med Sci Sports Exerc 27:1465–1470
Benko T, Cooke EA, McNally MA, Mollan RA (2001) Graduated compression stockings: knee length or thigh length. Clin Orthop Relat Res 383:197–203
Cohen J (1992) A power primer. Psychol Bull 112:155–159
Dill DB, Costill DL (1974) Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 37:247–248
El-Hagracy RS, Kamal GM, Sabry IM, Saad AA, Abou El Ezz NF, Nasr HA (2010) Tissue factor, tissue factor pathway inhibitor and factor VII activity in cardiovascular complicated type 2 diabetes mellitus. Oman Med J 25:173–178. https://doi.org/10.5001/omj.2010.52
ElSayed MS, Lin X, Rattu AJM (1995) Blood coagulation and fibrinolysis at rest and in response to maximal exercise before and after a physical conditioning programme. Blood Coagul Fibrinolysis 6:747–752. https://doi.org/10.1097/00001721-199512000-00009
Hilberg T, Jeschke D, Gabriel HH (2002) Hereditary thrombophilia in elite athletes. Med Sci Sports Exerc 34:218–221
Hilberg T, Glaser D, Reckhart C, Prasa D, Sturzebecher J, Gabriel HH (2003) Blood coagulation and fibrinolysis after long-duration treadmill exercise controlled by individual anaerobic threshold. Eur J Appl Physiol 90:639–642. https://doi.org/10.1007/s00421-003-0907-2
Hull CM, Hopkins CL, Purdy NJ, Lloyd RC, Harris JA (2015) A case of unprovoked venous thromboembolism in a marathon athlete presenting atypical sequelae: what are the chances? Scand J Med Sci Sports 25:699–705. https://doi.org/10.1111/sms.12262
Kestin AS, Ellis PA, Barnard MR, Errichetti A, Rosner BA, Michelson AD (1993) Effect of strenuous exercise on platelet activation state and reactivity. Circulation 88:1502–1511
Kraemer WJ et al (2001) Influence of compression therapy on symptoms following soft tissue injury from maximal eccentric exercise. J Orthop Sports Phys Ther 31:282–290. https://doi.org/10.2519/jospt.2001.31.6.282
Kupchak BR, Volk BM, Kunces LJ, Kraemer WJ, Hoffman MD, Phinney SD, Volek JS (2013) Alterations in coagulatory and fibrinolytic systems following an ultra-marathon. Eur J Appl Physiol 113:2705–2712. https://doi.org/10.1007/s00421-013-2709-5
Millar-Craig MW, Bishop CN, Raftery EB (1978) Circadian variation of blood-pressure. Lancet 1:795–797
Molz AB, Heyduck B, Lill H, Spanuth E, Rocker L (1993) The effect of different exercise intensities on the fibrinolytic system. Eur J Appl Physiol Occup Physiol 67:298–304
Para I, Leach N, Negrean V, Alexescu T (2015) Venous pathology in athletes. Palestrica of the Third Millen Civiliz Sport 16:351–354
Parker B, Augeri A, Capizzi J, Troyanos C, Kriz P, D’Hemecourt P, Thompson P (2011) Effect of air travel on exercise-induced coagulatory and fibrinolytic activation in marathon runners. Clin J Sport Med 21:126–130. https://doi.org/10.1097/JSM.0b013e31820edfa6
Parker BA et al (2012) Effect of marathon run and air travel on pre- and post-run soluble d-dimer, microparticle procoagulant activity, and p-selectin levels. Am J Cardiol 109:1521–1525. https://doi.org/10.1016/j.amjcard.2012.01.369
Posthuma JJ, van der Meijden PE, Ten Cate H, Spronk HM (2015) Short- and Long-term exercise induced alterations in haemostasis: a review of the literature. Blood Rev 29:171–178. https://doi.org/10.1016/j.blre.2014.10.005
Prisco D et al (1998) Evaluation of clotting and fibrinolytic activation after protracted physical exercise. Thromb Res 89:73–78
Siegel AJ, Stec JJ, Lipinska I, Van Cott EM, Lewandrowski KB, Ridker PM, Tofler GH (2001) Effect of marathon running on inflammatory and hemostatic markers. Am J Cardiol 88:918–920, A919
Sumann G et al (2007) Blood coagulation activation and fibrinolysis during a downhill marathon run. Blood Coagul Fibrinolysis 18:435–440. https://doi.org/10.1097/MBC.0b013e328136c19b
Tarnay TJ, Rohr PR, Davidson AG, Stevenson MM, Byars EF, Hopkins GR (1980) Pneumatic calf compression, fibrinolysis, and the prevention of deep venous thrombosis. Surgery 88:489–496
Telford RD, Sly GJ, Hahn AG, Cunningham RB, Bryant C, Smith JA (2003) Footstrike is the major cause of hemolysis during running. J Appl Physiol 94:38–42. https://doi.org/10.1152/japplphysiol.00631.2001
Theiss JL, Fink ML, Gerber JP (2011) Deep vein thrombosis in a young marathon athlete. J Orthop Sports Phys Ther 41:942–947. https://doi.org/10.2519/jospt.2011.3823
Versteeg HH, Heemskerk JW, Levi M, Reitsma PH (2013) New fundamentals in hemostasis. Physiol Rev 93:327–358. https://doi.org/10.1152/physrev.00016.2011
Weiss C et al (1998) Coagulation and thrombomodulin in response to exercise of different type and duration. Med Sci Sports Exerc 30:1205–1210
Weiss C, Bierhaus A, Kinscherf R, Hack V, Luther T, Nawroth PP, Bartsch P (2002) Tissue factor-dependent pathway is not involved in exercise-induced formation of thrombin and fibrin. J Appl Physiol 92:211–218
Zaleski AL et al (2015a) The effect of compression socks worn during a marathon on hemostatic balance. Phys Sportsmed 43:336–341. https://doi.org/10.1080/00913847.2015.1072456
Zaleski AL, Pescatello LS, Thompson PD, Taylor BA (2015b) Protective effect of compression socks in a marathon runner with a genetic predisposition to thrombophilia due to Factor V Leiden. Phys Sportsmed 43:324–327. https://doi.org/10.1080/00913847.2015.1043183
Acknowledgements
We wish to disclose that this project received financial support through compression garments being provided in-kind by sporting clothing manufacturer 2XU and the Australian Institute of Sport; however, this company was neither involved in the study design, the process of data collection, nor data analysis. The authors would like to thank Mr Samuel Hughes, Ms Kaylee Orton, Mr Mohammed Jawad Yousaf Zai, Ms Chris Heenan, Ms Sarah Trehearn, Ms Jasmine Wadham, Ms Laura Blay, Ms Franca Helman, Dr Shi Zhou, and Events Queensland for their assistance with this project.
Author information
Authors and Affiliations
Contributions
EKZ contributed to the concept of the study design, data collection, interpretation and analysis, and wrote the manuscript. MJA contributed to the study design, data interpretation and analysis, and the revision of the manuscript. SSXW contributed to the study design, data collection, and the revision of the manuscript. CMK contributed to the study design, data interpretation and analysis, and the revision of the manuscript. IS contributed to data collection and revision of the manuscript. AK contributed to data collection and revision of the manuscript. NB contributed to data collection and revision of the manuscript. ANBJ contributed to the study design and the revision of the manuscript. JC contributed to the concept of study design and revision of the mansucript. ACB contributed to data collection and revision of the manuscript. SLH conttibuted to the study design and revision of the manuscript. JWF contributed to the concept of the study design, data interpretation and analysis, and the revision of the manuscript.
Corresponding author
Additional information
Communicated by Fabio Fischetti.
Rights and permissions
About this article
Cite this article
Zadow, E.K., Adams, M.J., Wu, S.S.X. et al. Compression socks and the effects on coagulation and fibrinolytic activation during marathon running. Eur J Appl Physiol 118, 2171–2177 (2018). https://doi.org/10.1007/s00421-018-3929-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-018-3929-5