Compression socks and the effects on coagulation and fibrinolytic activation during marathon running

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.