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If you have intense training and race goals in your sights this year, recovery time should have a place on your schedule. While sleep, mobility, and foam rolling might take up some of that active rest time, one of the most common medical-grade recovery devices to become mainstream are compression boots.
These boots basically offer an air massage for your legs and some studies (albeit small ones) suggest they’re effective at reducing soreness and increasing blood flow, which is probably why many amateur runners now consider them must-haves. The catch: They are a financial investment.
Before you make the purchase, here’s what to know about compression boots, including benefits, downfalls, and how to use them.
What are compression boots and how do they work?
Compression boots use intermittent pneumatic compression, which basically means they inflate and deflate to create pressure at different points on the leg, helping to improve blood flow to your lower half.
“Your body is constantly generating metabolic waste as it produces and uses energy, and that waste gets circulated throughout your blood,” Kathleen Leninger, D.P.T., a physical therapist at Custom Performance in New York City tells Runner’s World. “Because your legs are below your heart, it’s harder for the heart to pump that waste from your legs to your lymph system, which helps get rid of it.”
The idea behind compression boots is pretty simple when you think about it that way. The compression helps your system increase blood flow to your legs, which helps circulate the waste, so your body can get rid of it faster. Not all compression is created equal, however.
How are compression boots different than compression socks?
There are two types of compression athletes use: compression and intermittent pneumatic compression. As mentioned, compression boosts use intermittent pneumatic compression, meaning they mechanically inflate and deflate segments of a sleeve at different times. Compression boots actually go all the way up to the top of your thighs, so your entire leg reaps the benefits.
Compression socks, on the other hand, squeeze the legs without movement or increases or decreases in pressure. Typically, compression socks are tighter at the bottom and get progressively looser to improve blood flow from the feet upwards, reducing swelling and discomfort in the legs.
Many compression boots allow you to control the amount of pressure and all of them offer more active compression than socks. It’s somewhat similar to the difference between an active stretch and a passive stretch. “The sheer amount of compression you’ll receive from a mechanical device will work exponentially faster than socks,” Eric Madia, assistant performance director at Athletes Warehouse in Pleasantville, New York tells Runner’s World.
The Benefits of Compression Boots
If you’ve ever worn a pair of these puffy sleeves, you know it just feels good—kind of like a massage. And “if the only benefit you get is sitting down and relaxing for 20 minutes while you use them, that’s still worth it,” says Leninger. Luckily, there are some scientifically-proven benefits when it comes to this method of exercise recovery.
For starters, the boots enhance blood flow and circulation. According to a study published in the Journal of Applied Physiology in 2018, intermittent compression applied during recovery from exercise resulted in increased limb blood flow. This can potentially contribute to changes in exercise performance and recovery, according to the authors. (Keep in mind, this study only involved 12 healthy participants.)
Compression boots can also reduce swelling. No matter what kind of run you do, whether it’s a 5K or a 50K, your muscles experience microtears from repetitive stress. “You may not even notice it, but edema, or swelling, occurs when your body starts to repair those microtears,” says Leninger. That swelling will go away naturally if you’re recovering appropriately (think: staying off your feet, elevating your legs, resting), but compression can help shorten the amount of rest you may need by preventing swelling from pooling in a certain area when you have to go straight from a run into life.
“When that metabolic waste from a workout is sitting there in your cells taking up space, that’s space that your blood could be bringing new nutrients to in the muscle,” says Leninger. The more nutrients your muscles are getting, the faster they can repair and rebuild.
A clinical trial published in 2016 in the Journal of Orthopaedic & Sports Physical Therapy, involving 72 ultramarathon runners, found that post-exercise pneumatic compression therapy offered the same benefits as post-exercise massage, specifically when it came to lowering overall muscular fatigue immediately after a run. Daily treatments using a pneumatic compression device also reduced recovery time from DOMS when compared to a continuously-worn compression sleeve, according to research published in 2018 in the International Journal of Exercise Science, which involved eight participants.
Compression Boots for Every Budget
With 10 pressure settings, you can find your precise comfort level, whether you’re using these boots for pre-training muscle activation or flushing out your legs after a workout.
These sleeves push air through four overlapping chambers, but if you switch them over to isolation mode, you can zero in on specific areas that might need more recovery.
These boots offer the same recovery benefits as the brand name devices, but at a fraction of the price.
More portable than the OG compression boots, these sleeves deliver three levels of localized compression while the detachable inner layer uses silicone spheres to enhance circulation.
With pumps integrated into each boot, these are less cumbersome than others and you can travel with them.
The NormaTec app lets you integrate your recovery data—using pre-programmed or custom massages that mimic the body’s natural recovery process—into your training plan.
The Downsides of Compression Boots
The real negative to compression boots? They can get kinda pricey. Some of the most popular systems cost around $1,000—a significant amount of money for many runners.
Another downside is that the systems are not always intuitive for the average user. Whereas your physical therapist may know exactly what setting to put you on, depending on your current training and feedback, it’s not always so obvious for the layperson who is using boots at home.
Also, while there is research on the benefits of compression boots (as explained above), most of the studies involve a small number of participants. There are also studies out there, still small but newer, that say compression boots do not have a significant benefit.
For example, one review published in the Journal of Sport Rehabilitation in 2021, which only included three studies on intermittent pneumatic compression in total, stated that this method was not an effective means of reducing exercise-induced muscle damage in endurance athletes. However, it did point out there is short-term relief, just not continued relief. And another study published in the International Journal of Exercise Science in 2020, involving just 10 distance runners, said this form of compression yielded no substantial benefits.
The bottom line: We need larger and more long-term research to say the science 100% backs up the benefits of compression boots.
How to Use Compression Boots
If you decide you want to try compression boots, even just to get that feeling of relief with them on (did we mention they simply feel good?), there are a few things to know.
First of all, while it may seem intuitive, the more training and racing you do, the more recovery you need. “In general, the harder your effort, the more metabolites, build, and waste you’re going to need to clear from your cells,” says Madia. Reserve them for after speed work, post-long run, marathon training, or after whatever workout is most taxing. They can also be especially helpful when you know you have two hard efforts back to back, says Leninger.
Madia recommends using the boots at least three to four times a week for recovery. “That’s usually one to two workouts, and then you flush your system,” he explains. “That ratio has really shown the best amount of recovery in our athletes.”
When you’re using the compression boots, Madia recommends staying below level seven on the pressure dial. “Higher pressures can cause discomfort and numbness,” he says. If you feel a tingling sensation in your feet, that’s a sign the pressure is too high. And if after a session, you can see a depression from the seams of the boots marked on your legs, that’s also a sign the pressure is too high.
In most cases, you’ll want to use the boots postworkout. “That goes back to your nervous system—before a workout, you want to to get neurologically excited; afterward, you want the opposite effect, you want your nervous system to switch to that rest and digest response, which is what the boots induce,” says Madia.
That said, not all stress is athletic stress. “If you’re someone who’s on your legs a lot—like a waitress on a later shift—then using them before a workout can be helpful in flushing out your legs,” says Leninger. In that case, 10 to 15 minutes before a workout could be helpful.
After a workout, Madia recommends spending 30 to 35 minutes in the boots. “That tends to be the sweet spot in terms of clearing out what you need to clear out,” he says. So throw on your favorite TV show and relax.
Of course, everyone’s training is different and your recovery is going to depend on your mileage, volume, and intensity. “My guideline for people is always to do the max amount of time the system allows (usually 20 minutes), then get up, go to the bathroom, walk around,” says Leninger. “If an hour later, you still feel like your workout was enough to warrant more compression, you can always do another 20 minutes.”
