Recovery aids are now a burgeoning industry as athletes seek to train harder, recover better, and ultimately improve overall performance. With a new product on the market every week claiming to be bigger and better, it’s hard to know which is best.
One such recovery aid that does have some scientific backing is pneumatic compression boots, of which there are multiple manufacturers offering similar devices.
In this article we look to investigate the benefits and evidence in support of this device for improving athletic recovery.
What are compression boots
Compression boots are not only for the feet. They are in fact air filled garments that cover the entire leg from hip to toe, with optional add on components for other areas.
A central hand-held control unit then intuitively inflates gradually more compartments at a pre-set pressure. It is this sequential inflation and deflation that brings the purported benefits of the device.
The benefits of compression boots
- Decreases exercise induced inflammation
It has long been accepted in the scientific community that long, intense bouts of exercise can cause a short-term spike in pro-inflammatory markers in the blood.
Long story short, inflammation increases in the short term after intense exercise. For those engaging in a moderate intensity occasional gym session or run, this is not something to necessarily be concerned with.
If, however you are a competitive athlete or bodybuilder you may want to reduce the inflammatory changes that could be contributing to the associated short term joint pain and muscle soreness which may hinder future performance.
A recent 2017 research study looking at athletes performing high intensity barbell back squats for 3 consecutive days found that those using compression boots had a quicker resolution of inflammatory changes at day 2 than those who did not. 
We can therefore accept the suggestion that compression boots do positively impact the inflammatory response, at least after heavy resistance exercise, as an optimal recovery tool.
2. Quickly improves flexibility that would be otherwise hindered by Delayed Onset Muscle Soreness (DOMs)
Flexibility within soft tissues can logically be assumed to be an important factor for injury prevention during exercise.
The same study used for inflammation also observed measurements of peak knee joint flexion as a measure of flexibility and extensibility in the Quadriceps muscle.
Measured both immediately after exercise, and over a longer timeframe, the authors were able to successfully conclude that the use of compression boots helped to improve flexibility both immediately and up to 7 days post exercise, versus recovery without.
We can therefore confidently say that compression boots do help to improve or reduce flexibility loss after intense exercise.
3. Increases protein signalling and gene expressions responsible for muscle hypertrophy (growth)
Serious athletes have long known that optimal performance extends way beyond the training session or gym floor. Recovery is an integral component in optimising performance and reducing the risk of injury.
A proper recovery period allows our body to effectively repair the micro-trauma that occurs whilst we train. This is in turn builds our skeletal tissues back stronger and more efficient. We call this hypertrophy.
According to the literature, using compression boots demonstrated a moderate effect on positively influencing the time taken to break down protein into amino acids.
As a result, the time taken to recover between bouts of intense exercise should theoretically be shorter when using compression boots versus just rest alone.
4. Increases resilience to the oxidative stress resistance exercises place on skeletal tissues
It is a well-established fact that heavy resistance exercise increases oxidative stress on skeletal muscle tissues.
Oxidative stress is essentially a markedly elevated level of highly reactive and upregulated molecules and proteins that have many deleterious effects on skeletal muscle tissue. This includes muscle atrophy and a reduction in peak force generation.
One of the most obvious results from the first study mentioned in this article was a clear reduction in markers that indicate oxidative stress when using the compression boots at a pressure of 70mmHg for 7 days post exercise.
Rather than reduce the level of oxidate free radical molecules initially present, compression boots appeared to upregulate the production of a protein responsible for increasing the resilience of tissue to the effects of oxidate stress.
In summary, compression boots support the body to increase its own resilience to oxidative stress and its associated negative impacts when used in an appropriate manner after training.
5. Increases localised superficial blood flow
During moderate to high intensity exercise the body builds up levels of lactic acid in the blood. Lactic acid tends to have negative effects on skeletal muscle tissue due to its catabolic properties.
Additionally, glycogen stores are depleted with moderate to high intensity exercise. This is often the cause of fatigue as glycogen converts to glucose, and subsequently ATP (Adenosine-Triphosphate), as an immediate source of energy for muscle tissue whilst contraction.
Although there is insufficient evidence to claim that compression boots can change levels of lactic acid or glycogen restoration, there is some evidence to support its use in improving blood flow within the skin and superficial tissues.
An increased blood flow should help to remove debris and inflammatory mediators whilst increasing oxygenation to tissues that have undergone oxidative stress. It will require further investigation to establish whether this is beneficial or not in longer periods of exercise.
While we are discussing that heat should help with muscle soreness, this article on treating muscle soreness with hot/cold packs.
Who should use compression boots?
I would recommend investing in a pair of compression boots if you are a serious and committed athlete with a regular regime of moderate to high intensity exercise. To reap the true benefits of these devices you need to have a true need to recover.
If you are a regular cyclist, bodybuilder, Olympic weight lifter, triathlete or track and field athlete then compression boots could be a fantastic addition to your recovery routine.
If you are struggling to adequately recover enough between sessions to maintain your performance then again compression boots could be ideal for you.
There are plenty of people who should not use compression boots, and the contraindication list is quite extensive. As a rule, I would also recommend reading the manufacturers guide and/ or speaking to an appropriately qualified health or wellbeing professional.
If you are still wondering whether or not recovery compression boots are for you I would recommend reading our recent Endurance Recovery Compression Boots Review.
 Haun, C. T., Roberts, M. D., Romero, M. A., Osburn, S. C., Mobley, C. B., Anderson, R. G., Goodlett, M. D., Pascoe, D. D., & Martin, J. S. (2017). Does external pneumatic compression treatment between bouts of overreaching resistance training sessions exert differential effects on molecular signaling and performance-related variables compared to passive recovery? An exploratory study. PloS one, 12(6), e0180429. https://doi.org/10.1371/journal.pone.0180429
 Steinbacher P, Eckl P. Impact of oxidative stress on exercising skeletal muscle. Biomolecules. 2015 Apr 10;5(2):356-77. doi: 10.3390/biom5020356. PMID: 25866921; PMCID: PMC4496677.
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