What Is Pneumatic Compression?
When air pressure is used to treat or support fluid circulation in the extremities, it’s considered to be pneumatic compression. Typically, the systems appear as a cuff, full-length inflated pants, or sleeves. An external air pump that is strong enough to inflate auxiliary sleeves at desired levels of pressure usually provides the external compression.
Pneumatic compression is intermittent, meaning the pressure is purposely not continuous and tends to be much higher than with compression garments. Pneumatic compression is measured in millimeters of mercury, and research includes the type and strength of the pressure in order to make comparisons and conclusions on equipment and alternative modalities. Compression is similar to hydrostatic pressure and has both health benefits and a potential role in recovery. Intermittent pneumatic compression (IPC) is sometimes described as sequential, since most systems provide a practical pulse up to the torso starting at the foot or wrist. Lastly, IPC is recovery, not a training modality, and is not to be confused with occlusion training.
Medical History of Pneumatic Compression
Like many recovery products in sport, most compression systems originated as medical devices. The most notable crossover was NormaTec, a solution that stemmed from an invention by Dr. Jacobs. In early 2007, it provided teams with their first sports recovery system. Later, other companies followed suit with similar systems, all employing air pumps and sleeves to facilitate recovery of the lower extremities. Today, dozens of systems exist internationally, with only a handful actually used consistently by professional and recreational athletes. To understand the pneumatic compression systems, readers should note a product’s medical past to invest smarter in not only compression solutions, but all recovery devices.
The three areas where intermittent pneumatic compression has strong carryover and success are lymphedema, deep vein thrombosis (DVT), and general medical needs that are complementary, such as diabetes and pulmonary embolism risks. Most of the interest lies in the circulatory benefits that can improve venous return and the mechanical support of the lymphatic system. Perhaps the most common question with sequential compression devices that are used in the medical arena is how they affect sports recovery, and that is discussed later in the theoretical recovery benefits section. Medically, the evidence for using compression for injury is not strong, but mechanical compression with external devices is supportive based on the pathology. Currently, the scientific literature defends the use of sequential devices for lymphedema and DVT, and other special cases with narrow parameters and limited outcomes.
Sequential pneumatic compression systems cease to be medical devices and become sport recovery devices mostly as a result of market positioning, as the designs and features are nearly identical. Manual therapy with athletes is as old as sport itself, so it’s no surprise that sports have gravitated to the device market along with self-therapy treatments.
Theoretical Recovery Benefits
Research on the recovery benefits of pneumatic compression tends to focus on performance enhancements before and after treatment, with little changes outside range of motion. Therefore, it’s likely that the benefits to athletes are more rooted in assisting the prophylactic needs of heavy sports training. Over the last decade, about 20 studies have investigated pneumatic compression devices and most saw responses in the following areas. Improvements in anaerobic and endurance performance have not been found, but it’s likely the systems supported by compression are not related to neuromuscular power.