Effects of post-exercise compression garments on subsequent endurance performance and delayed-onset muscle soreness in endurance athletes: a systematic review and meta-analysis

Objective To evaluate whether post-exercise compression garments improve subsequent endurance performance and delayed-onset or perceived muscle soreness in adult endurance athletes. Methods This systematic review and meta-analysis searched PubMed, Scopus, and Web of Science through 19 May 2026 for controlled intervention studies comparing post-exercise compression garments with no compression, usual clothing, sham/placebo, passive recovery, or lower-pressure controls. RoB 2 and GRADE assessed risk of bias and certainty. Soreness was synthesized as Hedges g using random-effects models with Hartung-Knapp-Sidik-Jonkman inference; performance was synthesized narratively. The protocol was registered in Open Science Framework (osf.io/46ck9). Results Of 503 records screened, nine studies were included (158 participants; six crossover, three parallel-group). All studies included in the final evidence base were randomized parallel-group or crossover trials. Ten of 11 assessments were high risk. At approximately 24 hours, soreness favored compression but was uncertain (four studies; Hedges g = 0.62, 95% CI -0.57 to 1.82; I 2 = 74.0%). Immediate-to-2-hour acute post-exercise perceived soreness/discomfort was also uncertain (three studies; g = 0.38, 95% CI -0.67 to 1.42; I 2 = 51.0%). Performance findings were not pooled because of heterogeneity or non-isolatable recovery effects. Certainty was very low. Conclusions Soreness estimates were directionally favorable to compression, but the evidence was very uncertain, statistically imprecise, and vulnerable to expectation effects because blinding was limited or poorly credible. Effects on subsequent endurance performance remain unresolved. Registration: OSF osf.io/46ck9 on 14/05/2026. Systematic Review Registration https://osf.io/b3c78/overview , identifier osf.io/46ck9.