Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT).

OBJECTIVE: This study aims to investigate the efficacy of two exercise interventions in reducing lower extremity (LE) injuries in novice recreational runners. METHODS: Novice runners (245 female, 80 male) were randomised into hip and core (n=108), ankle and foot (n=111) or control (n=106) groups. Interventions were completed before running and included exercise programmes focusing on either (1) hip and core or (2) ankle and foot muscles. The control group performed static stretching exercises. All groups were supervised by a physiotherapist and performed the same running programme. Injuries and running exposure were registered using weekly questionnaires during the 24-week study. Primary outcome was running-related LE injury. RESULTS: The incidence of LE injuries was lower in the hip and core group compared with the control group (HR 0.66; 95% CI 0.45 to 0.97). The average weekly prevalence of overuse injuries was 39% lower (prevalence rate ratio, PRR 0.61, 95% CI 0.39 to 0.96), and the prevalence of substantial overuse injuries was 52% lower (PRR 0.48, 95% CI 0.27 to 0.90) in the hip and core group compared with the control group. No significant difference was observed between the ankle and foot group and control group in the prevalence of overuse injuries. A higher incidence of acute injuries was observed in the ankle and foot group compared with the control group (HR 3.60, 95% CI 1.20 to 10.86). CONCLUSION: A physiotherapist-guided hip and core-focused exercise programme was effective in preventing LE injuries in novice recreational runners. The ankle and foot programme did not reduce LE injuries and did not protect against acute LE injuries when compared with static stretching.

A methodological proof-of-concept of the teeter-totter effect.

The Nike Vaporfly 4% (VP4) shoe is popular due to its unique design and reported performance benefits. However, the underlying mechanisms responsible for the improvements remain unclear. One proposed mechanism is the teeter-totter effect. This study aimed to 1) experimentally test the teeter-totter theory by estimating the teeter-totter moment (MTT) in the VP4 compared to a flat shoe (CONTROL) and 2) quantify the change in the anterior-posterior position of the centre of pressure (Δxa-p) in the VP4 compared to the CONTROL. Plantar pressures and high-speed video were recorded from 15 runners in two shoe conditions. The VP4 generated a larger propulsion moment, MP, (∫MPdt = 90.46 ± 38.87 Nms; p < 0.001, d = 1.95), suggesting the presence of an MTT in the VP4 (∫MTTdt = 57.16 ± 24.35 Nms) when compared to the CONTROL (∫MPdt = 33.30 ± 14.52 Nms). Δxa-p was greater in the VP4 (Δxa-p = 9.48 ± 6.08 mm; p < 0.001, d = 2.07) compared to the CONTROL (Δxa-p = 0.54 ± 0.67 mm). This study provides a methodological proof-of-concept for the teeter-totter theory. The findings highlight the possibility of a teeter-totter effect resulting in greater heel propulsion while running in an AFT shoe construction, assuming a constant muscle moment and pivot point.

Estimating Running Ground Reaction Forces from Plantar Pressure during Graded Running.

Ground reaction forces (GRFs) describe how runners interact with their surroundings and provide the basis for computing inverse dynamics. Wearable technology can predict time-continuous GRFs during walking and running; however, the majority of GRF predictions examine level ground locomotion. The purpose of this manuscript was to predict vertical and anterior-posterior GRFs across different speeds and slopes. Eighteen recreationally active subjects ran on an instrumented treadmill while we collected GRFs and plantar pressure. Subjects ran on level ground at 2.6, 3.0, 3.4, and 3.8 m/s, six degrees inclined at 2.6, 2.8, and 3.0 m/s, and six degrees declined at 2.6, 2.8, 3.0, and 3.4 m/s. We estimated GRFs using a set of linear models and a recurrent neural network, which used speed, slope, and plantar pressure as inputs. We also tested eliminating speed and slope as inputs. The recurrent neural network outperformed the linear model across all conditions, especially with the prediction of anterior-posterior GRFs. Eliminating speed and slope as model inputs had little effect on performance. We also demonstrate that subject-specific model training can reduce errors from 8% to 3%. With such low errors, researchers can use these wearable-based GRFs to understand running performance or injuries in real-world settings.

The effects of shoe upper construction on mechanical ankle joint work during lateral shuffle movements.

Lateral shuffles are common movements in sports and are facilitated by the hip, knee, and ankle joints. Shoe uppers can change ankle kinetics during walking and running. However, it is not known how shoe upper modifications affect ankle kinetics during shuffling. The purpose of this study was to investigate the effects of shoe upper construction on mechanical ankle joint work during shuffling. It was hypothesized that a shoe with a reinforced upper will result in decreased negative ankle joint work. Twenty participants performed Maximal (MLST) and Submaximal Lateral Shuffle Tests (90% of MLST) in footwear with a minimal (MU) and reinforced upper (RU). Ground reaction forces and ankle kinematics were collected to compute ankle joint work. Performing lateral shuffles in the RU condition resulted in significantly reduced positive (MU: 0.62 ± 0.16 J/kg, RU: 0.55 ± 0.16 J/kg; p = 0.001, d = 0.44) and negative (MU: -0.60 ± 0.20 J/kg, RU: -0.53 ± 0.19 J/kg; p = 0.004, d = 0.41) ankle work. A decrease in positive and negative work could be a performance benefit, enabling the athlete to perform the same movement with a lower energy cost. More extreme upper interventions may yield even larger performance benefits.

Isolating the Unique and Generic Movement Characteristics of Highly Trained Runners.

Human movement patterns were shown to be as unique to individuals as their fingerprints. However, some movement characteristics are more important than other characteristics for machine learning algorithms to distinguish between individuals. Here, we explored the idea that movement patterns contain unique characteristics that differentiate between individuals and generic characteristics that do not differentiate between individuals. Layer-wise relevance propagation was applied to an artificial neural network that was trained to recognize 20 male triathletes based on their respective movement patterns to derive characteristics of high/low importance for human recognition. The similarity between movement patterns that were defined exclusively through characteristics of high/low importance was then evaluated for all participants in a pairwise fashion. We found that movement patterns of triathletes overlapped minimally when they were defined by variables that were very important for a neural network to distinguish between individuals. The movement patterns overlapped substantially when defined through less important characteristics. We concluded that the unique movement characteristics of elite runners were predominantly sagittal plane movements of the spine and lower extremities during mid-stance and mid-swing, while the generic movement characteristics were sagittal plane movements of the spine during early and late stance.

Dr. Richard C. Nelson: A Facilitator and Door Opener.

Dr. Richard Nelson contributed to the development of sport biomechanics by being an international facilitator. Together with Dr. Jürg Wartenweiler, he contributed the necessary support and input that allowed the field of Movement and Sports Biomechanics to develop and flourish.

The Submaximal Lateral Shuffle Test: A reliability and sensitivity analysis.

Lateral ankle stability and how it changes in different footwear has been investigated for years. Research, however, has shown a lack of reliability or sensitivity of available methodologies. This study aimed to evaluate the test-retest reliability and sensitivity of a novel lateral stability protocol, the Submaximal Lateral Shuffle Test (SLST). We recruited 11 and 40 participants to assess reliability and sensitivity of the SLST, respectively. Participants performed the SLST in footwear that differed in collar height and upper stiffness. ICC values showed good to excellent reliability in peak ankle angles and moments, ground reaction forces, impulses, stance time, and performance time. Significantly lower peak inversion and adduction angles and lower medio-lateral push off peak forces were found in the high cut shoes compared to the low cut shoes. The medio-lateral landing peak force showed lower forces in the high cut shoes. The smallest worthwhile change indicated meaningful differences in 70.0-82.5% of participants for inversion, adduction, medio-lateral landing peak, and push off peak forces. These results, however, were not systematic such that there was not a consistent direction of the difference for all participants. In conclusion, the SLST is a promising protocol to further investigate lateral stability in footwear.

The effect of torsional shoe sole stiffness on knee moment and gross efficiency in cycling.

Altering torsional stiffness of cycling shoe soles may be a novel approach to reducing knee joint moments and overuse injuries during cycling. We set out to determine if the magnitude of three-dimensional knee moments were different between cycling shoe soles with different torsional stiffnesses. Eight trained male cyclists cycled at 90% lactate threshold power output in one of two cycling shoe conditions in a randomized crossover design. The shoe sole was considered torsionally flexible (FLEX) compared to a relatively stiffer (STIFF) sole. Gross efficiency (GE) and knee joint moments were quantified. No significant effect of shoe condition was seen in GE (21.4 ± 1.1% and 20.9 ± 1.6% for FLEX and STIFF, respectively, P = 0.12), nor in three-dimensional knee moments. 4 of the 8 subjects had reduced knee moments in at least 2 of the 3 moment directions. These "responders" were significantly shorter (1.73 ± 0.02 m vs 1.81 ± 0.04 m, P = 0.017) and had a higher relative maximal aerobic power (MAP) (4.6 ± 0.3 W∙kg-1 vs 3.9 ± 0.3 W∙kg-1, P = 0.024) compared to non-responders. These results suggest that certain shoe characteristics may influence certain individuals differently because these participants belong to different "functional groups"; certain individuals may respond positively to FLEX, while others may not. Further studies should test this proposed hypothesis.

Beta, gamma band, and high-frequency coherence of EMGs of vasti muscles caused by clustering of motor units.

The vasti muscles stabilize the knee joint during the running movement. This requires some motor units to synchronize. Test the hypothesis that EMGs from the vasti muscles (VM and VL) are coherent in four frequency bands, one below 30 Hz, the 40 Hz (30-45 Hz), the middle band up to 120 Hz, and the high-frequency band (135-280 Hz). Because the VM during one step and the VL during another step contain common EMG signal parts the inter-step coherence at low frequencies does not disappear when the coherence is computed between the EMGVM obtained from one step and the EMGVL of the previous step. Twelve participants ran on a treadmill at 2.9 m/s for 15 min. EMGs were recorded from the vasti muscles using bipolar current amplifiers. Ordinary coherence was computed between the EMGVM and EMGVL and for the inter-step-condition. Significant coherence was observed in all frequency bands. In the mid- and high-frequency range, coherence disappears for the inter-step condition, whereas the low-frequency coherence is still present. Four frequency bands must be considered. It was proposed that coherence at low frequencies reflects cortico-muscular interactions. However, the clustering of motor unit action potentials is sufficient to generate the low-frequency coherence as well. There is a low-frequency coherence resulting from EMGs of the vasti muscles that are similar in different steps. Therefore, at least these three effects must be considered to draw conclusions from the coherence of the vasti muscles at low frequencies that occur while running.

Changes in cortical activity measured with EEG during a high-intensity cycling exercise.

This study investigated the effects of a high-intensity cycling exercise on changes in spectral and temporal aspects of electroencephalography (EEG) measured from 10 experienced cyclists. Cyclists performed a maximum aerobic power test on the first testing day followed by a time-to-exhaustion trial at 85% of their maximum power output on 2 subsequent days that were separated by ∼48 h. EEG was recorded using a 64-channel system at 500 Hz. Independent component (IC) analysis parsed the EEG scalp data into maximal ICs. An equivalent current dipole model was calculated for each IC, and results were clustered across subjects. A time-frequency analysis of the identified electrocortical clusters was performed to investigate the magnitude and timing of event-related spectral perturbations. Significant changes (P < 0.05) in electrocortical activity were found in frontal, supplementary motor and parietal areas of the cortex. Overall, there was a significant increase in EEG power as fatigue developed throughout the exercise. The strongest increase was found in the frontal area of the cortex. The timing of event-related desynchronization within the supplementary motor area corresponds with the onset of force production and the transition from flexion to extension in the pedaling cycle. The results indicate an involvement of the cerebral cortex during the pedaling task that most likely involves executive control function, as well as motor planning and execution.

A Novel Approach to Determine Strides, Ice Contact, and Swing Phases During Ice Hockey Skating Using a Single Accelerometer.

This study presents a new approach for automated identification of ice hockey skating strides and a method to detect ice contact and swing phases of individual strides by quantifying vibrations in 3D acceleration data during the blade-ice interaction. The strides of a 30-m forward sprinting task, performed by 6 ice hockey players, were evaluated using a 3D accelerometer fixed to a hockey skate. Synchronized plantar pressure data were recorded as reference data. To determine the accuracy of the new method on a range of forward stride patterns for temporal skating events, estimated contact times and stride times for a sequence of 5 consecutive strides was validated. Bland-Altman limits of agreement (95%) between accelerometer and plantar pressure derived data were less than 0.019 s. Mean differences between the 2 capture methods were shown to be less than 1 ms for contact and stride time. These results demonstrate the validity of the novel approach to determine strides, ice contact, and swing phases during ice hockey skating. This technology is accurate, simple, effective, and allows for in-field ice hockey testing.

Relationship Between Lower Limb Muscle Activity and Platform Acceleration During Whole-Body Vibration Exercise.

The purpose of this study was to identify the influence of different magnitudes and directions of the vibration platform acceleration on surface electromyography (sEMG) during whole-body vibration (WBV) exercises. Therefore, a WBV platform was used that delivers vertical vibrations by a side-alternating mode, horizontal vibrations by a circular mode, and vibrations in all 3 planes by a dual mode. Surface electromyography signals of selected lower limb muscles were measured in 30 individuals while they performed a static squat on a vibration platform. The WBV trials included 2 side-alternating trials (Side-L: 6 Hz, 2.5 mm; Side-H: 16 Hz, 4 mm), 2 circular trials (Circ-L: 14 Hz, 0.8 mm; Circ-H: 43 Hz, 0.8 mm), and 4 dual-mode trials that were the combinations of the single-mode trials (Side-L/Circ-L, Side-L/Circ-H, Side-H/Circ-L, Side-H/Circ-H). Furthermore, control trials without vibration were assessed, and 3-dimensional platform acceleration was quantified during the vibration. Significant increases in the root mean square of the sEMG (sEMGRMS) compared with the control trial were found in most muscles for Side-L/Circ-H (+17 to +63%, p ≤ 0.05), Side-H/Circ-L (+7 to +227%, p ≤ 0.05), and Side-H/Circ-H (+21 to +207%, p < 0.01) and in the lower leg muscles for Side-H (+35 to +138%, p ≤ 0.05). Furthermore, only the vertical platform acceleration showed a linear relationship (r = 0.970, p < 0.001) with the averaged sEMGRMS of the lower limb muscles. Significant increases in sEMGRMS were found with a vertical acceleration threshold of 18 m·s(-2) and higher. The present results emphasize that WBV exercises should be performed on a platform that induces vertical accelerations of 18 m·s(-2) and higher.

The effects of isolated ankle strengthening and functional balance training on strength, running mechanics, postural control and injury prevention in novice runners: design of a randomized controlled trial.

BACKGROUND: Risk factors have been proposed for running injuries including (a) reduced muscular strength, (b) excessive joint movements and (c) excessive joint moments in the frontal and transverse planes. To date, many running injury prevention programs have focused on a "top down" approach to strengthen the hip musculature in the attempt to reduce movements and moments at the hip, knee, and/or ankle joints. However, running mechanics did not change when hip muscle strength increased. It could be speculated that emphasis should be placed on increasing the strength of the ankle joint for a "ground up" approach. Strengthening of the large and small muscles crossing the ankle joint is assumed to change the force distribution for these muscles and to increase the use of smaller muscles. This would be associated with a reduction of joint and insertion forces, which could have a beneficial effect on injury prevention. However, training of the ankle joint as an injury prevention strategy has not been studied. Ankle strengthening techniques include isolated strengthening or movement-related strengthening such as functional balance training. There is little knowledge about the efficacy of such training programs on strength alteration, gait or injury reduction. METHODS/DESIGN: Novice runners will be randomly assigned to one of three groups: an isolated ankle strengthening group (strength, n = 40), a functional balance training group (balance, n = 40) or an activity-matched control group (control, n = 40). Isokinetic strength will be measured using a Biodex System 3 dynamometer. Running kinematics and kinetics will be assessed using 3D motion analysis and a force platform. Postural control will be assessed by quantifying the magnitude and temporal structure of the center of pressure trace during single leg stance on a force platform. The change pre- and post-training in isokinetic strength, running mechanics, and postural control variables will be compared following the interventions. Injuries rates will be compared between groups over 6 months. DISCUSSION: Avoiding injury will allow individuals to enjoy the benefits of participating in aerobic activities and reduce the healthcare costs associated with running injuries. TRIAL REGISTRATION: Current Controlled Trial NCT01900262.

Comparison of muscle activity of the lower limbs while running on different treadmill models.

Treadmill running is a common method of exercise and to study human locomotion. Research has examined the kinematics and kinetics of overground and treadmill running, but there has been less focus on the levels of muscle activity during treadmill running. We investigated if muscle activity is different while running overground compared to running on a variety of treadmills. A total of 11 healthy individuals ran at 3 speeds (2.6, 3.6, 4.5 m/s) under 4 different running conditions (3 treadmills, overground). The three treadmills included a typical home exercise treadmill, a midsize commercial research treadmill, and a large, instrumented research treadmill. Surface EMG of the tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF) and biceps femoris (BF) muscles were measured for each running condition. The integrated EMG was computed for each running condition for the stance and swing phase, as well as 100 ms before and after the heel-strike. Friedman analysis revealed significant effects during the stance phase for GM and RF at all speeds, such that muscle activation was lower on the treadmills relative to overground. During the stance phase at faster speeds, the muscle activity was higher for the TA and lower for the BF while running on the different treadmills compared to overground running. Before heel-strike, the TA was significantly less active during treadmill compared to overground running at 2.6 m/s and the RF showed significantly higher activity at 3.6 m/s and 4.5 m/s while running on the different treadmills. Summarizing, differences were mainly observed between the different treadmill conditions relative to overground running. Muscle activation differences between the different treadmill conditions were observed at faster running speeds for RF during the pre-heel-strike phase only. Different types of treadmills with different mechanical properties affects the muscle activity during stance phase as well as in preparation to heel-strike. Additionally, the muscle activity is greater during overground compared to treadmill running during the stance phase for the GM, BF, and RF.

Counterweight mass influences single-leg cycling biomechanics.

INTRODUCTION: Single-leg cycling is a commonly used intervention in exercise physiology that has applications in exercise training and rehabilitation. The addition of a counterweight to the contralateral pedal helps single-leg cycling mimic cycling patterns of double-leg cycling. To date, no research has tested (a) the influence of a wide range of counterweight masses on a person's cycling biomechanics and (b) the optimal counterweight mass to emulate double-leg cycling. OBJECTIVES: The purpose of this study was to determine the effects of varying counterweights on the kinematics (joint angles) and kinetics (joint moments, work) of cycling using a 3D analysis. METHODS: Twelve participants cycled at 50W or 100W with different counterweight masses (0 to 30 lbs, 2.5 lbs increments), while we analyzed the pedal force data, joint angles, joint moments, and joint power of the lower limb using 3D motion capture and 3D instrumented pedals to create participant-specific musculoskeletal models. RESULTS: The results showed that no single-leg cycling condition truly emulated double-leg cycling with respect to all measured variables, namely pedal forces (p ≤ 0.05), joint angles (p ≤ 0.05), joint moments(p ≤ 0.05), and joint powers (p ≤ 0.05), but higher counterweights resulted in single-leg cycling that was statistically similar (p > 0.05), but descriptively, asymptotically approached the biomechanics of double-leg cycling. CONCLUSION: We suggest that a 20-lb counterweight is a conservative estimate of the counterweight required for using single-leg cycling in exercise physiology studies, but further modifications are needed to the cycle ergometer for the biomechanics of single-leg cycling to match those of double-leg cycling.

Greater foot and footwear mechanical work associated with less ankle joint work during running.

Footwear energy storage and return is often suggested as one explanation for metabolic energy savings when running in Advanced Athletic Footwear. However, there is no common understanding of how footwear energy storage and return facilitates changes in muscle and joint kinetics. The purpose of this study was to evaluate the magnitude and timing of foot, footwear and lower limb joint powers and work while running in Advanced and Traditional Athletic Footwear. Fifteen runners participated in an overground motion analysis study. Since footwear kinetics are methodologically challenging to quantify, we leveraged distal rearfoot power analyses ('foot + footwear' power) and evaluated changes in the magnitude and timing of foot + footwear power and lower limb joint powers. Running in Advanced Footwear resulted in greater foot + footwear work, compared to Traditional Shoes, and lower positive ankle work, potentially reducing the muscular demand on the runner. The timing of foot + footwear power varied only slightly across footwear. There are exciting innovation opportunities to manipulate the timing of footwear energy and return. This study demonstrates the research value of quantifying time-series foot + footwear power, and points industry developers towards footwear innovation opportunities.

Measuring lateral shuffle and side cut performance.

Lateral shuffle and side cut (SSC) movements are defensive basketball movements where movement speed is critical to performance. The purpose of this study was to compare SSC data obtained using timing lights with motion capture system data and to determine the most appropriate method for measuring SSC performance. Shuffle time data were recorded using both timing lights and a motion capture system while 9 male subjects performed 2 different SSC movement sets, with and without controlling for arm movements, which may influence performance times. Shuffle and side cut times and SSC displacements were used to calculate mean shuffle velocity for each trial. The SEs for the motion capture system were estimated for SSC times (± 4.2 milliseconds; ~0.24% of mean shuffle time) and velocities (± 5.5 mm · s; ~0.24% of mean shuffle velocity), respectively, indicating high levels of precision. Timing light movement time variability was significantly higher during the uncontrolled (SD = 42 milliseconds) when compared with the controlled (SD = 9 milliseconds, p < 0.001) condition, indicating a significant reduction in variability by controlling non-performance-related variability such as arm movement. A significant positive correlation was found between SSC time and SSC displacement (r = 0.42) indicating that performance times were dependent on displacement. Furthermore, the variance in motion-captured SSC velocity was significantly smaller than the variance in velocity determined using timing lights (p < 0.05). We concluded that motion-captured SSC velocity data reduced systematic errors and non-performance-related movement variability and, therefore, was better able to reflect true performance. As true performance variability in human movement provides important information, the presented method for calculating SSC velocity in this study is recommended for assessing SSC performance.

Identification of subject-specific responses to footwear during running.

Placing a stronger focus on subject-specific responses to footwear may lead to a better functional understanding of footwear's effect on running and its influence on comfort perception, performance, and pathogenesis of injuries. We investigated subject-specific responses to different footwear conditions within ground reaction force (GRF) data during running using a machine learning-based approach. We conducted our investigation in three steps, guided by the following hypotheses: (I) For each subject x footwear combination, unique GRF patterns can be identified. (II) For each subject, unique GRF characteristics can be identified across footwear conditions. (III) For each footwear condition, unique GRF characteristics can be identified across subjects. Thirty male subjects ran ten times at their preferred (self-selected) speed on a level and approximately 15 m long runway in four footwear conditions (barefoot and three standardised running shoes). We recorded three-dimensional GRFs for one right-foot stance phase per running trial and classified the GRFs using support vector machines. The highest median prediction accuracy of 96.2% was found for the subject x footwear classification (hypothesis I). Across footwear conditions, subjects could be discriminated with a median prediction accuracy of 80.0%. Across subjects, footwear conditions could be discriminated with a median prediction accuracy of 87.8%. Our results suggest that, during running, responses to footwear are unique to each subject and footwear design. As a result, considering subject-specific responses can contribute to a more differentiated functional understanding of footwear effects. Incorporating holistic analyses of biomechanical data is auspicious for the evaluation of (subject-specific) footwear effects, as unique interactions between subjects and footwear manifest in versatile ways. The applied machine learning methods have demonstrated their great potential to fathom subject-specific responses when evaluating and recommending footwear.

Effects of compression on muscle tissue oxygenation at the onset of exercise.

The effects of compression on gastrocnemius medialis muscle oxygenation and hemodynamics during a short-term dynamic exercise was investigated in a sample of 15 male subjects (mean ± SD; age 25.8 ± 4.9 years; mass 70.6 ± 4.3 kg). Elastic compression sleeves were used to apply multiple levels of compression to the calf muscles during exercise, and noncompressive garments were used for the control condition. Tissue hemoglobin oxygen saturation was measured as the relative "tissue oxygen index" (TOI) with a near-infrared spectrometer. The recovery of TOI during exercise was determined from the slope of oxygenation recovery in a nonoccluded situation. The TOI recovery rate during the first 2 minutes of the exercise was 24% higher (p = 0.042) for the compression condition than for the control condition. A significant correlation (r = 0.61, p = 0.012) between the level of compression and the tissue oxygenation recovery during exercise was observed. Muscle energy use was determined from the rate of decline of TOI immediately upon arterial occlusion during early exercise. Muscle energy use measured during the occluded situation was not significantly influenced by compression. Based on these results, it was concluded that compression induced changes in tissue blood flow and perfusion appear to result in improved oxygenation during short-term exercise. Assuming that increased muscle oxygen availability positively influences performance, compression of muscles may enhance performance especially in sports that require repeated short bouts of exercise.