Simply Science: NormaTec with Expert Matt Hanson
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By: Recover-Zone Team
Our amazing team consist of a wide variety of writers, from novice athletes, to serious competitors. Competing in an array of fitness challenges.
If you follow any famous athletes on social media you probably have seen photos of one of the most recognizable recovery products in the fitness industry, NormaTec’s recovery boots. Although these boots make anyone who wears them resemble the Pillsbury Dough Boy, the product itself and the industry-leading brand behind them are no joke, and they make some bold claims when it comes to helping your recovery. The question is, do they really work? In this article, we take a look at how NormaTec’s recovery boots stack up against the science and let you decide for yourself, “Is NormaTec the real deal or not?!
“Our Athlete-Scientist.” Who is Matt Hanson?
When it comes to researching recovery products, you need to know two things. First, the studies making the claims are hard to read and second, they are seemingly impossible to understand…that is, for your everyday health and fitness enthusiast. That’s why we enlisted Doctor of Exercise Science turned professional triathlete, Matt Hanson, to help us simplify the topic. Who exactly is Matt Hanson? Are you ready for a long list of accomplishments…Matt is a 5-time Ironman and 5-time 70.3 triathlon champion, including 3 North American Championships with 3 course records, but that’s all before you consider his education. On top of that, Matt has a Doctor of Education, has worked as an athletic trainer as well as human performance director, and has taught exercise science at the collegiate level. With all these credentials it’s Matt’s job in this article to help you understand the mumble-jumble behind science talk, or in other words, make the science simple.
What is NormaTec?
Before we dive too deep, we need to understand what NormaTec actually is. Simply put, NormaTec is a dynamic, pneumatic, compression device created to expedite recovery. Initially designed by a physician bioengineer, NormaTec employs a variety of key features that claim to improve recovery in various ways. Among NormaTec’s highlights are the gradient, distal release, and pulsing features, the last of which falls under NormaTec’s patented massage pattern. Each of these features NormaTec strongly promotes is backed by science, but let’s take a look for ourselves at behind how NormaTec works.
In this article, we are going to explain what the NormaTec is and what the research has to say about it. The first part of each section will be a complex and in-depth examination of the NormaTec device. What follows each of these sections are highlighted blocks where I will summarize the main points covered in the main article in bite-sized chunks that will be practical and untechnical. I will also add a few of my personal insights and perspective as a professional athlete who was formally an educator. In the interest of full disclosure, NormaTec has been a partner of mine since 2015. Some of you may dismiss my thoughts as bias as a result, but I hope you will take my comments as a means of showing why I partnered with them and continue using them on a daily basis.
How NormaTec Works?
The best way to understand how NormaTec’s product works is by imagining that you’re wearing their boots. The NormaTec boots are made of multiple individual segments that can inflate independently of each other and move as a sort of wave. At the start, the NormaTec unit begins by utilizing its pulsing feature in the first segment, at your feet. We’ll cover how this patented feature works in the next section but for now, we will focus on the other two main features. Once the pulsing is complete at your feet, it will move up to the second zone, at your calves, while your feet begin a static hold. This hold at your feet is NormaTec’s gradient feature, which is incorporated to replicate the one-way valves found in the veins and lymphatic vessels of the human body. This style of compression prevents the backflow of fluid and keeps blood from being forced in the wrong direction by the pulsing feature which is working in the segment just above. Studies that have been done on gradient type features like this have shown that this type of compression is a superior option for hemodynamics. Two other similar studies presented the findings that sequential compression could be effective in treating exercise-induced muscle damage and DOMS.
Hemodynamics [hee-moh-dahy-nam-iks]
A term representing the flow of blood between organs and tissues of the human body.
Back to our wave analogy, as the NormaTec unit moves yet again, the alternating compression feature moves up to your knees, the static hold moves to your calves, and NormaTec’s final major feature, distal release, begins work at your feet. As the name suggests, distal release is simply the release of the static compression hold from the gradients feature explained above. NormaTec claims that this distal release prevents the detrimental effects on the human body’s natural flow of blood that can be interrupted by extended periods of time under static compression, particularly high pressure. What does the science say? Unsurprisingly, many doctors warn of numerous health risks, some of which have been backed by studies. In addition, a small pool of other research has shown that compression garments may cause problems by misuse. However, with all this in mind, it has not been conclusively shown that long term application of static compression is harmful.
In layman’s terms, NormaTec uses programmed cycles to help the body with its natural circulation process. The inflammation and other byproducts of exercise need to be brought from the extremities to the core in order to be dealt with and disposed of by the body’s other natural systems. The cycles work to squeeze the inflammation out of your feet and ankles then maintain pressure on these segments while it squeezes the calf. This movement progresses up-ward throughout the boots. A good way to picture this is to think of holding a plastic straw with a little bit of water in it. If you squeeze the bottom of the straw the water will move up. If you were to let go then squeeze a few inches above, the water would go with gravity back to the bottom. However, if you hold the bottom with one hand and squeeze right above it with the other, then let go with the hand on the bottom and keep squeezing up, you can force the water to move against gravity and exit out the top of the straw. This sequential compression, as NormaTec calls it, has been demonstrated in research to work more effectively than static compression alone (such as wearing compression socks).
To accomplish the above-mentioned cycle, NormaTec uses higher pressures than standard compression garments. The issues which could potentially arise from static compression for extended periods of time are more so when the pressure levels are higher than one’s diastolic blood pressure. The distal release function of the NormTec is designed to ensure that normal blood flow is not disrupted to the extremities for an extended period of time. As a result, there should be no issues regardless of how long you sit in NormaTec’s gear.
NormaTec’s patented feature.
Now that we understand how most of the NormaTec unit works, let’s take a special look at their patented pulsing feature that we previously mentioned. According to NormaTec, this feature is designed to mimic the natural muscle pump of the human body. It does this by sequentially alternating compression with relaxation. In other words, the product repeatedly inflates and deflates to flush out metabolites and increase the flow of blood in the compressed area. What enables NormaTec to do this is their style of pneumatic compression. Aka, NormaTec uses air to compress a portion of the body rather than tight fabric like other compression products. The studies researching how pneumatic, intermittent compression stacks up against other forms of compression appear to show that NormaTec might have the upper hand when it comes to a greater movement of blood flow.
As you exercise, your muscles are constantly contracting and relaxing. This creates a “pump” of sorts that allows the blood, inflammation, and other waste byproducts created during exercise to travel against gravity through the veins and/or lymphatic system. The pulsing feature on the NormaTec has been shown to mimic the muscle pumping action which has been demonstrated to clear waste better than static compression such as compression garments. This is an area that could use more research, but with the limited studies out there, it does seem that pulsing offers superior benefits to static compression.
What are the benefits?
Finally, we come to the question that you probably care most about, can NormaTec improve your recovery and performance? Although we have covered the science behind various NormaTec features, none of that ultimately matters if it doesn’t have any impact on recovery. Let’s begin by examining a few different meta-analyses on compression garments. The first of these meta-analyses was done on various recovery modalities, not just exclusively compression. This analysis found that compression was one of the highest-ranking forms of recovery capable of lowering DOMS, delayed onset muscle soreness, and perceived fatigue. This came as compression ranked just below massage and alongside water immersion. Two further and separate meta-analyses looking exclusively at compression garments found that compression was effective at expediting muscle strength and power return, following exercise.
To clear any confusion, a meta-analysis is simply a study that looks at and compares results from a large number of different but related studies and then draws a general conclusion.
Meta Analysis [mee-tuh, uh-nal-uh-seez]
A study that looks at and compares results from a large number of different but related studies and then draws a general conclusion.
Moving onto singular studies, one group of researchers, when comparing compression devices to other forms of recovery, showed that compression appears to lower blood lactate levels in a much more significant manner than that of passive recovery, while active recovery produced the same results. An even more potentially significant study tested participants utilizing HIIT, which is high-intensity interval training, alongside a NormaTec style compression device. What did researchers find? Interestingly, their results concluded that pneumatic compression prevented the breakdown of skeletal muscle proteins, something that is very valuable for eliminating negative workout responses. Further, a related study also found that pneumatic compression used following resistance exercise reduced skeletal muscle oxidative stress, a marker of muscle protein breakdown. In addition, some studies have not only found that compression prevents protein breakdown, but that on the contrary, it upregulates protein synthesis and gene expression, two human body mechanisms that promote muscle growth. Unfortunately, of the two studies that characterized these findings, one was done without any form of workout included by the researchers. Lastly, and the most specific study to NormaTec, one team of researchers reported that even among compression devices that use air to apply their pressure, the means by which NormaTec’s devices go about their cycles was the most effective. As you can see from the research, NormaTec has some room to talk when it comes to the science of their product.
The research is overwhelmingly clear that compression increases recovery. The sequential pulsating compression provided by the NormaTec has been shown to be more effective than static compression alone in numerous studies. There is ample evidence suggesting that using the NormaTec can help prevent muscle breakdown and also promote muscle healing (Meaning that it will not inhibit the adaptations you are going for while exercising!). The NormaTec device can help reduce lactate levels post-exercise. What is even better though, is that some findings suggest that the NormaTec can improve whole-body circulation and not just the limbs being treated. There are numerous other benefits that could be discussed in length. However, when the findings in numerous meta-analysis (the gold standard of research protocols) are in agreement, it is safe to say that the recovery and, therefore, performance benefits claimed by NormaTec are legitimate.
Frequently Asked Questions
After reading through all of this, you probably have some questions. So, we’ve done our best to answer some of the most frequently asked ones, below:
What makes NormaTec different from their competitors?
If you do a quick search online, you’ll immediately find that NormaTec is the premier recovery pneumatic compression device, but why? Well, first it’s hard to overlook the fact that NormaTec is incredible at marketing and has partnered with various professional sporting organizations as well as many well-known athletes. NormaTec has gotten their name out there and has associated themselves with the best of the best. A second key feature is that, unlike static compression garments such as compression socks, at the beginning of each session NormaTec calibrates to your specific body shape. This component helps maximize each individual recovery session. A final key difference, which we took an in-depth look at above, is NormaTec’s patented massage pattern which NormaTec holds as an exclusive advantage.
Not all compression boots are made identical and they certainly do not perform with the same effectiveness. Research studies comparing NormaTec to many of its competitors have shown that NormaTec’s technology which allows for body size calibration and the patented sequential pulse compression feature makes the NormaTec a superior option. As an athlete and coach, I find that other functions such as Bluetooth capacity and the ability to upload directly into training logs, help NormaTec add distance to its competitors.
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Are there any contradictions?
The short answer is, yes. Studies have seemed to come up with differing opinions when it comes to the effects of NormaTec. Take for example one study which produced no finding to indicate that NormaTec improves muscle recovery and stated that many of the reported benefits for compression have been found in a clinical setting and not when directly related to training. Two further studies have gone on to show that compression reportedly does not improve vascular function or decrease creatine kinase, a marker of muscle damage. These two studies are just a few of many contradictory studies either showing NormaTec works or it doesn’t. Overall, when looking at the research behind NormaTec there are two things to keep in mind. First, when reviewing studies, the word compression is a broad term used in various studies to refer to different things. In some studies, the word compression refers to static compression, while in other studies the word compression can refer to dynamic, pneumatic compression. It’s important to understand the difference between the two. The research used throughout this article looked at both. The other thing to remember is that NormaTec has been influential in funding studies relating to its product. Although this doesn’t necessarily make the studies invalid, most researchers are careful when looking at studies funded by companies that could benefit from a positive result.
Rarely will you have a 100% consensus in research findings. There are numerous different study designs, protocols, and environments where these studies are being conducted. In situations such as this, it is important to focus on two things: 1. strength of the study and 2. the significance of the population. From the strength of a study standpoint, a meta-analysis is as good as you can find. Every meta-analysis referenced in this article showed benefits from using compression and/or the NormaTec boots. While some individual studies have shown mixed results, the overall consensus seems quite positive. Beyond general benefits, you want to look at results as specific to the sport you are participating in and the specific adaptations you are going for. While that is well beyond the scope of this discussion, I can tell you that as a professional athlete, I find the research is well sufficient enough for me to continue using my NormaTecs on a daily basis.
And the winner is…
The science is out, and as of now, it appears that NormaTec has some bragging rights. With promising research that’s leaning in favor of NormaTec, you might conclude that it’s a flawless way to improve recovery. However, keep in mind the science is not 100% soundproof. With more time and exploration, questions should continue to be answered about compression and recovery, and what it means for your performance. If you’re looking for that one thing that will help you get a little bit more out of your training, you now can decide for yourself whether NormaTec is a bang for your buck.
Still want more? Check out Matt's Blog:
NormaTec Pulse 2.0
All images curtesy of Matt Hanson and NormaTec. (Rebecka Rice)
