Compression stockings are specially made, snug-fitting, stretchy socks that gently squeeze your leg to promote circulation. They fit tighter than normal so they gently squeeze your legs, which helps improve your blood flow and reduces pain and swelling in your legs. They can also lower your chances of getting deep vein thrombosis (DVT), a kind of blood clot, and other circulation problems.
They come in different lengths and tightness; you can get open-toe compression for comfort. You may feel compelled to buy them over the counter, but remember that the ideal minimum compression is usually 30 to 40 mm Hg (millimeters of mercury). Although greater compression may be necessary for some people, that usually happens when a non-healing wound or difficult-to-treat edema is present. To ensure the pressure is correct, your leg must be measured appropriately for the proper fitting. Otherwise, you will end up overpaying for regular socks or, worse, choking your leg with overtight stockings. The latter could predispose you to blood clots, precisely the opposite you might have been trying to prevent.
Compression stockings are safe for most people to wear. However, you need to be cautious if you suffer from peripheral arterial disease (PAD) of the legs, as they could potentially restrict flow on an already damaged blood vessel.
They might be beneficial if you:
- Are at risk for circulation problems like varicose veins or a history of DVT
- Are recovering from surgery (especially those with knee surgery)
- Suffer of leg swelling
- Have, or are at risk for, lymphedema (a buildup of fluid usually drained by your lymphatic system)
- Are bedridden or have a hard time moving your legs
- Sit or stand all day at work (did you know that certain jobs could triple your risk of developing vein problems and varicose veins?)
- Are pregnant
- Spend long stretches of time on airplanes
Graduated compression stockings are tightest around your foot and ankle, and the pressure eases as the socks go up your leg. They enhance the function of a little pump built-in into your foot and calf, the plantar and calf venous pumps. This helps increase how much and fast your blood flows from your feet and back up to your heart. Your veins get a boost pushing blood back to your heart, which helps keep it from pooling and clotting. This is especially important in people with flat feet and other foot issues.
Some people may have issues with the hoses rolling down when walking. Here is a trick… remember I was talking about the foot and calf pumps? They manage up to 85% of the pumping function in the leg. As a result, there is little need for the compression stocking to be above the knee (unless your doctor recommends it for a specific reason.) However, if you need or prefer to wear thigh-high compression stockings, you can get special skin glue or rubber to keep them in place. My favorite trick is to wear a pair of Spandex biker shorts over to keep the edges in place. Now, if you wear knee-high compression, remember the edges have to fall two finger-breaths below the popliteal crease (the line behind our knee, where the leg bends.) It is inappropriate to fold the stocking if it is longer than your leg because this could double the compression in that area and limit proper blood flow.
Because they are tight, compression stockings may be difficult to put on. There are many devices to aid with this. However, I usually recommend my patients learn the “puppet technique.” This consists of stocking up your arm and then rolling it back to the heel. This leaves the pocket where you can fit your foot in and easily pull the stocking up once you pass the heel area with the stocking on.
Compression stockings are an aid but do not replace physical activity and regular exercise. The hoses will not be able to pump the blood flow on their own; leg motion is a must.
I value your opinion. Let me know if this article is helpful to you.
Best,
Dr.E
PS: If you would like to know more about:
- the “puppet technique” and other aides for compression hoses, read “Compression stockings: how to put on and take off.”
- For flat feet and other foot problems, read “flat feet and venous disease.”
- alternatives and supplemental activities to compression stockings, read “aquatherapy for compression”