Compression Stockings

Prescription compression socks or stockings gently squeeze your legs to assist with blood flow and movement of fluids in the lower limb. Compression stockings are commonly used as a treatment for people with acute or chronic venous insufficiency. Venous insufficiency is a condition where the valves in the veins don’t work as good as they should. The veins have trouble pumping blood back to the heart – causing swelling, aching, and heaviness in the lower leg.

By squeezing your calves, compression socks counteract the increased pressure in the veins. That helps blood flow back toward your heart.

Benefits of Compression Stockings:

Compression stockings can be used for many reasons:

- Post-Surgery

- Pregnancy

- Extended Travel Time or Long-Haul Flights

- Aching and swelling of the lower limb

- Phlebetis

- Lipodermatosclerosis

- Deep Vein Thrombosis/Post-thrombotic Syndrome

- Chronic Venous Insufficiency

- Edema Management

- Immobility/Sedentary Individuals

- Spider Veins (mild varicosities)

- Varicose Veins

- Sport Performance/Injury Prevention

How do you use compression stockings?

Compression stockings are most effective when worn consistently. They are useful during activity and when gravity is acting on your body. So, this means when you are walking, sitting, and standing. They are not effective when you are lying down, for instance when you are sleeping. Wearing them overnight or 24/7 may not be beneficial as this can sometimes cause your skin to break down. It is not necessarily harmful unless the compression socks are uncomfortably tight.

There are some instances where compression socks are contraindicated. When you should not use compression stockings:

- Suspected or proven peripheral arterial disease, including history of peripheral arterial bypass grafting

- Severe peripheral neuropathy or other cause of sensory impairment

- Allergy to stocking material

- Massive leg edema or pulmonary edema from congestive cardiac failure

- Local skin or soft-tissue condition, including recent skin graft, fragile “tissue paper” skin, gangrene, oozing dermatitis and severe cellulitis

- Extreme deformity of the leg, or unusual leg shape or size preventing correct fit

(Source: Lim, C. S., & Davies, A. H. (2014). Graduated compression stockings. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 186(10), E391–E398. https://doi.org/10.1503/cmaj.131281)

Using Compression Garments Post-Surgery

Wearing compression garments may be suggested by your doctor after surgery. Always check with your doctor to be sure if you are ok to use compression stockings post-surgery. There are some procedures where you will be directed to keep a compression garment on until your doctor asks you to remove it. It is important to not break any hip/knee precautions post surgery while putting on your stocking. Have someone help assist put the stocking on for you to prevent this.

Wearing compression stockings after surgery helps with:

Promoting Circulation after Surgery:

o It is important to keep blood moving in the extremities without disturbing the incision site and disrupting the stiches from surgery. Graduated compression after surgery can help maintain blood flow with gentle tapering pressure at the lower limb.

Preventing Deep Vein Thrombosis (DVT):

o DVT is a condition where blood clots form in the veins. These clots can travel upstream into the lungs or heart which can become fatal. Surgery increases the risk of DVT. Studies have shown that wearing compression socks after surgery reduces the risk of developing DVT by 50%.

Reduces Swelling to the Lower Limb:

o Post surgical swelling is normal and expected. The fabric in compression stockings is designed so that the skin does not expand, and fluid is forced up the leg and into larger circulatory channels.

Prevents Varicose and Spider Veins:

o Varicose and Spider veins can develop after an operation. This is when the walls of certain veins expand and allow blood to pool. Spider veins are cosmetic whereas varicose veins may be itchy, ache, and/or sting. Compression stockings improve circulation and reduce the formation of these veins.

Accelerates Healing

o With improved circulation, it is easier for oxygen and nutrients to reach the damaged tissues after surgery.

Types of Compression Stockings

There are several types of prescription compression socks or stockings. Each type is specially made to treat or prevent different circulatory problems and provide comfort by improving blood flow in the lower extremity of the body.

Graduated compression socks

Graduated compression socks feature an intense compression at the ankle that decreases as you move up the leg. This type of socks requires professional fitting, and they are designed for mobility.

Graduated compression socks can be below-knee, which are primarily used to treat or prevent lower leg edema, or above-knee, which are used to reduce pooling of blood and to avert orthostatic hypotension.

Anti-embolism stockings

Anti-embolism compression stockings are used to reduce the chances of deep vein thrombosis in immobile individuals, including bedridden persons and those recovering from surgery. They have to be prescribed by a professional to meet specific compression strength.

They are similar to graduated compressions stockings in that they are also graduated. However, the degree of compression varies between the two.

Nonmedical support hosiery

Nonmedical compression socks or stockings do not require a prescription. They exert low, uniform pressure to your legs. Unlike medical-grade compression socks, non-medical socks have a lower level of pressure.

This type of compression socks is typically used to relieve aching legs. Athleisure Sport Compression Socks, Calf Sleeves, Hose, Flight Socks, and Performance Compression Socks are good examples of nonmedical compression socks.

Compression Stockings Brands:

There are many brands that offer compression stockings. At Vaughan Physiotherapy Clinic we carry a wide variety of medical grade compression stockings for women and men for your needs:

- CEP Compression Socks

- Jobst Compression Stockings

- Sigvaris Compression Wear

- Mediven Compression

- Juzo Compression Stocking

Tips for Using Compression Stockings

Before you put them on

1. Hand wash your stockings before you use them. This will help soften the fabric making it easier to put on. It is recommended to have a second pair so that you have a clean pair while the other is in the wash.

2. Put a dressing on any open wound before putting on the compression stockings.

3. Keep your stockings by your bed or somewhere near by, so that you can put them on when you first get up.

To put them on

1. Put them on in the morning. This is when your legs will have the least amount of swelling.

2. Sit down on a stable chair with a backrest.

3. Be careful not to grab and pull at the top of the stocking, because that can cause it to rip or tear.

4. Turn the Stocking inside out so that you are able to roll the stocking up your leg rather than pulling it through.

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How to put Compression Stockings on for Someone Else (Using a Butler)

https://www.youtube.com/watch?v=6lXQKPpGKK0

Medi How to Put on Compression Stockings

https://www.youtube.com/watch?v=wU3fnH_34NA\

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If you have trouble:

- Wear rubber gloves to help you grip the fabric.

- Use Talcum/baby powder on your legs to help the stockings slide on.

- Try a "stocking butler." It's a metal device that holds the stocking open while you step into it.

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Talk to your doctor or the certified fitter at your medical supply store, especially if you have a disability that makes it hard to put the stockings on.

Call your doctor if your toes get numb or painful or turn dark while you are wearing compression stockings.

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Speak to a specialist at Vaughan Physiotherapy Clinic about your health condition and any discomfort you may be experiencing and find out if compression garments can help you.

Call us at (905) 669-1221 to speak with one of our specialists.

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