How to Find the Right Compression Socks
Shopping for compression socks or stockings can be mind boggling. There are just so many options that it is difficult to tell what would work best. In an ideal world, people would consult with a trained fitter such as a Certified Lymphedema Therapist, but let’s face it…everyone shops online.
To that end, I’ve put together some tips for finding the right compression sock for you.
Choose a Level of Compression
Compression is measured in millimeters of Mercury (mmHG), just like blood pressure. The more severe your condition, generally the more pressure you need. Here are the different levels:
15-20 mmHg – “Over the Counter” Compression
This level of compression is great for people who just get a little achy in their legs after standing for long periods – like when they are traveling or playing sports. 15-20 mmHg is very light compression and generally quite comfortable for most people. They can be worn daily.
You can typically find this level of compression at big retailers (like the one with the famous blue sign with white writing). But, buyer beware! These inexpensive brands are not designed with the precision of the pro-manufacturers. Pro Tip: Stick with the pros. Having the right compression socks or stockings makes all the difference when it comes to whether or not you will put them on every day.
20-30 mmHg – Mild Symptom Management & Medical Recovery
Great for anyone with spider veins, swelling after surgery (edema), or mild varicose veins. These are also a daily wearable stocking pressure and would also be great for people who are constantly on their feet (e.g. retail workers).
30-40 mmHg – Moderate Symptom Management, DVT Treatment, Lymphedema
Ideal compression level for people who have medical problems such as a DVT or lymphedema. People who have severe swelling (edema) as well as severe varicose veins or who have undergone surgery recently will benefit from this compression class.
Knee High Sock, Full Leg Stocking, or Panty Hose?
Knee High Socks
Knee high compression socks are designed to stop at the top of the calf, just below the knee. When choosing your knee high size, make sure that you get ones that stop below the knee. If you try to pull them up and over the knee they are likely to roll down. When this happens, each layer of sock in the roll adds to the compression of the other layers in the roll making a very tight constriction on the leg which can be quite dangerous. With all compression socks or stockings it is imperative that no folds or rolls happen because of this phenomenon.
Thigh High Stockings
Thigh high compression stockings are designed to stop at the place where your buttock meets your thigh. Because they cover the entire leg they improve circulation throughout the leg, not just below the knee. Thigh high stockings often come with a silicone band or beads to hold them in place which is generally sufficient. If not, you can apply an adhesive product called “It Stays” by Jobst.
This style of compression stocking is made of two legs and a torso portion that comes to the waist. There are regular, maternity, and men’s leotard versions available. Because this compression goes up over the hip, it compresses both the inguinal lymph nodes (ones located in the hip crease) and lower abdominal lymphatics. If the legs are swollen due to damaged or removed inguinal lymph nodes, these make for better lymphatic drainage than thigh-high stockings.
How to Choose the Right Length
Choosing the right length of sock or stocking depends on why you are wearing compression. If you are wearing them for a very mild condition such as minor swelling or fatigued legs you can wear whatever is most comfortable for you.
If, however, you have a more serious condition such as lymphedema or severe varicose veins, you should choose a length that completely covers the affected area and then some. The “and then some” is because you don’t want to just push the swelling above the affected area. You want to push it into areas with good lymphatic circulation. Err on the side of more length than you think you need.
Choose the Right Material
Compression socks and stockings come in a huge array of materials nowadays. They mimic everything from sheer pantyhose to fluffy cotton-like material.
Sheer Stockings for Women
Sheer stockings are a very popular option for many women who want to have compression that matches their wardrobe and looks stylish. Sheer styles are fine for mild conditions such as minor swelling and fatigue, but do not do very well for moderate to severe conditions like lymphedema. They also tear like pantyhose, but they are not nearly as cheap to replace. Opting for an opaque fabric may not be as fashionable, but you will likely get more wear out of the sturdier materials.
Opaque compression socks and stockings offer durability and come in a variety of thicknesses, ranging from the approximate thickness of thin tights to very sturdy material. The opaque fabric is better suited to moderate swelling, post-operative swelling, and varicose veins. Opaque fabrics tend to be comfortable and are available for both men and women.
High-tech Cotton/Wool Blends for Sports and Active Lifestyles
Active people who are in need of compression often find this material to be the best option because they are super durable while also controlling moisture and heat. They are very comfortable, sometimes even having a cushioned bottom like a tube sock.
Spider veins, varicose veins, mild swelling, and post-operative conditions are all well-served by these sporty socks. Cotton and wool blends are great up to the moderate compression level of 20-30 mmHg, but lose their effectiveness at higher compression levels. People needing 30-40 mmHg or higher should consider one of the opaque fabric options.