Everything You Need to Know About Compression Socks

Everything You Need to Know About Compression Socks

You may have seen runners or older people wearing compression socks (also known as compression stockings), but if you’ve never worn them you might not know much about them. We turned to foot surgeon Georgeanne Botek, DPM, for everything you need to know to determine if they’re right for you. 


What Are Compression Socks?

Compression socks are socks that are designed to prevent swelling and improve circulation in your legs. They come in various lengths, including ankle, knee-high, and full-leg options. 


How Do They Help?

There are plenty of studies and evidence that prove that compression socks work, particularly for venous problems of the legs. “Nearly 90% of leg disorders originate within the veins,” Dr Botek notes. 

For example, venous insufficiency (when the valves in the veins fail to work properly) causes blood to stay in the legs instead of travelling back to the heart. This results in swelling and other problems, such as skin changes, inflammation of the vein (also called phlebitis thrombophlebitis), damage to vein walls and valves, varicose veins and even blood clots. 

Compression socks put gentle pressure on the tissues beneath the skin. “This reduces excess leakage of fluid from the capillaries,” Dr. Botek says, “and it increases the absorption of this tissue fluid by the capillaries and lymphatic vessels.” 

The result: reduced swelling and prevention of the aforementioned problems.

Compression socks also help with improving blood flow when you’re sitting for long periods of time, like a long flight or car ride. 

Because you’re not moving around, blood circulation decreases and there’s more blood retention in the legs, which can increase the chance of blood clots. The risk of clots isn’t high if you’re healthy, but you might notice some discomfort or swelling after long periods of sitting. 

Compression socks will maintain your circulation and reduce any discomfort. 

Types of Compression Socks

There are three types of commonly-used compression socks:

  • Graduated compression stockings
  • Anti-embolism stockings
  • Non-medical support hosiery

Graduated Compression Stockings

These socks have the highest level of compression at the ankle, and the compression level gradually decreases towards the top. In other words, the sock will be tightest around your ankle and more stretchy at the top of the sleeve. These are designed for people who are able to walk and run. Some can be purchased over the counter, but they can also require professional fitting.

Graduated compression stockings that end just below the knee prevent peripheral edema (lower leg swelling).

Stockings that extend to the thigh or waist help reduce pooling of blood in the legs and help prevent orthostatic hypotension.

Anti-Embolism Stockings

Anti-embolism stockings reduce the risk of deep vein thrombosis, a serious condition that occurs when a blood clot forms.

Like graduated stockings, they provide gradient compression. However, they typically provide a much higher level of compression and must be fitted by a professional. Anti-embolism stockings are designed for those who aren’t mobile–usually patients who are bed-bound after surgery.

Non-Medical Support Hosiery

Non-medical support hosiery don’t typically require a prescription. They provide the same level of compression from top to bottom, and tend to exert less pressure than prescription socks. 

Should Athletes Wear Compression Socks?

Compression socks are widely used by athletes of all types, especially runners. They can help to keep your legs warm, dry and protected from the elements during long runs outside. They also may increase oxygen delivery to muscles, improve blood circulation, and increase the removal of lactic acid, but there are not many studies that prove this. 

However, there is evidence that compression stockings can help recovery. “There was an Australian study that looked at runners that found that compression socks could possibly have a positive impact on subsequent running performance,” Dr Botek said. 

“It can be about personal preference, too,” she adds. “People might wear them because they feel good and everyone wants that little competitive advantage.” 

Can Anyone Wear Them? 

If you experience discomfort from swelling in your legs, trying compression socks is worth a shot. You don’t need a prescription or a doctor’s approval to get a pair of compression socks, so there’s no harm in trying them. 

If you’ve never worn compression socks before, you might be surprised by how tight they are. Some people experience indentations on their legs from the socks, and they are definitely tighter than normal socks. 

However, you shouldn’t worry about whether they’re actually cutting off your circulation or if they’re doing more harm than good. But Dr Botek says, “for 99% of people, that’s just not the case. The only place issues might crop up is for unhealthy individuals who have severe reduction of their heart function or they have a severe peripheral arterial disease where they have poor blood flow between either the feet or legs and the heart.” 

Compression socks that are available without a prescription provide light to medium compression, which is too low to worry about. 

Advice for New Wearers

While some people have no problem wearing compression socks from day one, others might need some time to get used to the feeling. If you find them uncomfortable as you wear them throughout the day, it’s okay to take them off. “Don’t feel you have to wear them from breakfast to dinner,” she says. “Sometimes you need to adjust to them if you find them uncomfortable.”

Another thing to consider before you buy a pair is which style is right for you. If you only have swelling in your lower legs, start with the style that ends below your knee. Less surface area covered means you’ll be able to get used to the feeling of compression more easily. 

However, if you have swelling above and below your knees, go with a style that goes up to your thighs. A tip for those with larger calf muscles–choose your size based on your calf measurement, as this is where the sock will be tightest. The thigh part of the sock will be stretchy enough to fit a wider range of sizes. Even if the size chart is way off for your thigh measurement, you should be fine in most cases.

One final takeaway: compression socks should not be your only line of defense against swelling. Make sure you move your legs, drink plenty of water, and maintain a low-salt diet.

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