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FAQ - Compression therapy
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What are graduated compression garments?
What are compression garments used for?
What is venous insufficiency?
What causes venous insufficiency?
What is lymphoedema?
What causes lymphoedema?
How do graduated compression garments help?
When should I wear graduated compression garments?
When shouldn't I wear graduated compression garments?
How is compression measured?
Is all mmHg the same?
Medical stockings vs anti-embolism stockings:
What stocking styles are available?
What style should I wear?
What materials are compression stockings made of?
How do I get them on and off?
Fitting Tips
What are graduated compression garments?Graduated compression stockings for the leg are manufactured so as to exert the strongest pressure at the ankle, reducing proportionately up the leg (pressure at the calf is 60-70% of the ankle; pressure at mid-thigh, 60-70% of the calf). Similarly, graduated compression armsleeves are strongest at the wrist, with pressure reducing up the arm. What are graduated compression garments used for?Graduated compression garments are used in the preventative and therapeutic treatment of venous insufficiency of the leg, and also in the treatment of lymphoedema of the leg and hand and arm. What is venous insufficiency?The main function of veins in the leg is the return of blood to the heart. The veins in the leg are characterised by a series of one-way, or non-return, valves. In a healthy leg, when the heart pumps, blood moves up the leg, and then is stopped from flowing back by these non-return valves. This is aided by physical activity (walking, swimming etc), where the calf muscle contracts & relaxes (this action is sometimes referred to as the ‘muscle pump’. In an unhealthy leg, when one or more of these valves fails to function correctly (“leaks”), some blood is able to flow back down the leg - in the wrong direction - and tends to overfill and distend branches of superficial veins under the skin. Over a period of time, this additional pressure of blood causes the veins to stretch, bulge and become visible, resulting in varicose veins, the most common form of chronic venous insufficiency. At the same time, tiny capillary branches of the veins are also overfilled with blood, producing multiple spider veins and purple discolouration. A common complication of varicose veins, apart from pain, leg tiredness and fatigue, is pronounced oedema (swelling) of the ankles. This swelling is due to inability of the capillary network to take up tissue fluid because of elevated venous pressure. Untreated varicose veins can lead to permanent damage to the leg, which over time, may lead to ulceration. Such venous ulcers are difficult to heal. What causes venous insufficiency?Varicose veins, the most common form of venous insufficiency, may be inherited in some people. Other factors which can cause the valves to stretch and leak are obesity, pregnancy, heavy lifting, prolonged standing, and any other factor which can exert downward pressure on the veins in the groin. What is lymphoedema?Lymphoedema is a high protein oedema caused by lymphatic transport capacity and tissue proteolytic capacity being less than normal. Basically, it is a problem with the body’s lymphatic system in removing non-blood fluid from the body extremities. What causes lymphoedema?Things which disrupt the functioning of the lymphatic system –
How do graduated compression garments help?In the case of venous insufficiency, medical compression stockings assist in promoting the flow of blood up the leg. By exerting pressure on the outside of the leg, the compression stocking restricts the ability of the blood to flow through the surface or superficial veins. The blood is therefore forced, through the network of communicating veins, into the deep veins. As a result, there is a greater volume of blood in the deep veins, which aids in its upward flow towards the heart. When should I wear graduated compression garments?You should wear graduated compression garments when prescribed by your physician to treat venous insufficiency or lymhoedema. In such cases, your physician will usually specify a particular level of compression.... normally, the compression level which applies to therapeutic garments, is over 20mmHg. Garments over 20mmHg should be prescribed by a physician. Lighter graduated compression stockings....up to 20mmHg, are often available over-the-counter at pharmacies. Such stockings are suitable for self-prescription for prevention of varicose veins during pregnancy, for long distance travel – assisting in the prevention of swollen ankles and feet, and reducing the risk of DVT - and in everyday use to ease general leg fatigue for those who spend a lot of time on their feet. When shouldn’t I wear Graduated Compression stockings?Those with arterial insufficiency should not wear graduated compression stockings. Also, those with diabetes should consult their physician regarding the wearing of stockings, as should those with venous ulcers or severe swelling or any other complications. How is compression measured?The strength or pressure of a graduated medical compression stockings and armsleeves is expressed in The mmHg is expressed as a range (eg. 20-30mmHg). In the case of stockings, this means that, depending on the ankle size of the wearer, the stocking will exert between 20 and 30mmHg pressure at the ankle. Is all mmHg the same?In the USA, compression values of stockings tend to be expressed in terms of 20-30 and 30-40mmHg. etc. The European compressions are expressed differently, where medical stockings of therapeutic value, are assigned ‘classes’ or ‘grades’ of compression (1, 2, 3 etc). …. usually expressed as K1, K2 or Cl1, Cl2 etc. To confuse matters even further, the European system of measuring mmHg is different from that in the USA. So, for example, you may see a European stocking of Class 2 with a stated mmHg of 23-32, which is actually of equivalent compression to the USA stocking of 30-40mmHg! However, in most cases, European stockings will not mention mmHg on their packaging, only the compression class. These are as follows -
Medical stockings vs anti-embolism stockings:The following is an excerpt from an information brochure published by Ganzoni & Cie, St. Gallen, Switzerland (manufacturer of Sigvaris medical stockings): “The anti-embolism stockings frequently prescribed in hospitals for bedridden patients are designed to provide mild pressure to help reduce the possibility of blood clots. Patients often assume that the anti-embolism stockings should continue to be worn after they leave the hospital and become ambulatory. This is simply not true. The anti-embolism stockings are specifically designed for non-ambulatory use with pressures up to 18mmHg at the ankle. They do not provide the higher compression required by the ambulatory patient…….. when the patient becomes ambulatory, higher compression is required to overcome the effects of gravity” What stocking styles are available?Medical Compression Stockings are available in different styles–
The thigh length with waist attachment incorporates a belt which goes around the waist and fastens with Velcro® or a buckle, keeping it in place, and of course, the pantyhose are also self-supporting. Most of the higher grade medical stockings are available in either open or closed toe models. This is often a personal thing, but usually, with stockings of class 2 (30-40mmHg) and above, an open toe is preferable, as the stocking may be too constrictive and therefore uncomfortable around the toe - especially for those with a larger foot. What style should I wear?Most vascular problems occur in the lower part of the leg, as this is where pooling of blood usually occurs, and therefore where varicose veins develop. If there is oedema, it is usually around the foot/ankle/lower calf area. In such cases, a below the knee (or knee length stocking as it is often called), is usually appropriate. However, if for whatever reason, the physician specifies compression above the knee, or to the groin, then a full length stocking or pantyhose would be appropriate. If, for aesthetic or comfort reasons, you personally prefer a stocking above the knee rather than a below knee stocking, this would not usually present a problem. This may also be preferred, where the wearer has a particularly fleshy knee, in which case a below knee stocking may have a tendency to ‘cut in’ or roll down. What materials are compression stockings made of?Stockings are usually composed of lycra stretch, covered with nylon fabric. There are also stockings with various levels of nylon/cotton blends. In higher compression stockings, there are also stockings which have natural rubber (latex) stretch instead of lycra, as natural rubber is stated to have preferable stretch characteristics more suitable for higher compression stockings (especially Class 3 compression and above). How do I get them on and off?Lighter preventative stockings usually do not present as much of a problem, as they are easier to handle. The stronger therapeutic stockings often present more of a problem, due to lack of strength in hands and fingers, arthritis, lack of joint flexibility, obesity. Important things to remember when putting on stockings:
Fitting Tips:
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FAQ - Compression therapy
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