What You Should Know About Compression Socks

They're not just for older patients
man running while wearing compression socks

Chances are, you’ve probably seen compression socks before, specially made stockings that gently squeeze around legs at various lengths. But if you’ve never had to use them, there’s probably a lot you don’t know about them.

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From their medical advantages to the misconception about age-appropriate use, there’s lots to learn about compression socks. So we turned to foot surgeon Georgeanne Botek, DPM, for everything you need to know. 

What are compression socks?

Compression socks (or compression stockings) are socks of various length that are designed to gently squeeze legs a bit more than typical socks. “The key intention,” Dr. Botek says, “is to promote better blood circulation in the legs.”

A proponent of compression socks, Dr. Botek adds, “It’s a very practical and common thing. But, at the same time, it’s a very underutilized option.” In other words, more people could benefit from using them. 

How they help

Dr. Botek notes that there are plenty of studies and evidence that compression socks work, particularly with regard to venous problems of the legs. “Nearly 90% of leg disorders originate within the veins,” she notes. 

One example is venous insufficiency. “That’s the failure of the valves of the veins to function,” Dr. Botek explains. “Your blood would be retained in the legs and you’d have diminished returns to the heart.” 

By gently squeezing the legs, compression socks increase the pressure in the tissues beneath the skin. “This reduces excess leakage of fluid from the capillaries,” Dr. Botek adds, “and it increases the absorption of this tissue fluid by the capillaries and lymphatic vessels.” 

The result: reduced swelling and swelling prevention. Additionally, Dr. Botek says, “It also reduces the ability of superficial veins to expand in order to fill with blood, which prevents that blood from flowing backwards and causing congestion.”

If blood pools in the veins of the legs, she says, that can cause a variety of problems including skin changes, damage to vein walls and valves, inflammation of the vein (also called phlebitis thrombophlebitis), varicose veins and even blood clots. 

Besides venous insufficiency, Dr. Botek also says that another common reason for wearing compression socks is to aid in blood flow when you’re sitting for long periods of time, like a long flight. 

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With less movement and weaker circulation, there’s more pooling and retention of blood in the legs which can raise chances of clots. While the threat of clots isn’t that high if you’re healthy, you’ve probably noticed discomfort or swelling still taking place on long fights. Compression socks help keep that circulation going and reduce those symptoms. 

The types of compression socks

You’ll generally find two types of compression socks: graduated and anti-embolism stockings. As always, be sure to check with your healthcare provider with any questions you have.

Graduated compression socks are the more common types you’ll find and what most people use. While available in a range of compression tightness, these socks are all tightest around the ankle, getting looser the higher up the leg they go. Compression socks generally come in two lengths — knee-high and thigh-high — but full compression tights are growing more common with athletes.

Anti-embolism stockings are more specific in purpose. They’re designed to help maintain circulation, thus preventing blood clots, for bed-bound patients, particularly those confined to bed after surgery.

Do athletes benefit from compression socks?

It’s not uncommon to see athletes in various sports wear different iterations of compression socks or even compression sleeves. According to Dr. Botek, while there’s not a lot of evidence to support “a mechanism of action” for athletes wearing compression socks, there has been some evidence that it 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,” she said. In other words, if you wear compression socks for a run, you might have a better run the next time out.

According to Dr. Botek, there have been theories about the effects they have for a runner’s circulation — increasing oxygen delivery to muscles, improving blood circulation, speeding the removal of lactic acid — but, she says we don’t really know yet if that’s the case.

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

But she does add that there’s one advantage for athletes to wear compression socks and that’s protection. “The materials that compression socks are made from are usually thicker than the average sock so they’re protecting the skin and keeping the legs warm and dry. 

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Can anyone wear them?

The great thing about compression socks, Dr. Botek says, is that you don’t need a doctor’s approval to try them and for most people, there are no risks to giving them a go. 

Some people might be worried by the fact compression socks are tighter than normal socks or the indentations compression socks leave on their legs. “They may be worried,” she says, “about whether or not the compression socks are actually cutting off their circulation.” 

That’s a misnomer, she 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.” 

Most compression socks you’d find on store shelves, be it an athletic store or even a drugstore, are going to be of light to medium compression, anyway, she says. 

Dr. Botek adds that while compression socks may be most associated with older patients, they’re actually applicable for adults of any age. “You just need to try it for your own personal use to know if it’s right for you or not give up on it after just one day, whether it’s for everyday use or as an athlete,” she says. 

Advice for new wearers

If it’s your first time wearing compression socks, but you find them uncomfortable as you wear them throughout the day, Dr. Botek says 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, like when you break in a new pair of shoes.”

One more thing to consider is below- or above-knee socks, Dr. Botek notes, and below-knee are more common. “If you have thicker calf muscles, I would say go with the above-knee compression socks,” she says. “Sometimes that extra few inches of material can create more comfort at the top of your calf so it’s not necessarily tight on your skin there.” 

And she adds, “Remember, compression socks are just one part of your regiment. Make sure you’re drinking plenty of water, consuming a low-salt diet and moving your legs.”

She elaborates, “Between just sitting for long periods of time or just standing for long periods of time can cause swelling in the legs. Try to find that happy balance between the two, keeping your muscles working and not just succumbing to gravity.”

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