Writing about when to wear compression socks may not be the most exciting topic, but it’s an important one for sure! The topic came up last year when one of my clients came in wearing compression socks as she was heading to the airport after our appointment. She explained that the last time she flew her ankles became “cankles” and she freaked out. She recommended that I buy compression socks for my long flights and I thanked her for the idea and did nothing about it. 

Why would I need compression socks on a flight? Well, funnily enough, on the last trip I took my ankles became cankles too and I freaked out! Luckily, I landed in London Heathrow and marched straight into Boots pharmacy. I wriggled my swollen legs into the tight socks for my next jaunt. It took almost 2 days for my ankles to become normal. Now, compression socks are the first thing I pull out while preparing my travel bag.

Why Should We Wear Compression Garments

Compression socks can provide relief for people who experience symptoms of vascular insufficiency (swelling of the legs or leg pain) by increasing circulation. Compression socks are also great for people who spend much of their day standing, sitting, or traveling on airplanes. Standing in place or sitting for long periods without stretching causes blood to pool towards the bottom of your legs. This stagnant blood has a higher likelihood of forming blood clots, also known as thrombi. On an airplane, you’re typically sitting in one spot for hours at a time and your legs are bent with your feet flat on the floor. This is the perfect way to get cankles or worse. 

Travel tip: For best results, you should slip into your compression socks several hours before your flight. Try not to wait until you board the flight. In the morning, your feet are less swollen. When you put them on early, you give your legs more time to adapt so that you can board your flight with good circulation. Also, while flying, be sure to periodically flex and extend your ankles to promote blood flow.

Additionally, on the scarier side, this lack of activity makes you more susceptible to developing deep vein thrombosis (DVT). DVT occurs when stagnant blood starts to coagulate and form blood clots. If one of these blood clots ends up blocking a vein, you now have a DVT. This is a serious, yet avoidable health condition. Signs of DVT include painful swelling, typically affecting one side more than the other. 

Knee-High vs Thigh-High Compression Socks

When it comes to choosing the right compression socks, your first choice is whether to go with a stocking that covers your knee or sits just below. For most people, compression socks are used to improve circulation within the lower leg. Not only do they help prevent blood clots, they also reduce the chance of getting varicose veins. Either sock-length works well; the difference between them lies in comfort and the area of treatment. 

Thigh-high, over the knee compression stockings or socks can be less comfortable. This is due to tightness and perspiration. The area above the knee tends to accumulate more sweat in comparison to the area below the knee. Tight-fitting compression stockings can cause this area to become itchy and irritated. Moreover, thigh-high stockings can constrict blood flow in your upper leg, creating a tourniquet-like sensation. And finally, thigh-high socks are simply harder to put on; it takes a bit of extra effort to pull them over your knees. 

That being said, for most people under-the-knee compression socks are a better option. However, if you suffer from knee-stability issues or have varicose veins within your thighs, you may want to consider using over-the-knee, thigh-high stockings, despite their lack of comfort. 

How Much Compression Do We Need

When looking for compression socks and stockings you may run into the acronym mmHg. This is defined as a unit of measurement for “millimeters of mercury”. It is the same measurement of pressure used when we have our blood pressure checked.

Another unit of measurement I came across was denier. It determines the thickness of fabric fibers. The higher the denier count the thicker the fabric (think tights). Lower denier counts offer sheer textures like pantyhose. Understanding these measurements will help you select the best type of compression for your needs.

3 Classes of Compression

Class I typically refers to basic compression socks and hosiery to prevent swelling (edema) during flights or standing for long periods of time. If you’ve had recent sclerotherapy to remove spider veins or varicose veins your doctor may recommend this lightweight option. The range will be between 15-20 mmHg.

Class II is recommended for moderate to severe medical conditions, such as general swelling from lymphatic swelling, ulcers caused by pooled blood, deep vein blood clots or vein valve disorders. These compression socks are usually prescribed by your doctor and should not be worn without consultation. Class II has a range between 20-40 mmHg.

Class III is anything above 40 mmHg and supposed to be available by prescription only, however, I found a few on Amazon. This level is for very serious cases of valve issues, pooling of blood in the legs and skin damage.

Note: It’s important that you are measured for compression socks above 20 mmHg. Your doctor will “fit” you for the correct size. 

Stayed tuned for my next post on athletic compression gear for athletics and pregnancy. You’ll learn interesting facts about increasing blood circulation to your muscles while wicking away sweat. 

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