Medically reviewed by Dr. David Ferenci — Written by Kari Johnson
Published July 8th, 2020
Many doctors recommend compression socks as a way to help patients increase blood flow, boost circulation, and reduce discomfort. With so many types of compression socks available, selecting the ideal pair may seem intimidating. In particular, if you're unfamiliar with compression therapy, you may not understand the difference between graduated and regular compression. To explain the distinction, we first have to look at the way that we measure compression. Socks come with a pressure label, or a pressure range, in mmHg. This stands for millimeters of mercury, and it's the same unit of measurement doctors record when taking your blood pressure.
Uniform, or regular, compression socks maintain the same mmHg throughout the length of the sock. On the other hand, graduated compression garments offer gradient pressure. By providing a range of pressure, with more pressure closer to the feet and less pressure closer to the knees, graduated compression socks assist the veins as they pump deoxygenated blood and waste fluids to the heart. Graduated compression socks also prevent blood and fluids from pooling in the lower legs and ankles, which can reduce your risk of developing venous insufficiency, deep vein thrombosis (DVT), and edema.
Is There a Difference Between Graduated Compression Socks and Stockings?
Functionally, knee-high graduated compression stockings and knee-high graduated compression socks work in the same way. Both garments apply precise amounts of pressure to different parts of the leg, in order to constrict the veins and increase the velocity of venous blood flow. Socks with different compression levels —which range from light (8-15 mmHg) to extra firm (40-50 mmHg)—come in any number of materials.
For example, we offer True Graduated Compression socks in both merino wool and SmartSilver antimicrobial fabric. At our factory, we measure compression with a Swisslastic MST MK V pressure measuring device for medical compression socks and stockings. So, whether you buy a 15-20 mmHg compression sock from our site online or from a trusted medical supply store, you can expect to find 20 mmHg of compression at the ankle and 15 mmHg of compression at the calf.
A 2013 study of sports compression garments showed that, while some small differences in elasticity exist, "no clear relationship between percentage of fabrics composition and generated pressure was established." (Troynikov 160-161) Therefore, when you look for graduated compression garments, the most important measurement to look for is the mmHg rating. The fabric composition—whether you're wearing a garment made of stocking material, merino wool, or a high-tech antimicrobial blend—doesn't have the same impact on compression that the mmHg rating does.
The Benefits of Graduated Compression
Graduated compression has been shown to help prevent blood clots in deep veins, also known as deep vein thrombosis (DVT). (Agu) Deep vein blood clots can lead to complications, including post-thrombotic syndrome and pulmonary embolism. People become more likely to develop DVT during post-surgical recovery (Sachdeva), long periods of sitting (Homans), long-haul flights (Clarke et al.), and pregnancy ("Deep Vein"). By wearing graduated compression garments, people maycan avoid DVT and the potentially fatal medical conditions that sometimes result from blood clots.
For this reason, doctors recommend wearing compression garments if you:
- Plan on taking a flight
- Must sit for long periods
- Are pregnant or have given birth within the past six weeks
- Have just had surgery
Additional Use Cases for Graduated Compression
In addition to aiding in the prevention of preventing DVT, graduated compression therapy also reduces your risk of developing chronic venous insufficiency, which can lead to varicose veins, spider veins, and even ulcers. By compressing your veins, graduated compression socks and stockings promote healthy blood flow and prevent the buildup of lactic acid, as well.
Consider wearing compression socks in order to:
- Stand for long periods
- Increase athletic endurance
- Avoid muscle aches after exercise
- Improve circulation and blood flow
- Reduce swelling in the legs and ankles
- Reduce risk of developingPrevent varicose veins
Use Cases for Uniform Compression
In some circumstances, uniform compression may be more beneficial than graduated compression. For example, if you have been advised by a doctor to stay in bed following a surgery or during pregnancy, you do not need compression garments to work against gravity. Graduated compression socks are not recommended for use when lying in a prone position. If you are bedridden, you may want to consider anti-embolism stockings or other mild compression garments designed for use in bed.
Similarly, a recent study from 2018 showed that athletes reported varied preferences, between uniform and graduated compression socks, depending on which activity they had performed. In the study, those participants wearing uniform compression socks reported lower levels of pain when wearing uniform compression after a trail run; however, for some activities, graduated compression yielded the best results. (McDonnell et al.)
Because we know you participate in different kinds of activities, That's why Comrad also created ankle-length socks with targeted compression. For some forms of exercise, you may prefer ankle socks. Plus, you can try both uniform and graduated compression during and after your favorite sports and activities. See which style leads to better results, a greater reduction in pain, and improved performance.
Are Graduated Compression Socks Available Over-The-Counter?
You can buy both uniform and graduated compression socks online and in-stores, although not all levels of compression are available over-the-counter. Some medical compression stockings, such as 50-60mmHg (extra firm) garments, are only available with a prescription. The strongest compression socks that Comrad sells are?is the Companions, a 15-25 mmHg knee-high sock made from SmartSilver antimicrobial fabric. Because we bind real silver to the fabric at a molecular level, you'll experience reduced odor, fewer holes, and fresher feet. More importantly, Companions walk the line between mild (15-20 mmHg) and medium (20-30 mmHg) compression levels. So, they help aid in the prevention of significant health issues like venous disease, treat active ulcers, and reduce symptoms of post-thrombotic syndrome (PTS), orthostatic hypotension, and superficial thrombophlebitis. Yet, because these socks occupy what we call, "the compression sweet spot," they're just as comfortable as socks with a mild level of compression.
Compared to regular socks and pantyhose that you might find at a clothing store, our targeted Allies ankle sock featuring targeted compression offers all the health benefits from targeted compression focused on the arch of the foot therapy—including better blood flow and decreased soreness. You may experience increased endurance (Engel et al.) and faster muscle recovery (McDonnell et al.) when you trade your regular ankle socks for Allies. You don’t need any special measurements to buy them; like most socks, they come in small, medium, large, and extra-large sizes.
Thanks to True Graduated Compression, Companions and Guides offer additional medical benefits that are unique to gradient compression, such as reduced risk of dangerous blood clots, decreased swelling from lymphedema, and protection against new varicose veins. Without a prescription, you can safely order the correct size online. As long as you know your shoe size and calf circumference, you have the information you need to get started with graduated compression therapy. You'll just have to choose the best compression level and fabric for your lifestyle.
Allies | Targeted compression, made with SmartSilver antimicrobial fabric
These uniform compression socks are ideal for forms of exercise where you'd prefer to wear an ankle-length sock.
Guides | 15-20 mmHg, made with premium merino wool
These knee-high socks offer 20 mmHg compression at the ankle and work well to reduce swelling and fatigue, while keeping your feet dry.
Companions | 15-25 mmHg, made with SmartSilver antimicrobial fabric
These knee-high socks offer 25 mmHg at the ankle, enabling additional medical benefits without sacrificing comfort.
Ask Your Doctor About Graduated Compression
Graduated compression has been proven in hundreds of clinical studies to increase circulation and move lymph fluid. By improving blood flow and reducing inflammation, compression socks benefit every aspect of your health. Since researchers publish new studies about compression therapy all the time, ask your doctor for personalized advice about how you should introduce graduated compression socks into your routine. Mild and medium compression socks are generally safe to wear every day. Still, if you have certain medical conditions, like peripheral neuropathy, compression socks may not be the best choice for you. For most people, graduated compression socks provide an easy, inexpensive way to support the veins. After all, your veins work hard, moving your blood against gravity all day, every day. Why not give them a boost?
For more information about how to measure for compression socks, be sure to check out this handy article on the topic. In order to get the most medical benefits out of your graduated compression socks, it's important to wear the correct size. If you need help measuring your calf, your doctor may be able to assist you.
To find the best sock for your activities, it may be beneficial to give both targeted and graduated compression socks a try. With a Wellness Guarantee that covers free returns and exchanges (including free return shipping) within 30 days of purchase, you have nothing to lose—and a lot to gain.
Sources:
Agu, O., Hamilton, G., and Baker, D. "Graduated compression stockings in the prevention of venous thromboembolism." British Journal of Surgery, Vol. 86, Iss. 8, Aug. 1, 1999, pp. 992-1004. British Journal of Surgery Society Ltd., https://bjssjournals.onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2168.1999.01195.x.
Ali, A., Caine, M. P., and Snow B. G. "Graduated compression stockings: Physiological and perceptual responses during and after exercise," Journal of Sports Sciences, Vol. 25, Iss. 4, Feb. 20, 2007, pp. 413-419, https://shapeamerica.tandfonline.com/doi/full/10.1080/02640410600718376.
Clarke MJ, Broderick C, Hopewell S, Juszczak E, Eisinga A. "Compression stockings for preventing deep vein thrombosis in airline passengers." Cochrane Database of Systematic Reviews, Iss. 9, 2016, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004002.pub3/abstract.
“Deep Vein Thrombosis (DVT) in Pregnancy.” NHS Choices, NHS, 27 Mar. 2018, www.nhs.uk/conditions/pregnancy-and-baby/dvt-blood-clot-pregnant/.
Engel FA, Holmberg HC, Sperlich B. "Is There Evidence that Runners can Benefit from Wearing Compression Clothing?" Sports Med. Vol. 46, Iss. 12. Dec 2016(12):, pp. 1939-1952. PubMed, https://www.ncbi.nlm.nih.gov/pubmed/27106555.
Homans, John. “Thrombosis of the Deep Leg Veins Due to Prolonged Sitting.” New England Journal of Medicine, vol. 250, no. 4, 1954, pp. 148–149., https://www.nejm.org/doi/pdf/10.1056/NEJM195401282500404.
McDonnell, Adam C., et al. “The Effect of Post-Exercise Application of Either Graduated or Uniform Compression Socks on the Mitigation of Delayed Onset Muscle Soreness.” Textile Research Journal, vol. 89, no. 9, May 2019, pp. 1792–1806, https://journals.sagepub.com/doi/10.1177/0040517518780002.
“Medical Clinic: Do compression socks help varicose veins?” Spider and Varicose Vein Treatment Center, YouTube, 2019.
Sachdeva, Ashwin. “Graduated compression stockings for prevention of deep vein thrombosis during a hospital stay,” Cochrane Vascular Group, Nov 3, 2018, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001484.pub4/abstract.
Troynikov, Olga, et al. “Influence of Material Properties and Garment Composition on Pressure Generated by Sport Compression Garments.” Procedia Engineering, vol. 60, 2013, pp. 157–162. ScienceDirect, https://www.sciencedirect.com/science/article/pii/S1877705813011053.