What Level of Compression Socks Do I Need?

Compression therapy works for almost everyone—including those with diagnosed vascular conditions, people who stand all day at work, and athletes who hope to recover faster after a workout. Graduated compression, in particular, has been proven to help prevent deep vein thrombosis in hospital patients (Sachdeva) and to be an effective treatment for patients with chronic venous insufficiency, especially those with ulcers. (Lim and Davies E391) Graduated compression describes a form of compression therapy in which garments exert the greatest degree of compression at the ankle, with the level of compression gradually decreasing up the leg. 

Compression Therapy for Medical Conditions

Doctors often recommend that patients use compression socks to alleviate symptoms associated with—

• Varicose veins and spider veins
• Deep-vein thrombosis (DVT)
• Edema (swelling)
• Chronic venous insufficiency (CVI)
• Post-thrombotic syndrome (PTS)
• Postural orthostatic tachycardia syndrome (POTS)
• Shin splints
• Plantar fasciitis 
• Lymphedema 

Because compression socks help to prevent edema and the formation of new varicose and spider veins, many physicians suggest that women wear compression socks and stockings during pregnancy. 

Doctors sometimes prescribe compression socks in a particular strength (measured in millimeters of mercury) to relieve pain and treat medical conditions, but socks are also available over-the-counter at light, mild, and medium compression levels. Non-medical support hosiery also comes in uniform compression. Unlike graduated compression, uniform compression maintains the same level of compression throughout the garment. (Lim and Davies E392)

How Do Anti-Embolism Stockings Differ From Compressions Socks?

After surgical procedures, patients become vulnerable to developing blood clots in their deep veins. If one of these deep vein clots breaks off and becomes lodged in a blood vessel, fatal complications may result. This occurrence, called an "embolism," becomes particularly dangerous when the clot lodges in the lungs. Both compression socks and anti-embolism stockings help to prevent deep vein thrombosis (DVT) and pulmonary embolism. 

Whereas compression socks work well for people who are able to walk around, anti-embolism stockings—also called thrombo-embolic deterrent hose or TED hose—reduce the risk of DVT for bedridden patients. Typically, anti-embolism stockings come in uniform compression with a pressure level less than 20 mmHg. Since bedridden patients stay in a reclining position, they may not need graduated compression, which works against gravity by exerting pressure up the leg. While compression socks and anti-embolism stockings both reduce the risk of blood clots and DVT, anti-embolism stockings are designed to be worn during times of decreased mobility such as a period following sclerotherapy, endovenous ablation, phlebectomy, or any major surgery. ("Anti-Embolism")

Other Reasons to Wear Compression Socks

While most people can benefit from compression therapy, we particularly recommend it for anyone who is—

• Taking a flight
• Pregnant
• Sitting for long periods
• Standing for long periods
• Looking to increase athletic endurance
• Experiencing muscle aches after exercise 
• Recovering from surgery
• Hoping to improve circulation and blood flow
• Trying to reduce swelling in the legs and ankles

What Compression Levels Are Available?

Product manufacturers and health care providers describe graduated compression levels by stating two numbers. First, we list the compression level—measured in mmHg—at the loosest part of garment. For knee high compression socks, this lower number comes from a measurement taken at the calf. Next, the larger number gives the compression level at the tightest part of the sock, measured at the ankle. In other words, a range of 15-20 mmHg would describe a pair of socks with a 15 mmHg calf measurement and a 20 mmHg ankle measurement. 

Light Compression: 8-15 mmHg 

If you're looking to treat mild symptoms, you may want to consider light compression socks. They reduce minor leg swelling and discomfort caused by prolonged periods of sitting or standing. Pregnant women hoping to avoid spider and varicose veins during pregnancy often choose light compression, as well. 

Mild Compression: 15-20 mmHg

This is the most commonly available over-the-counter compression strength, so you'll be able to pick up a pair at the airport, the pharmacy, or online. Doctors often recommend mild compression for first-time wearers. It’s a great option for anyone hoping to prevent swelling, achy legs, and DVT, especially during long flights. 

Medium Compression: 20-30 mmHg (Medical Grade Class I)

Class I compression socks offer a number of health benefits. They relieve the symptoms of severe edema or lymphatic edema. Medium compression offers enough pressure for the management of active ulcers. In addition, symptoms of post-thrombotic syndrome (PTS), orthostatic hypotension, and superficial thrombophlebitis can be considerably reduced by applying medium compression. This is also an optimal compression level for athletic recovery and endurance.

Firm Compression: 30-40 mmHg (Medical Grade Class II)

You should only consider Class II compression socks to treat more severe cases of edema, PTS, orthostatic hypotension, and superficial thrombophlebitis. They’re also recommended for patients at extreme risk of developing DVT, like post-surgical patients. You'll probably notice an increase in pressure when wearing these socks, especially compared with compression levels under 25 mmHg.

Extra Firm Compression: 50-60 mmHg (Medical Grade Class III)

Class III compression socks treat acute lower body swelling, severe varicose veins, and DVT. Extra firm compression garments can only be purchased through a medical supply store or a pharmacy and require a prescription.

What Makes Comrad Socks So Special?

At Comrad, we make compression socks that are safe to wear for long periods, throughout the workday or on long-haul flights. Our products include knee-high, graduated compression socks in two different pressure ranges. Guides fall within the mild compression category, providing 15-20 mmHg compression. Companions measure 15-25 mmHg and deliver the benefits of both mild (15-20 mmHg) and medium (20-30 mmHg) pressure. For that reason, we say that our 15-25 mmHg socks occupy “the compression sweet spot”—in between the mild products you'd find at the drug store and medium-strength, medical-grade socks. 

To ensure accuracy, we measure compression with a Swisslastic MST MK V pressure measuring device for medical compression socks and stockings. Swisslastic has been a specialist in compression pressure measuring devices for over 50 years.

Beyond offering support and relief for a variety of medical conditions, our socks also look modern and stylish. They're garments that you'll be happy to put on each day. Plus, you can feel confident that your socks have been made ethically. In fact, I visited our factory on several occasions before we ever launched the company in order to make sure that our factory met my own high standards. We provide support for our employees with various activities for their families and the local community, including an annual sports festival, ESL classes, and a summer camp for kids. We also offer an on-site garden where employees can pick vegetables and pet farm animals. 

As for the environmental impact of our business, since the dyeing process has the most potential for harm, we start with river water, then engage high-efficiency dyeing equipment to conserve that water. After passing it through a customized filtration system, we recycle 80% of the water that we use. Our factory conserves energy by using a thermal heat retrieving system and rooftop solar panels. We also recycle most of our used materials, like waste yarn, paper cartons, and food.                                                   

So, who can benefit from Comrad socks? Just about anyone who spends time on their feet or in their seat. We've chosen to produce socks in the two compression levels that we think can support the largest number of people—15-20 mmHg and 15-25 mmHg. We selected these level ranges because we believe that they address important medical concerns and provide amazing health benefits, while remaining comfortable to wear. 

We’re a small team devoted to making socks that empower people to get the most out of every day. We produce our socks ethically, holding ourselves to the highest environmental standards. Most importantly, we’ve designed our socks to offer an optimal level of compression for both preventative health and the ongoing treatment of existing conditions.

Whether you’re an athlete who wants to recover faster, a chef who stands all day, a pilot who sits, or an expectant mother who wants to avoid varicose veins, we’ve created socks with the perfect level of support to keep you feeling your best. Ask your doctor if you have any medical conditions that contraindicate compression therapy. If you get the green light, we recommend giving "the compression sweet spot" a try! Begin graduated compression therapy with 15-25 mmHg socks today, and experience an immediate improvement in your circulation.     

Sources:

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. 

“Anti-Embolism Socks: for Safety's Sake (after Surgery).” Atlanta Vascular & Vein Center, 12 Jan. 2018, http://atlantavascularandveincenters.com/anti-embolism-socks-safetys-sake-surgery/.

“Blood Clots and Travel: What You Need to Know.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 Feb. 2020, www.cdc.gov/ncbddd/dvt/travel.html.

“Boosting circulation with compression stockings.” Harvard Health Publishing, Harvard Medical School, Nov 2013, https://www.health.harvard.edu/staying-healthy/boosting-circulation-with-compression-stockings.

Cornu-Thenard, André, and Pierre Boivin. “Chronic Venous Disease during Pregnancy.” Phlebolymphology, Vol. 21, No. 3, Iss. 1, Jan. 1, 2014, pp. 138-141, https://www.researchgate.net/publication/274043255_Chronic_venous_disease_during_pregnancy.

Dolibog, Pawel et al. “A comparative clinical study on five types of compression therapy in patients with venous leg ulcers.” International journal of medical sciences Vol. 11, Iss. 1, Dec. 14, 2013 pp. 34-43, https://www.ncbi.nlm.nih.gov/pubmed/24396284.

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, 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.

Hutchinson, Alex. “Standing All Day Is Twice as Bad as Sitting for Your Heart.” Runner's World, Hearst Magazine Media, 21 Oct. 2019, www.runnersworld.com/health-injuries/a20860422/standing-all-day-is-twice-as-bad-as-sitting-for-your-heart/.

Lim, Chung Sim and Alun H. Davies. “Graduated compression stockings.” CMAJ  Vol. 186, Iss. 10 pp. E391-E398. July 08, 2014, https://www.cmaj.ca/content/cmaj/186/10/E391.full.pdf.

Roth, Stephen M. “Why Does Lactic Acid Build Up in Muscles? And Why Does It Cause Soreness?” Scientific American, Springer Nature America, Inc., 23 Jan. 2006, www.scientificamerican.com/article/why-does-lactic-acid-buil/.

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.