Why do compression socks feel tight to a client?

From the Guidelines

Compression socks feel tight to a client because they are designed to apply graduated pressure to the legs, with the greatest pressure at the ankles and decreasing pressure moving up the leg. This tightness is intentional and necessary for their therapeutic function. Compression socks work by applying external pressure to the tissues of the leg, which helps improve venous return by pushing blood back toward the heart against gravity. The compression also reduces the diameter of superficial veins, which increases blood flow velocity and prevents blood from pooling in the lower extremities. Additionally, compression socks help reduce tissue swelling by improving lymphatic drainage.

Key Points to Consider

• The level of tightness varies based on the compression class, ranging from mild (8-15 mmHg) to extra-firm (30-40 mmHg), with higher compression levels prescribed for more severe conditions 1.
• Clients should be properly measured for compression socks to ensure they are tight enough to be effective but not so tight that they cause discomfort or impair circulation.
• It's normal for compression socks to feel snug, especially when first putting them on, but they should not cause pain, numbness, or skin discoloration.
• A study published in the Journal of Thrombosis and Haemostasis in 2024 found that compression sleeves or socks were associated with lower PTS severity at follow-up, and half the patients found compression garments to be helpful 1.
• Another study published in Sports Medicine in 2022 found that compression garments can increase skin temperature at the point of coverage, improve heat maintenance during and following exercise, and improve perceptions of muscle soreness and pain in the days following exercise 1.

Recommendations for Use

• Compression socks should be worn as directed by a healthcare professional, typically for 8 to 12 hours a day and at least 3 days a week.
• Clients should be educated on how to properly put on and take off compression socks to avoid discomfort or injury.
• Regular follow-up appointments should be scheduled to monitor the effectiveness of compression socks and make any necessary adjustments.

From the Research

Compression Socks and Tightness

• Compression socks are designed to provide graduated compression, which means they apply more pressure at the ankle and less pressure as they move up the leg 2.
• This compression can sometimes feel tight to clients, especially if they are not used to wearing compression socks.
• The tightness is usually due to the compression material and the pressure it applies to the leg, which can help improve venous blood flow and reduce swelling 3.

Benefits of Compression Socks

• Compression socks have been shown to increase lower limb venous blood flow, which can help reduce the risk of deep vein thrombosis and pulmonary embolism 3.
• They can also help reduce lower limb swelling and alleviate delayed-onset muscle soreness 4.
• However, the effectiveness of compression socks for athletic performance and recovery is still a topic of debate, and more research is needed to fully understand their benefits 4.

Potential Discomfort

• Some clients may experience discomfort or tightness when wearing compression socks, especially if they have certain medical conditions such as advanced peripheral arterial occlusive disease or polyneuropathy 5.
• It is essential to consider the individual needs and comorbidities of each client when recommending compression socks, and to ensure that they are properly fitted to avoid discomfort or tightness 5.