Patient education: How to put on and take off compression stockings (The Basics)

What are compression stockings? — These are special snug-fitting socks. They are used to help prevent swelling and improve blood flow in the legs.

There are 2 main types of compression stockings:

●Anti-embolic stockings – These are often called "TED hose." TED stands for "thromboembolic deterrent stockings." Anti-embolic stockings:

•Are used to help prevent blood clots

•Have the same amount of pressure throughout the stocking

•Might be needed if you are on bedrest or right after surgery

•Come in knee-high and thigh-high lengths

●Gradient pressure stockings – These have different levels of compression on different parts of the leg. The most pressure is at the ankle. The pressure lessens as you go higher up the leg. Gradient compression stockings:

•Are worn by people with lymphedema or vein disorders

•Have different amounts of pressure. Some offer more compression than others: class 1 (15 to 20 mmHg), class 2 (20 to 30 mmHg), class 3 (30 to 40 mmHg), and class 4 (40 to 50 mmHg).

•Come as knee-high, thigh-high, pantyhose, chaps-style, and maternity pantyhose

•Can be standard or custom made

Your compression stockings are specific to your needs and measurements. Do not share or borrow stockings.

You can also buy some kinds of compression stockings over the counter. Talk with your doctor before buying or using these.

How do I put on compression stockings? — To put on compression stockings:

●Start with the stocking right-side out.

●Put your hand in through the top of the stocking. Hold it at the heel area, and turn the rest of the stocking inside out. The foot portion is now the only part of the stocking that is right-side out.

●Line up the heel portion of the stocking with the heel of the foot. Put the stocking on the foot. Carefully pull the stocking over the heel.

●From the bottom of the leg, slowly work the material up the leg. Do not pull from the top of the stockings. Smooth out any wrinkles.

Compression stockings need to be snug to work. This can make it difficult to put them on. Here are some tips that might help:

●Use rubber gloves or special gloves with a rough surface on the palms. This can help you grasp the stocking material.

●Use a tool called a "stocking donner". You put the stocking on the device and then put your foot into the stocking.

●If you have open-toed stockings, you can use a tool to make the material slide more easily. This tool might be called a "slide aid," "sock slip," or "easy slide." Once the stocking is on, you pull the slippery material out.

●There are also compression stockings with zippers that might be easier to put on.

●Apply a small amount of cornstarch or powder on your skin to help the stockings glide on more easily.

●Make sure that your legs are completely dry before putting on the stockings. Do not use lotion before putting them on. Bathe at night, and put lotion on before you go to bed.

How do I take off compression stockings? — To take off compression stockings:

●Slowly work the stocking down the leg from the knee to the ankle.

●Pull it down past the heel, and work the foot part off.

When you remove your stockings, it is normal to have some mild dents in your skin. These should go away after about 20 minutes.

How do I take care of the compression stockings? — Check the box or label on your brand of stockings for specific washing and drying instructions.

●Some need to be hand washed in mild detergent or dish soap. Others can be machine washed.

●Most stockings need to lie flat to dry. There are only a few brands that can go into the dryer. Heat can break down the elastic in the stockings.

It is helpful to get 2 pairs of stockings. This way, you can wash one while you are wearing the other.

What else should I know?

●It is best to put on compression stockings first thing in the morning when your legs are at their smallest size. Leg swelling increases throughout the day.

●If the stockings aren't staying up, it can be helpful to get a stocking with a wide silicone band at the top.

●Be extra careful if you have long, sharp, or uneven nails. The material can snag.

●If you use gradient compression stockings, take them off before you go to sleep at night.

●Always wear shoes or socks over your compression stockings.

●Do not stop wearing your stockings without talking to your doctor first. Compression stockings can be an important part of your treatment plan. Your doctor or nurse will talk to you about how long you need to wear them.

●Depending on how much you wear them, stockings should be replaced every 3 to 6 months. They might need to be replaced earlier if they stop working.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel short of breath or have trouble breathing.

●You have sharp or severe chest pain when you breathe.

●You are coughing up blood.

Call the doctor or nurse for advice if:

●You notice new or worsened swelling in your leg.

●Your leg becomes numb or very painful to touch.

●Your leg hurts when you walk.

●Your leg turns blue or gray.

●You have discomfort when you take a deep breath.

●You have open sores on your leg.

●You have fluid leaking from your leg.

Call the supplier or the person who fitted you with the stockings if you have:

●Severe dents in your skin that last longer than 20 to 30 minutes after the stockings are removed

●Improper fit

●Redness or areas of irritation

●More numbness or tingling in your feet

More on this topic

Patient education: Varicose veins and other vein disease in the legs (The Basics)
Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)
Patient education: Peripheral lymphedema after cancer treatment (The Basics)
Patient education: Superficial vein phlebitis and thrombosis (The Basics)

Patient education: Lower extremity chronic venous disease (Beyond the Basics)
Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)
Patient education: Lymphedema after cancer surgery (Beyond the Basics)