What Are Graduated Compression Stockings & How Do They Work?

Compression socks are a great recovery tool and really useful for those suffering from a range of medical conditions linked to blood circulation. If you’re looking for fuller coverage of the whole leg, compression stockings or tights also offer the same benefits. But you may have also heard of graduated compression  - a term often used to describe these garments.

What is the difference between “regular” compression socks and how does graduated compression work? Here’s a primer on this important concept, along with a guide on how these garments can benefit you. 

What Are Graduated Compression Socks?

The term “graduated” means arranged in a series or scale - in other words, from lowest to highest value. When it comes to compression, this refers to how tight the item of clothing is on the body. So, graduated compression socks don’t apply the same level of pressure throughout. They are tighter around the ankle, then gradually loosen up towards the knees. 

What Does Graduated Compression Do?

Compression therapy in general can be applied using a number of garments or devices, including bandages and pneumatic machines. The advantage of graduated compression stockings is that they are easier to put on and remove on your own, but also that the compression is not applied uniformly on the lower leg.

In terms of ease of wear, graduated compression socks can be put on by the patient on their own. The tightest section is at the ankle, so you simply need to allow for this by following the manufacturer’s instructions. Then, it is easier to pull the rest of the sock up, since it is less tight than the bottom part. 

More importantly, in terms of benefits, graduated compression ensures that blood is pushed up from the section that’s tightest, towards the less tight area. This means that, for socks, when blood or fluid has the propensity to pool around the ankles after lots of time spent immobile or on your feet, the pressure applied by the socks supports its travel back towards the heart. As a result, those wearing graduated compression stockings avoid getting swollen ankles and feet. Moreover, graduated compression socks can prevent the formation of blood clots and can be very beneficial to those suffering from circulatory system conditions - such as varicose veins, for example. 

What’s the Difference Between Graduated Compression Stockings and Regular Compression Stockings?

So, how are graduated compression items different from “regular” ones? Simply through the level of pressure applied to the limbs. Graduated compression socks apply more pressure on the lower part of the legs, primarily the ankles. The pressure then eases off gradually (hence the name) towards the knee. This allows the sock to support better fluid circulation, whether it’s blood or lymph. It reduces the risk of swelling and discomfort. And it makes the socks slightly easier to put on than a sleeve which is just as tight from one end to the other.

Regular compression items are equally tight throughout. While they have the same benefit of massaging the muscles, stimulating blood flow, and helping with recovery, they are less effective at directing blood flow from the ankles towards the heart. 

The Benefits of Graduated Compression Socks

When choosing a pair of compression socks, it’s important to understand the extra benefits that graduated compression can bring. And they are all linked to better blood flow, which in turn plays a role in most healthy bodily functions. 

Improved Blood Flow and Circulation

Graduated compression socks constrict the veins lower down in the legs, which increases the speed of blood flow and “pushes” blood up from the ankles towards the heart. This counteracts the effects of gravity and poor blood circulation. As a result, the overall circulatory system works better.

Prevention of Blood Clots

Sitting immobile for long periods of time can cause blood flow below the knees to decrease massively, which increases the risk of a blood clot. Clotting can be the harbinger of medical issues when it happens in the veins. Preventing blood clots reduces the risk of developing deep vein thrombosis, or even a heart attack.

By continually stimulating the blood flow in the lower legs, graduated compression stockings reduce the likelihood of blood clots developing. This is why they are often recommended by doctors for patients recovering from surgery and staying immobile or bed-ridden for long periods of time. More recently, the CDC also raised the importance of using compression stockings to counteract the risks of extended travel and immobility. 

Reduction of Swelling and Edema

Poor circulation also makes the legs swell and feel uncomfortable. By supporting healthy blood flow, compression garments reduce the risk of swelling and edema. The combination of swelling and feeling of “heavy legs” occurs when small blood vessels called capillaries leak fluid in the body. This then saturates surrounding tissue, leading to the discomfort we all know as edema.

Since this sort of swelling usually takes place around the ankles after sitting or standing for a long period of time, wearing graduated compression socks helps reduce it and even prevent it where possible. The gentle massage, stronger by the ankles, prevents fluid build-up and stimulates it flushing out of the issues. 

Relief from Varicose Veins and Spider Veins

When the veins are unable to send blood from the limbs back to the heart, this causes it to pool into the legs. As a result varicose veins and spider veins can develop. Not only are they unsightly, but they can lead to more serious issues such as sores and ulcers.

To treat the symptoms of varicose and spider veins (which include swelling, burning or aching feelings), patients can wear compression socks. The graduated garments help move the blood back up towards the heart and reduce the swelling, while also offering a pleasant light massage to the lower limbs.

Enhanced Athletic Performance and Recovery

While there’s no directly demonstrable link between athletic performance and wearing compression socks, there are multiple studies that show their benefit for recovery after effort. Athletes who wear graduated compression socks in between workouts and pre- and post-competitions can:

• Shorten their recovery time, thanks to more blood being transported to the muscles for recovery;
• Increase their muscle recovery thanks to blood delivering oxygen and nutrients to them;
• Reduce inflammation and soreness, enabling them to get back to exercising sooner;
• Reduce swelling and discomfort, especially when running or exercising in hot conditions.

Taken together, these benefits enable runners and other athletes to return to high-intensity levels of activity sooner when they wear graduated compression socks. This then has a beneficial effect on their performance overall. 

Support During Pregnancy and Postpartum

Pregnancy and the postpartum period can bring a lot of unpleasant symptoms, including swelling due to fluid retention. To combat this, graduated compression stockings can be helpful against edema. Moreover, compression helps relieve leg cramps and prevent the formation of varicose veins.

Especially the latter can be caused by the increase in blood volume putting pressure on the blood vessels in women’s bodies during pregnancy. That boost in circulation from graduated compression stockings can be a real help during this period. 

Who Uses Graduated Compression Socks?

So, who stands to benefit from graduated compression stockings and socks? Whether you’re a recreational athlete, a nurse, a salesperson, or a bed-ridden person recovering from surgery, there are benefits you can draw from compression garments. 

Athletes and Active Individuals

Active people who push themselves on a regular basis, either by running or playing sports that have an impact on the lower legs, stand to benefit from compression during their recovery. Graduated compression stockings support better blood flow in the legs, which means blood can travel to the muscles and deliver oxygen and nutrients for recovering quickly and efficiently.

Additionally, jumping or hitting the pavement while running can cause lots of micro-vibrations that take their toll on leg muscles over time. They can cause painful conditions like shin splints, for example. This is where wearing compression socks can reduce the vibrations’ impact, through tighter support and a bit of extra protection. 

Individuals with Certain Medical Conditions

If you suffer from edema, venous insufficiency, deep vein thrombosis, or any other medical condition linked to poor blood circulation, your doctor has probably spoken to you about wearing compression socks already. 

Research shows that graduated compression supports better blood flow for those patients with circulatory problems. By supporting blood moving back up towards the heart, compression socks reduce the risk of blood clots and relieve the painful and uncomfortable symptoms of DVT and other illnesses. 

Those Who Sit or Stand All Day

Finally, standing or sitting for prolonged periods of time can be detrimental to healthy blood flow in the lower limbs. Gravity pushes blood down and this leads to swelling, discomfort, heavy legs, and the formation of blood clots and other possible medical issues.

This is why people in certain professions, like nurses, teachers, or those spending lots of time on their feet at events and conventions, can benefit from wearing compression socks to boost their lower limb blood flow and avoid all these problems. Moreover, if you’re travelling for long periods without moving, such as when on long flights, compression socks are recommended to prevent swelling and blood pooling around the ankles. 

How to Choose Compression Socks

Picking the best graduated compression socks for your case involves understanding materials and compression levels. This will ensure you’re as comfortable as possible and that you’re getting the pressure that best suits your medical condition. 

Compression Level

Graduated compression stockings and socks are measured by the tightness of the material - i.e., the compression level. These are:

• Moderate (15-20 mmHg) - The most accessible compression socks, suitable for all-day wear. They support the lower leg muscles, stimulate blood flow, and help reduce swelling and discomfort, without being too tight. This level is also recommended during pregnancy and for active people;

• Firmer (20-30 mmHg) - Usually prescribed by a medical professional, these socks are used for moderate edema, DVT, or for people recovering from surgery;

• Firm (30-40 mmHg) - Specifically prescribed for health conditions such as venous insufficiency.

Material

Depending on weather conditions and your activity levels, you’ll want to choose socks made from different materials. Here are the most common for graduated compression socks and stockings:

• Cotton - an all-around great option for all-day wear, casual wear during recovery from exercise, and for pairing with any outfit. Cotton is less moisture wicking, so can be less comfortable in hot weather or during activity;

• Nylon and moisture-wick nylon - tight, thinner socks that are very flexible and move with your body during exercise. These are great in hot weather, especially the moisture-wick line that’s been designed to keep feet dry and comfortable;

• Merino wool - comfortable, soft, moisture-wicking and antibacterial, these socks are great for those who have sensitive skin. Thanks to the thermoregulating properties of merino wool, it can keep you warm in cold weather and cool in warm weather. A great choice for hiking, skiing, but also just staying comfortable all year round. 

Style

There’s more to graduated compression than just standard socks and stockings. Depending on other medical conditions or personal preferences, those looking to keep their toes free can opt for open-toe compression socks that work just as well on the ankles, calf muscles, and shins.

Full-length compression tights or leggings are an option for those who need coverage for the whole legs. These also come in graduated designs.

Finally, for focusing only on the shins and calf muscles, with the option to change socks or go bare-footed, calf sleeves provide the benefits of compression, too. However, sleeves are usually not graduated, so they will only deliver equal pressure throughout the length of the garment. 

Size

It’s really important that your graduated compression socks fit right in order to actually get the most out of their design. This means they fit tightly on the limbs, but not so much that they’re cutting off your circulation. However, go too loose and you won’t get any benefit at all. 

To ensure they’re the right size, measure your calf circumference before you check the sizing guide for compression socks. Follow our instructions here to find the best pair for you. 

The Best Graduated Compression Socks

Thanks to how they stimulate blood circulation, compression socks help reduce swelling and inflammation in the lower legs and are great for countering the symptoms of a wide range of medical conditions. They also provide a gentle massage and help support muscle recovery after exercise. Graduated compression socks are especially effective at reducing the risk of blood clots and of blood pooling around the ankles.

As long as you pick the right size, style, and material for you, graduated compression socks can be both a recovery tool and a pre-emptive item to wear before you even get close to swollen, uncomfortable legs. Browse our range of options here and start feeling lighter–footed and re-energized.