Compression Garments in PT

In physical therapy, I see a variety of patients with conditions that have associated swelling or edema.  Many patients post-operatively suffer from swelling that is very painful and restricts mobility.  Compression garments can be an extremely useful self management tool for many types of swelling.  The most common type of garments used are compression stockings for leg swelling.  These come in a variety of sizes and lengths and are used to support the venous and lymphatic systems of the leg.  They provide graduated compression which means there is more compression at the foot and ankle and less compression higher on the leg around the thigh.  The compression stockings act as a pump for the fluid in your legs.  The exterior tissue support that the stockings provide helps to keep fluid moving more efficiently in the direction of your heart.

Today, compression garments are available in a wide range of colors, styles, and sizes.  There are varying degrees of compression as well, and the intensity of support needed often must be matched with an individual’s ability to get the garments on and off.  There are aids and other strategies available to make putting them on and taking them off an easier task.  As a physical therapist that specializes in the treatment of swelling, I get many questions about compression garments.  Here are the most common ones.

Q: How do compression garments work?

A: The pressure they exert against the tissues helps to keep fluids in circulation instead of collecting in the lower part of your legs.  Compression garments help keep the fluid moving toward your heart instead of out toward the extremities.

Q: Who might benefit from compression garments?

A: Really, just about anyone who struggles with leg swelling.  There are a few conditions where it is not warranted but for the most part, we see people who are on their feet all day, post-operative, or who are aging.  As we age, the valves in the veins in our legs begin to leak a bit.  So, as the day goes on and gravity takes its toll, fluid tends to pool in our ankles and lower legs.

Q: How have compression garments changed over the years?

A: Many of the same fundamental principles still apply.  For instance, compression garments are “graduated”, meaning they have a higher pressure at the foot and ankle and progressively less pressure as they move up the leg.  However, today there are a wider range of “pressures” available, and they often are available in much more attractive colors and materials.

Q: What is the difference between compression garments and TED hose?

A: TED hose are designed to help prevent blood clots in individuals who may be in bed or not moving much for extended periods of time.  This is why you often see people with them on after surgery, while they are still in the hospital.  TED hose are not meant to be worn when you are on your feet for extended periods.  Also, compression garments are not supposed to be worn at night, but rather during the day, when you are up and around.  They are “graduated” in compression, whereas TED hose are not.

Q: I know a lot of people who get compression garments but never wear them.  Why?

A: We find that most often people do not wear them for two reasons.  They either don’t fit correctly or they are too hard to get on.  Typically, both of these problems are avoidable or can be addressed.  Another reason is that people think that the only options available to them are the thick, heavy, beige stockings.  Nowadays, you have lots of styles and colors to choose from.