Choosing compression garments
Why wear compression garments?
Compression garments often pair well with lymphatic massage, and are a key way to manage swelling. There are a number of types of compression, and even more reasons a person might use compression.
Breast cancer survivors may want a compression sleeve to prevent lymphedema.
People on their feet a lot might want knee high compression stockings / socks to keep their ankles from swelling.
People who get lightheaded when they stand up may want compression pantyhose / tights to help with blood flow.
People with lipedema may want leggings or tights to reduce pain or heaviness in their legs.
People with chronic swelling will almost certainly need compression garments to manage their swelling.
Frequently, people will be told to get compression by their doctors or other healers, but don’t know what to choose. It can get confusing, and to make it harder most doctors and nurses have no idea what to recommend. So let’s talk about it.
How do you know if a compression garment is right for you?
The right garment will be comfortable to wear all day. It should fit snugly, like it’s giving you a hug. It should never hurt, and it should never feel like it’s cutting off your circulation.
The right garment will also do the job you need it for. If you’re trying to prevent swelling, the right garment is one that keeps the swelling away. If you’re trying to reduce pain, it should make you feel better.
To pick out the right garment, you’ll need to answer the following questions.
Question 1 - what body parts need compression?
Compression garments help the body parts they cover. Knee high stockings are great for the feet and ankles, but they won’t help the knees or thighs. A compression sleeve helps the arm, but a hand piece would be needed for swelling in the hand. In general, compression for the legs should start at the feet and continue up as far as there’s swelling.
If you’re not sure which body parts need compression, that’s a good question for your healthcare team.
Question 2 - how much compression is needed?
In other words, how much support is needed? How firmly do you need to be held? This is measured in mmHg, or millimeters of mercury.
8-15 mmHg provides a tiny amount of support, and can be useful for for legs that get a little tired or preventing blood clots while flying in the absence of other problems.
15-20 mmHg is a bit more support, and is the amount often recommended for people with no swelling who want to prevent lymphedema.
20-30 mmHg is considered “medical” compression and is more likely to control swelling than the lighter garments.
Stronger compression also exists, but you should have a conversation with your healthcare team before buying anything stronger than 20-30 mmHg.
Question 3 - what size do you need?
Just like buying clothes or shoes, you want to buy compression garments that fit your body. Don’t use your clothing size to pick out your garments, though - the sizing for compression is all over the place. The same person might be a Medium in one brand and an XL in another. Instead, get your body measurements with a soft measuring tape and look at the sizing charts to pick out your size.
Measuring for lower body
For garments up to the knee, you’ll need three measurements
Ankle: Place the measuring tape lightly around the ankle while the foot is flat on the floor.
Calf: Place the measuring tape snugly around the widest part of the calf.
Floor to knee length: With the foot flat on the floor, measure from the floor to just below the knee.
If you need something to the top of the thigh, you’ll need those three plus a few more. Someone else will need to help for accurate numbers.
Top of the thigh: Place the measuring taping firmly around the widest part of the thigh while standing up. The tape should be squishing the thigh tissue a bit.
Floor to thigh length: While standing, measure from the floor to just below the curve of the butt.
For pantyhose or tights, you’ll also need around the waist and around the widest part of the hips.
Measuring the arm for a sleeve
For arms, and hands, the measurements are similar. You’ll likely need someone to help measure you.
Hand: Measure below the knuckles while the fingers are spread out.
Wrist: Measure lightly around the wrist while it’s straight.
Elbow: Measure around the elbow while it’s bent about 45 degrees.
Upper arm: Hold the arm straight out to the side and measure snugly around the widest part of the upper arm. The arm tissue may be a little squished.
Wrist to shoulder length: With the arm straight and out to the side, measure from about an inch out of the armpit to the wrist.
Once you have all the measurements you need, check the sizing chart for the garment you’re considering. Pick a size that fits all the measurements. If none of the sizes will work, look at a different brand’s sizing. If you can’t find anything that will fit, you may need to get something custom made for you.
What are the best brands?
Different brands will be best for different people, and it may take some trial and error to find the one that fits you the best. The brands with the best reputation for medical-grade compression are Juzo, Jobst, Mediven, and Sigvaris. Other brands popular among people with lipedema are Bioflect, WearEase, Marena, Solidea, and CzSalus.
How to wear compression garments?
Once you’ve got garments that fit, congrats! How much and how long you wear them depends on why you need them, but make sure not to wear them overnight. You’ll want to wear a clean pair every day, so most people get at least two so they can wear one while the other is drying.
****
I hope this helps! If you’ve got any questions, drop me a line. And if you need individualized advice, talk to a professional fitter or a therapist that specializes in lymphedema like me.
