Everyday fixes
Compression Stockings: Sizing, Classes and Fit
Most people who gave up on compression gave up because of sizing, not because it did not work. 🧦
Key takeaways
- Get measured: ankle, calf and leg length.
- Put them on first thing, before swelling builds.
- A donning aid turns a wrestling match into ten seconds.
- Check with a clinician if you have arterial disease or diabetic neuropathy.
Classes and what they are for
Compression is measured in millimetres of mercury at the ankle, with the pressure graduating down as it goes up the leg.
- 8–15 mmHg — light support. Tired legs, mild puffiness, desk work.
- 15–20 mmHg — the common over-the-counter range. Travel, mild varicose veins, standing jobs, pregnancy (check with your midwife).
- 20–30 mmHg — established venous insufficiency, more pronounced varicose veins, post-thrombotic management. Often where real symptom benefit begins.
- 30–40 mmHg and above — specialist territory, usually prescribed and fitted.
The NHS varicose veins page covers where compression sits among treatment options.
Sizing is the whole game 📏
A stocking that is too tight at the top acts as a tourniquet and makes swelling worse below it. One that is too loose does nothing. Neither failure is the fault of compression as a treatment.
- Measure in the morning, before swelling builds.
- Ankle circumference at the narrowest point above the ankle bone.
- Calf circumference at the widest point.
- Leg length — floor to just below the knee bend for knee-highs.
- Compare against the manufacturer’s chart. Charts differ between brands; do not assume your size carries over.
Knee-high is sufficient for most ankle and calf swelling and is far easier to tolerate than thigh-high, which is usually reserved for specific indications.
Getting them on, and keeping at it
The practical obstacles are solvable:
- Put them on before you get out of bed, when the leg is at its smallest. Trying at 7pm over an already swollen leg is how they end up in a drawer.
- Use a donning aid — a silk slip sock, a metal frame, or rubber washing-up gloves for grip. This single tip rescues more people than any other.
- Smooth out wrinkles. A fold creates a pressure ridge.
- Never roll the top down. That creates a tight band — the tourniquet problem.
- Replace every three to six months of daily wear; elastic fatigues invisibly.
- Buy two pairs so one is always clean.
⚠️ Check first if
You have peripheral arterial disease, diabetes with neuropathy, significant skin breakdown, or heart failure. Compression is not safe for everyone, and reduced arterial supply is the important contraindication.
Compression outranks every supplement in this category on evidence — see the comparison. 🧦