How do you know if compression socks are too tight?

One of the biggest complaints about compression socks is that they are too tight. People who wear compression socks often find them to be uncomfortable. Sometimes people who wear compression socks stop wearing them because they find them to be intolerable.

Compression socks don’t do any good unless you wear them. That’s why everyone who wears compression garments of any kind needs to know when compression socks are really too tight, and they need a bigger size, when you need a different compression level, and when there are other reasons for discomfort and what to do about them.

Some objective signs you need larger compression socks

Let’s be real about the symptoms of tight compression socks. If your eyes bug out of your head, that’s not because your compression socks are too tight. And it’s not a legitimate excuse for canceling your gym membership that you get all the exercise you need by putting on and taking off your compression socks every day.

But these symptoms are actionable indications that your compression socks are too tight:

• Wearing compression socks leaves marks on your skin.
• Wearing compression socks changes the color of your skin.
• Wearing your compression socks hurts.
• You can’t get your compression socks on no matter how hard you try.

We’ll take a look at each of these problems one by one.

What do you do when compression socks leave marks on your skin?

It’s not unusual for socks to leave marks on your skin, even if you aren’t wearing compression socks. Socks have elastic bands on top to keep them from sliding down your legs. Pressure from the elastic leaves a mark on your skin.

If wearing compression socks leaves marks on your skin, chances are the marks are caused by a combination of two factors:

• The red circle around your leg left by the top of the sock is a sign that the sock is tight, and
• The condition for which you are wearing compression socks, such as lymphedema or venous reflux disease, is making your legs swell.

There are days that leg swelling is worse than others. If you consume too much sodium, your legs may swell, and you may have red marks on your skin. Hormonal changes and hot weather can cause your legs to swell. So can gaining weight, especially when you gain water weight due to congestive heart failure (and should consult your doctor).

If you are just starting with compression socks, or you haven’t worn compression socks for several days or longer and you are getting back into your routine, they may not have had a chance to do their work. That red mark on your leg may be much less noticeable tomorrow and the next day and the next when your legs aren’t as swollen.

But if you wear compression socks regularly, and you get red marks on your skin regularly, that’s a sign your socks are too small.

Some wearers will need extra wide calf compression socks.

Many wearers of compression socks need more room at the calves to prevent tightness behind the knee. Look for brands that contain more spandex woven into the fabric to give you a perfect fit. You want a softer elastic band at the top of your extra wide compression socks so they won’t dig into your skin. You may feel a lot more comfortable in extra wide calf compression socks with ridged material that supports your calves but also has a stylish look.

What do you when compression socks change the color of your skin?

Blanching of the skin isn’t unusual for wearers of thigh-highs or compression stockings. Your skin may look unusually pale when you take your compression garments off, and then return to its normal color in an hour or so.

This skin color change isn’t usually a sign that your compression stockings are too tight. It’s more likely to be a sign that you are a little dehydrated. It can also help to use a moisturizing cream when you aren’t wearing your compression stockings.

What do you do when wearing compression socks or compression stockings hurts?

Compression socks and compression stockings should never hurt. If they hurt, you are either wearing a size that is too small or your socks are compression levels that is too strong.

The first thing to do is to take new measurements of your legs. You need to measure the circumference of your legs at the narrow point just about your ankles. You need to measure the circumference of your leg at the widest point of your calves. If you are wearing thigh-highs, you need to measure the circumference of your thighs. Unless you are still growing upward, you don’t need to remeasure length.

Use these measurements to choose the right size of compression garment. When you are buying new compression socks or compression stockings, consider the location of the pain. If your toes hurt, consider wearing open-toed compression socks or compression stockings. If you have pain behind your knee, make sure your compression garments aren’t bunching up behind your knees. And let your doctor now that you have had to get larger compression socks.

What do you do when you can’t get compression socks on at all?

There’s a special skill to putting on compression socks. Some people try bunching their socks around their feet and then pulling them up a little at a time. The problem with this approach is that it bunches al of the compression around your feet. That makes it harder to pull your socks up.

An easier approach is to insert your hand and grab your stocking at the top of the heel pocket. While still holding the heel pocket, turn the stocking down toward the toe. Then open the stocking and slide your foot in.

Compression garment wearers who cannot reach their feet may need to use a SIMON donning device to help you reach your feet.

If these techniques don’t work for you, then the problem may really be that your compression socks or compression stockings are too small. Check your measurements again. Your measurements may have changed, and it’s easy to get the wrong size.

What do you do if you know you have the right size, but the garments still feel too tight?

Size is the tricky part of getting the right fit with compression socks and compression stockings, but it’s not the only factor. Compression socks and compression stockings also come at different compression levels. We’ve saved compression levels for last, but they are equally important with size for getting a comfortable fit.

Compression socks and stockings come in different levels of compression for different purposes: The pressure in compression garments is measured in mmHg, millimeters of mercury, the same as your blood pressure:

• 8 to 15 mmHg is light compression. Even if you don’t have lymphedema or a vascular problem in your legs, this level of pressure may help you feel less fatigued and more energized if you have to stand all day. It also may help prevent the formation of spider veins during pregnancy.
• 15 to 20 mmHg is moderate compression. This is the compression level used to prevent deep vein thrombosis (DVT) during long segments of air travel.
• 20 to 30 mmHg is firm compression. This is the pressure used after surgical procedures on leg veins, for moderate to severe lymphedema, for a known tendency for DVT, and to prevent orthostatic hypotension, suddenly low blood pressure that can cause someone to pass out when moving from a seated position to a standing position.
• 30 to 40 mmHg is extra-firm compression. This is the pressure used to treat severe varicose veins, severe lymphedema, and recovery from DVT. It’s the pressure level you get in the stockings you are sent home with after vein surgery.

We always recommend checking your size and your donning technique before trying to change your compression level. Always try to use the compression level your doctor prescribes. But if the compression is just too much, wearing compression socks and compression stockings is still better than not. Let your doctor know there is a problem and shop here when you are ready for new compression socks.