For people with varicose veins, lymphedema, and a number of other painful health conditions, compression socks act as a tool to help relieve symptoms. By exerting gentle pressure on the legs and the veins, these socks reduce the diameter of major vein walls, creating what we call “the garden hose effect.” If you were to turn on a garden hose and place your thumb on top of the nozzle, you would get a tight, concentrated spray of water. This is effectively what a compression sock is doing to your veins—decreasing the vein wall and improving the velocity of blood flow.
Since veins help your body to carry oxygen-poor blood and waste material away from your extremities, you’ll feel the difference from improved velocity. By wearing compression socks, you reduce the pooling of fluids in your lower legs, increase blood flow, and eliminate the buildup of excess lactic acid in your legs and feet.
According to a 2015 study published by The Journal of Strength & Conditioning Research, wearing graduated compression socks for 48 hours following a marathon helped promote functional recovery in runners. In order to test that hypothesis and prove that graduated compression socks had a statistically significant impact, the researchers first had to design an experiment in which participants wore compression garments. When sizing participants for socks, they used the same methodology that most compression sock customers use every day outside of the experimental framework.
The researchers explain, "The correct size was determined according to the manufacturer's instructions using self measurement of calf diameter and shoe size by each participant." Indeed, most people who buy compression socks online or in stores measure their own body to achieve the perfect fit. While some people receive a compression sock prescription from a doctor, it's also common to determine the correct measurements independently, without any professional assistance.
In this article, we'll provide all the information you need to measure your body for compression garments. We'll also provide answers to questions about how compression is measured and which compression levels are available over-the-counter.
How to Measure
We recommend measuring for compression socks when your legs are not swollen. For most people, this means that the early morning, after you first get out of bed, is the best time to take measurements.
No matter what compression range you plan to buy, you should measure your calf the same way. The procedure we recommend doesn't differ based on gender or age. Everyone should follow these instructions before making a purchase from Comrad:
- Remove your shoes and socks. Measure your bare legs with soft measuring tape, while keeping your feet flat to the floor.
- Take the calf measurement at the widest part of your calf. Wrap the tape measure around the circumference of your calf and write down the length.
It's that simple!
As long as you know your shoe size, that's the first measurement—and the only measurement—you'll need in order to checkout with your Comrad socks. We offer a range of sizes for calf measurements between 10-20".
Compare Measurements to the Sizing Chart
Now that you've determined your calf circumference, it's easy to select the right size on the Comrad website.
First, look for your shoe size on the sizing chart.
Are you a women's size 5? That would translate to a small compression sock.
Are you a men's size 14? That would translate to an extra large size.
Before you make your purchase, please be sure to check your calf measurement. If your shoe size equates to a medium, but your calf measures over 14", you should purchase a medium wide. If your shoe size is large and your calf measures over 17", you should purchase the large wide fit.
What If My Feet Are Between Sizes?
If you normally wear a women's size 6 or 12 or a men's size 10 or 13, then your foot measurement sits on the cusp between sizes. You could size up or down, depending how shoes normally fit you. Remember to select your sock based on your calf measurement, as well.
In the event that you still can't decide between sizes, opt for the smallest size that fits your measurements. After all, you're looking to receive all of the benefits of compression, so make sure that the sock fits snugly.
What If I Don't See My Shoe or Calf Size Listed?
Sometimes, we encounter individuals who fall outside of standard range for sock sizing. If you don't see the combination of shoe size and calf measurement that you need, you can order custom-sized compression socks from another manufacturer. In order to get all the medical benefits from your compression socks, you should always wear the correct size.
If you don’t see your measurement listed on our sizing chart, you should check with other manufacturers to find the correct size to fit your body. If you need to order a custom-made pair of socks, find a manufacturer that allows for special orders based on your individual measurements. Unfortunately, we cannot accommodate custom orders at this time.
- Some brands of knee high socks also require a calf length and an ankle measurement. Take the ankle measurement above the ankle bone at the narrowest part of the ankle. The calf length is measured from the floor near your heel to the start of the knee on the backside of your leg.
- For thigh-high compression stockings, take a thigh measurement at the widest part of your thigh. For these stockings, the leg length should be taken from the bottom of the heel to the crease of the buttocks.
- For waist-high hosiery or compression pantyhose, you'll need to measure your hip circumference as well.
- For compression arm sleeves, measure the narrowest part of the wrist, the elbow circumference at the crease of the elbow, and the arm circumference underneath the armpit.
- For gauntlet and glove measurements, measure the narrowest part of the wrist and the circumference of your palm excluding your thumbs.
How Compression Is Measured
Compression is measured in millimeters of mercury (mmHg). According to Merriam-Webster, an mmHg is a unit “...equal to the pressure exerted by a column of mercury 1 millimeter high at 0°C and under the acceleration of gravity...” So, the lower the measurement in mmHg, the less pressure you’ll feel on your calf and ankle.
Graduated compression socks are labeled with an mmHg range because they offer more pressure at the ankle and less pressure toward the calf. For example, our merino wool Guides offer 15-20 mmHg compression, providing 15 mmHg at the calf and 20 mmHg at the ankle.
In addition to helping you feel your best, a 2016 study suggests that graduated compression socks and stockings reduce incidence of deep vein thrombosis (DVT) during long-haul flights of five hours or more. Blood clots in the deep veins can break off and travel to the lung, with potentially fatal consequences. Participants who wore compression stockings experienced a large reduction in DVT compared to airline passengers who did not wear compression garments. (Clarke et al.)
Similarly, compression therapy is recommended to help reduce the incidence of DVT in hospital inpatients. A 2007 study cites the absolute risk of developing DVT in patients recovering from hip surgery, knee surgery, or major trauma as 40%-80% without preventative therapies. (Cayley) For anyone who experiences limited mobility—whether flying on an airplane, sitting at a desk for long hours, or recovering in a hospital bed—compression therapy offers a way to prevent blood clots in deep veins and related complications.
What Compression Levels Are Available Over-The-Counter?
There are several compression levels available for compression socks, but the four standard levels include:
- Light: 8-15 mmHg
- Mild: 15-20 mmHg
- Medium: 20-30 mmHg (Medical Grade Class I)
- Firm: 30-40 mmHg (Medical Grade Class II)
Light Compression (8-15 mmHg)
Light compression socks provide 8-15mmHg and are commonly used for tired, heavy, and achy legs. They are commonly used by healthy wearers that sit or stand for extended periods, and they’re available in national pharmacies as over-the-counter purchases.
Mild Compression (15-20 mmHg)
Mild compression socks provide relief for mild leg and foot swelling, minor varicose veins, and tired or achy legs. 15-20mmHg is the most commonly used compression level for travel, pregnancy, swelling, aches, and pains. Comrad offers 15-20 mmHg Guides in sizes medium and large.
Medium Compression (20-30 mmHg)
Medium compression socks provide support for moderate leg and foot swelling, moderate discomfort, moderate spider and varicose veins, support and recovery for athletic performance and endurance. 20-30mmhg compression requires a prescription and is most commonly used for long-haul travel, moderate edema, lymphedema, DVT, post-operative recovery, injury recovery, pregnancy, and moderate varicose veins.
The Compression Sweet Spot
Comrad offers Companions in 15-25 mmHg, which means the amount of compression does not fall below 15 mmHg or go above 25 mmHg. We refer to this range as “the compression sweet spot,” since it provides the full benefits of both mild and medium compression. You can add Companions to your shopping cart in small, medium, medium wide, large, large wide, and extra large sizes.
- Armstrong, Struart, et al. “Compression Socks and Functional Recovery Following Marathon Running: A Randomized Controlled Trial.” Journal of Strength and Conditioning Research, Wolters Kluwer Health, Inc., 1 Feb. 2015.
- Cayley, William E. “Preventing deep vein thrombosis in hospital inpatients.” Clinical Review, Midlands Business Journal, Jul 19, 2007.
- Clarke, Mike J. “Compression stockings for preventing deep vein thrombosis (DVT) in airline passengers” Cochrane Vascular Group, Sept 14, 2016.
- “How To Shop For Compressions Socks.” CVS Pharmacy, 2019, www.cvs.com/shop/how-to-shop-compression-socks-c.