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A Cyclist’s Thoughts on Compression Socks

Racing in Worcester

By Jon O. (a BrightLife Customer)

I recently tried out a few different brands of compression socks and sleeves and wanted to share my thoughts with the world.

I cycle competitively as a CAT 4 cyclist (amateur racer).  I race most weekends and train intensively for 8-12 hours per week.  Recovery is a key aspect to improving. Unfortunately, just recovering well is more involved than I would have imagined before I got into the sport a few years back.  Stretching, foam rolling, elevating, and –when I’m really cooked–icing are all things needed to ease the legs back to life after long hard rides.  I know the price of not doing these things:  two years ago I over trained and was off the bike for 8 months with hamstring tendonitis.

Needless to say it’s tough to be diligent with these routines especially as a full time teacher who takes grad school classes.  Often when getting back from a ride I have to get back on my feet and get to work.   Compression tights have been a way to give my legs a little extra TLC without sacrificing additional time.  There is reasonable research and anecdotal evidence to justify their use.  I also have a varicose vein on my right leg that is the size of a python, so even if I didn’t bike, I know I should be wearing compression socks.

In the past, I have used full leg medical thigh highs. They were expensive and not very comfortable.  I opted for the black versions which were slightly less creepy than the “skin” color pair, but still make me feel like Tim Curry in Rocky Horror when I put them on.  These have a tendency to slip down when I walk in them – when I cover them with pants, they’re not easily adjusted and become uncomfortable quickly. I could have opted for full bottomed tights instead of legs, but after 4 hours in bike shorts the last thing I want to do is smother my undercarriage. Needless to say, I don’t wear these as often as I should.

So, it was nice to get two pairs of knee high style compression socks recently – CEP Progressive+ Socks and Allegro Rumba Calf Sleeves.  I’ve heard that one doesn’t really need full length compressors anyway:  just to the knee is where it matters for athletic recovery.

The CEP product is a very cool looking sock with an aggressive design.  Call me insecure but looks do matter here:  I want to feel like an athlete when I hit the supermarket: not a dude in pantyhose. They came well packaged in a stylish neon box with instructions about how to roll them on properly. These are the first socks I’ve had that are foot specific. I think there is a reason for this:  It seems they’ve varied the density of the knit to help fit securely, breathe well and be reinforced for regular wear. Time will tell how tough these guys are; I think they are my new go-to sock.  I’ll probably buy a couple pairs so that I can wear them regularly.

The Rumba calf compressors are nylon bands which stretch from the ankle to the knee leaving the foot exposed. Once again, we’re back to the pantyhose look: just nylon with no cool logo. But, these can easily be worn under pants because they’re thin. They are also very small, so they are easy to put in a pocket on the way to a race, and I can wear them on the way home. Only challenge: because they are small and black they are just the type of thing to disappear in the laundry. Or get confused with my wife’s stockings and wind up in her dresser.

Both the Rumba and the CEP are snug, but not super tight.  They’re comfortable enough that I don’t notice either after a few hours of wear and they do help with muscle recovery.

Overall – I’m excited to have more options for recovery after my races. If you’re looking for something manly enough to wear to the supermarket with shorts, I recommend CEP.

Compression Stockings for Dysautonomia

Compression stockings worn throughout the day can alleviate symptoms of dysautonomia and Orthostatic Hypotension (OH). Dysautonomia is a disease that affects the autonomic nervous system, often manifested by a low blood pressure and/or a high heart rate upon standing (also, called Orthostatic Hypotension and/or POTS, Postural Orthostatic Tachycardia Syndrome).

They also come in a variety of different styles and grades to suit everyone’s needs while making work and daily activities easier. Compression stockings are different than regular socks or hosiery. They are constructed to provide a certain amount tensile support around the ankle that gradually lessens up the leg (aka “graded compression” usually denoted in “mmHg”). This support can help to alleviate the symptoms of OH and POTS, helping to normalize the heart rate and blood pressure and reducing fatigue.

How compression stockings can help:
The compression of the stocking is able to promote better circulation throughout the entire body by creating better blood flow through the veins of our legs. Putting the right amount of pressure around the legs improves the functioning of the one-way valves within the veins and prevents the old blood from pooling (aka “venous stasis”). The old blood can then make it back to the heart and lungs where it receives a fresh oxygen supply. Improving the circulation in your legs will thereby make your legs less fatigued because they are not being fueled by the pooled, oxygen-deprived blood.

Wearing compression stockings promotes health in other parts of the body as well. For example, with less blood pooling in the legs, more blood is able to reach the brain. This can decrease the dizziness or lightheadedness that occurs with standing such as in those with orthostatic hypotension. In addition, increasing the amount of blood returning to your heart and lungs may help with other symptoms of dysautonomia to some extent (ie: tachycardia, palpitations, SOB, general fatigue).

What compression stockings can prevent:
There are a variety of venous disorders that benefit from the use of compression stockings. Daily appropriate use can help with the management of spider veins and varicose veins, while preventing the new occurrence of unsightly veins. Open leg ulcers, thrombosis, inflammation (of veins) are some of the more serious conditions that may warrant compression therapy under the supervision of a healthcare
professional.

For those without any apparent venous disease, compression stockings can still help to alleviate swollen ankles at the end of a hard workday, while protecting against future venous disease.

Who should wear compression stockings:
Individual needs may vary depending on your medical issues and level of activity. It certainly may help with the venous disorders listed above and for those with dysautonomia. There are also compression stockings designed specifically for times of pregnancy and for athletics as well. For overall healthy individuals, wearing compression stockings during times of prolonged standing may improve leg fatigue and prevent venous problems later in life. SIZE DOES MATTER! It is also important to realize that not all brands that market their socks as “compression” offer the same quality of medical grading as more reputable suppliers. Be wary of one-size fits all companies that don’t provide detailed instructions on how to fit yourself before purchasing their product. Better yet, many medical supply stores will provide you with a free fitting for compression stockings from a trained professional.

The level of compression delivered by the stocking depends very much on the size and length of your calf or leg. Therefore, it is important to take careful measurements and wear the right size stocking. A poorly fitted stocking may feel very uncomfortable and may not provide very much symptomatic relief. Your height will also affect the size of hosiery that you should buy. Many companies therefore provide both petite and regular sizes.

Caution should be taken if you have any type of hypertension, neuropathy, or arterial disease, however. Compression stockings may not be useful in these cases. It is always good to consult your healthcare provider about wearing stockings, especially if you have a serious medical condition.

When to use compression stockings:
Compression stockings can be worn throughout the day, although it is best to put them on in the morning before any blood has pooled in the legs. The benefits of compression stockings can definitely be felt during periods of prolonged standing where gravity is most likely to cause blood to pool. In addition, many athletes wear them to improve their performance during physical activity and to help with muscle recovery.

It is very important to remove compression stockings before sleeping or lying down, however. Removing the stockings before lying down will help your body to sense the right amount of fluid in your body, which is needed to prevent the worsening of your symptoms when you are not lying down.

On a personal note, I have worn compression stockings myself for the last 5 years to help lessen the orthostatic symptoms of my dysautonomia. In conjunction with medication and lifestyle changes, I feel like they played an important role in helping my recovery and reconditioning. When I am at school or Zumba, I’ll use the 30-40 mmHg knee-high; when I’m at home (sitting usually), I’ll wear the 20-30 mmHg. Although stockings alone are not a cure-all for dysautonomia, I have found that they lessen my feelings of lightheadedness and general fatigue, especially when I have to stand for extended periods of time. However, it is important thing to realize is that everyone is different and unique, as will be their journey to health. Trial and error is often necessary along the way, but eventually you will find what works best for you. Fortunately, compression stockings come in a variety of different grades and styles to suit
everyone’s individual needs as they are on their path to wellness.

Best wishes to everyone for better health and wellness!

Linda Nguyen, DINET Volunteer
Dysautonomia/NCS since 2008
M.D. candidate University of Miami Miller School of Medicine c/o 2016

Learn more about Dysautonomia at the Dysautonomia Information Network – www.dinet.org.