Compression Garments

Compression garments and abdominal binders can help decrease blood pooling in the lower extremities and abdomen. ¹ ² ³ ⁴ ⁵ ⁶

It can help some individuals manage symptoms of orthostatic intolerance and potentially help decrease drops in blood pressure upon standing in those with orthostatic hypotension. ⁷

In one recent study, the use of thigh-high and abdominal compression garments helped reduce heart rate and symptoms during a head-up tilt table test. ⁸ Even in healthy individuals, compression can help to reduce the increase in heart rate during a head-up tilt table test. ⁹

However, individual responses to the use of compression garments will vary.

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Varicose veins prevention, Compression tights, relief for tired legs. Beautiful long female legs in stockings

Compression garments, specifically stockings, are designed to gently squeeze the legs to help blood flow back to the heart.

They are designed to provide the most substantial amount of pressure around the ankle and gradually decrease the pressure as it moves up the leg. ¹⁰ This pressure is measured in mm of Hg (mercury).

It is usually recommended that the compression garments be at least thigh high and include abdominal compression, as shorter garments have not been shown to be as beneficial. ¹¹ ¹² ¹³ 

The most reliable garments are ones that are purchased from a medical supply store and are fitted based on measurements to ensure that the recommended amount of compression is obtained. ¹⁴

These will often be at 20-30 mm of Hg up to 30-40 mm of Hg, depending on physician recommendation. ¹⁵ ¹⁶ ¹⁷

Some insurances will cover the cost of compression garments depending on the condition and benefit coverage with a prescription from the physician. 

Here are some best practices for the use of compression garments/abdominal binders ¹⁸ ¹⁹:

  • Get compression garments sized and fitted by a professional. 
  • If there have been weight changes, get resized and fitted to ensure the appropriate.
  • Take compression garments off during periods of rest. Do not wear overnight unless directed to by your healthcare provider.
  • Check skin daily for changes from wear that might include redness, dents, dryness, or chafing.
  • Hand wash compression garments and air dry to prevent distortions in the fabric.
  • A stocking donner can be purchased to help put on compression stockings if it is more difficult to grasp and position the stockings.
  • Some brands make gloves that can be worn when putting on compression garments to make them easier to adjust while not damaging the material.
  • Make sure your skin is dry before putting them on, especially after using lotion. Any moisture on the skin can make putting them on more difficult. 
  • Take your time putting them on. Begin by sitting on the side of the bed or in a chair and prop your foot on something while you put them on one leg at a time. Lying down can also help when pulling up towards the abdomen. Take a break if needed. 
  • If you get a tear or run in the stocking, it will need to be replaced. This breach in the integrity of the material lessens the compression strength. 

It is often easier to put on the compression garments first thing in the morning, upon getting up. At this time, blood pooling is usually at a minimum, and swelling of the legs is less likely. Check with your provider regarding specific recommendations about when to put on and take off the compression garments.

Reviewed by Medical Content Experts, 2021

REFERENCES

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Bryarly, M., Philips, L. T., Fu, Q., Vernino, S., & Levine, B.D. (2019). Postural orthostatic tachycardia syndrome: JACC focus seminar. Journal of the American College of Cardiology, 73(10). 1207-1222. {1}

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Kelly, K.L., Johnson, C.P., Dunne, L.E., Holschuh, B., Joyner, M., & Johnson, B.D. (2019). Active compression garment prevents tilt-induced orthostatic tachycardia in humans. Physiological Reports, 7(7). E14050. {9}

Maxwell, A. J. (2020). Dysautonomia In D. Jovin (Ed.), Disjointed: Navigating the diagnosis and management of hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders. (1st ed., pp. 135-215). Hidden Stripes Publications, Inc. {4, 14, 16}

Protheroe, C.L., Dikareva, A., Menon, C., & Claydon, V.E. (2011). Are compression stockings an effective treatment for orthostatic presyncope? Plos One, 6. {12}

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Ruzieh, M., & Grubb, B. P. (2018). Orthostatic intolerance and postural tachycardia syndrome: New insights into pathophysiology and treatment. German Journal of Cardiac Pacing and Electrophysiology, 29(2), 183–186. {17}

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