Compression socks use graduated pressure, highest at the ankle and decreasing up the calf, to improve blood flow. This mechanism moves blood from the lower extremities back toward the heart, reducing swelling, alleviating leg fatigue, and preventing blood clots. However, the tightness required for this function makes application difficult, especially for older adults with reduced flexibility, limited grip strength, or difficulty bending over. This challenge often leads to inconsistent use, compromising the garment’s therapeutic benefits.
Essential Preparation for Safe Application
Proper preparation must occur before attempting to put on the sock to ensure both safety and maximum therapeutic effect. Compression garments must be correctly sized, typically requiring measurements of the ankle and calf circumference. An improperly fitted sock, whether too loose or too tight, will not deliver the intended graduated pressure or may restrict circulation. Apply the socks first thing in the morning when the legs are least swollen, before gravity causes significant fluid pooling.
Skin and foot care are also important preceding application. The skin must be completely dry, as residual moisture increases friction, making the tight fabric nearly impossible to slide on. Avoid heavy lotions or moisturizers immediately before donning, as they create resistance and can degrade the sock material. A light dusting of cornstarch or specialized donning powder can reduce friction and allow the sock to glide more smoothly over the skin. Check the skin for any cuts, abrasions, or rashes before application, as the tight material can worsen existing issues.
Step-by-Step Manual Technique
The most effective manual method for applying compression socks is the inside-out technique, which minimizes the fabric pulled over the heel. Begin by reaching into the sock and grasping the heel pocket from the inside. Pull the upper portion down over the hand, turning the garment inside out until the heel portion is exposed. Gently insert the foot, ensuring the heel aligns perfectly with the sock’s heel pocket.
Once the foot is fully in and the heel is seated correctly, the remaining bunched-up fabric is walked up the leg. Grasp the double-layered cuff and pull the sock upward in small increments, reversing the inside-out portion. Using rubber donning gloves or heavy-duty kitchen gloves is highly recommended, as the rubberized surface provides a superior grip on the slippery fabric. These gloves also protect the delicate knit from being snagged by fingernails or rings.
The final step involves smoothing the material across the entire calf, from the ankle up to the top band. Eliminate all wrinkles and folds, as bunched fabric creates a localized band of intense pressure. This concentrated pressure acts like a tourniquet, impeding blood flow and counteracting the graduated compression effect. If wrinkles cannot be smoothed out, or if the sock feels twisted, remove the garment and start the entire process again.
Utilizing Specialized Donning Aids
For individuals with severely limited flexibility, grip strength, or difficulty reaching their feet, specialized tools can make the application process manageable. These assistive devices fall into two main categories: rigid frames and flexible sliders. Rigid donners, typically metal or molded plastic, are sturdy frames that hold the compression sock open. The sock is loaded onto the frame first, allowing the user to slide their foot into the wide opening without bending over.
The stocking is fully loaded onto the frame until the heel pocket is positioned near the base. The frame often includes long handles, allowing the user to pull the sock up the leg while remaining seated. Flexible cloth sliders, often made of slick nylon, reduce friction between the skin and the compression fabric. The foot is placed into this sleeve, the sock is pulled over the sleeve and onto the foot, and the sleeve is then easily removed through the open toe.
Another flexible aid is the molded plastic sock aid, which features a curved trough attached to long cords. The sock is loaded onto the trough, the user drops the device to the floor, and uses the cords to pull the apparatus and sock up their foot and leg. These aids are a practical alternative to the manual technique, allowing for greater independence by eliminating the need for bending at the hip or knee during application.