Thigh-high compression stockings are medical garments that apply graduated pressure to the leg, tightest at the ankle and gradually decreasing toward the thigh. This pressure distribution supports circulation, helping to manage conditions like deep vein thrombosis, varicose veins, and lower limb swelling. The high elasticity and snug fit necessary for therapeutic benefit make the process of putting them on, or “donning,” challenging. A clear, step-by-step method ensures the stocking is applied correctly to deliver the intended medical support.
Preparing the Skin and Stockings
The optimal time for application is first thing in the morning before swelling develops in the legs. Since gravity increases fluid accumulation when standing, applying the stockings when the legs are least swollen makes the process easier. The legs must be completely clean and dry before donning, as moisture creates friction that makes the stocking stick to the skin.
For added ease, or if the skin is naturally moist, a dusting of unscented talcum powder or cornstarch can be applied to the foot and leg. This powder acts as a lubricant, reducing skin tackiness and allowing the compression garment to slide smoothly. Before beginning, inspect the stocking for any snags or tears. Also, remove any rings or jewelry from the hands to prevent damage to the fabric.
The Complete Step-by-Step Donning Method
The most effective technique involves the “inside-out” method, which minimizes the fabric that needs to be stretched over the wider foot and ankle. To prepare, reach inside and grab the heel pocket. Pull the top portion down and over itself until the stocking is completely inside out, stopping at the heel. This creates a tight “sock” with the heel pocket exposed and ready for the foot.
Next, carefully insert the foot into the stocking, ensuring the heel sits perfectly within the defined heel pocket and the toe area is comfortable. This precise placement is important because the heel pocket anchors the garment and dictates the correct compression gradient up the leg. Once the foot is seated, pull the material (still inside out) up and over the ankle and lower calf in a smooth motion.
Using specialized rubber or textured donning gloves is highly recommended for subsequent steps. They provide enhanced grip on the slick material and protect the stocking from snags. With the gloves, grip the rolled-up cuff and begin pulling it up the leg in gradual, short segments. The goal is to smoothly unroll the stocking up the leg, rather than pulling the top band directly toward the thigh.
Continue working the stocking up the calf and knee, ensuring the fabric is evenly distributed and not bunched up, especially behind the knee. Once the stocking reaches the mid-thigh, it should be fully unrolled and lie flat against the skin. The final placement requires the top band, known as the welt, to sit a few centimeters below the fold of the buttocks, ensuring the compression gradient is utilized.
Solving Problems and Ensuring Proper Fit
After the stocking is fully applied, a thorough visual and tactile check is necessary to ensure the garment is working correctly. The most important check is smoothing out any wrinkles or folds. These wrinkles can act like a tourniquet and create dangerous pressure points that impede circulation. Using the flat of the gloved hands, gently massage the stocking from the ankle upward to remove any subtle bunching that may have occurred during the donning process.
The top band of the thigh-high stocking must never be rolled down, as this doubles the compression in that area and can cause a painful constriction of blood flow. If the stocking tends to slip, the issue may be incorrect sizing, and the leg measurements should be re-evaluated, particularly if swelling has significantly reduced. For individuals who experience extreme difficulty in the application process due to limited mobility or strength, specialized mechanical aids, often called stocking donners, can be utilized. These devices use a frame or trough to hold the stocking open, allowing the foot to slide in easily and the garment to be pulled up the leg using long handles.