Thigh-high compression stockings are specialized medical garments designed to improve blood flow in the legs by applying graduated pressure. This pressure is strongest at the ankle and gradually decreases up the leg toward the thigh, which helps push venous blood back toward the heart. This prevents pooling and reduces the risk of conditions like deep vein thrombosis, edema, and chronic venous insufficiency. Because they provide precise, therapeutic pressure, they are made with a strong, tight elastic weave, making the donning process challenging.
Essential Preparation Steps
It is beneficial to apply the stockings first thing in the morning when the legs are typically least swollen, and it is usually easiest to do so from a seated position. The skin on the leg must be completely dry. Moisture from lotions or recent showers significantly increases friction, making the tight fabric nearly impossible to slide up the leg.
Turning the stocking inside out down to the heel pocket is a fundamental step that isolates the foot portion from the rest of the garment. To do this, reach inside the stocking and grab the heel or toe, then pull the top half down over itself. This creates a manageable sleeve of fabric, allowing the foot to be placed correctly before dealing with the long leg section. Rings, bracelets, and other jewelry should be removed from the hands to protect the fabric from snags and tears during application.
Detailed Donning Technique
The technique starts by inserting the foot into the isolated foot section. The toes must be aligned first, ensuring the heel of your foot is settled precisely into the stocking’s heel pocket. Proper heel placement is essential because it anchors the graduated pressure zones, guaranteeing the strongest compression is centered at the ankle.
Once the foot is fully seated, the material that was turned inside out can be gradually pulled up over the ankle and calf. Instead of forcefully tugging the top band, use a gentle, “massaging” motion, unrolling the fabric bit by bit with flat palms or finger pads. This incremental approach prevents the fabric from stretching unevenly or creating a tourniquet effect from bunching.
Continue unrolling the fabric up the leg, maintaining smooth, even tension as you pass the knee and move toward the thigh. The goal is to distribute the material equally across the skin without stretching one area more than another, which would disrupt the intended pressure gradient. When reaching the top, the silicone band should be smoothed flat against the skin, ensuring it does not fold or roll down.
Post-Application Checks and Adjustments
Once the stocking is fully on, a thorough inspection is necessary to confirm its therapeutic effectiveness and comfort. Check the entire length, from ankle to thigh, for any wrinkles, creases, or bunched-up areas. Folds in the fabric create localized areas of excessive pressure, potentially restricting circulation and defeating the garment’s purpose.
The most critical check is confirming that the heel pocket remains perfectly aligned with your anatomical heel. If the heel is misplaced, the entire graduated pressure profile will be incorrect, making it less effective in supporting venous return. For thigh-high styles, the top band must lie smoothly against the upper thigh without twisting or cutting into the flesh.
Monitor for signs of incorrect fit, such as numbness, tingling in the toes, or localized pain. While compression stockings are designed to feel snug, they should never cause pain or discomfort that suggests blood flow is being blocked. If these symptoms occur, the stocking should be immediately removed, and the application process repeated after resting the leg.
Tools and Methods for Increased Ease
For individuals who struggle with the strength or dexterity required to don the tight fabric, specialized tools can simplify the process. Donning gloves, often made of rubber or silicone, are recommended because they provide a superior grip on the slippery elastic material. Using gloves protects the fabric from fingernails and allows the wearer to apply more friction and force without damaging the stocking.
Various assistive devices, known as donning aids or butlers, are available, ranging from tubular silk sliders to rigid metal frames. These devices reduce the high friction between the stocking and the skin, allowing the wearer to push the stocking onto the foot and up the leg, rather than pulling the fabric. For example, a frame-style butler holds the stocking open, enabling the foot to slide in easily, and the handles are used to pull the garment up the leg without excessive bending or straining.
A small amount of cornstarch or specialized donning powder can be applied to the leg to decrease friction temporarily, helping the stocking slide more smoothly over the skin. This is helpful with high-compression, rubber-based garments where the material’s inherent tackiness makes movement difficult. This ensures consistent and correct application.