– The mistakes made when selecting the size of the stockings are one of the most important problems that lead to their lack of use and, therefore, hinder the improvement of patients.
When we buy stockings for varicose veins or compression socks, it is essential that their size corresponds to us.
Inconsistencies between the dimensions of our limbs and the dimensions of the stockings that we choose also generate inconsistencies in the effect that is intended to be obtained.
Problems with the size of compression stockings
Many times buying a wrong size stocking can be frustrating, for example stockings smaller than our actual size cannot even be put on, we lose money, and end up without the beneficial effect that the correct stocking would provide. In some cases it is possible that, under certain circumstances, it will harm us.
Many of the patients that come to my office have varicose compression stockings – we often ask them to wear them – this provides an opportunity to assess their adherence to treatment and identify any inconvenience they may have with their use.
In general, we ask patients if they’ve been using stockings regularly, and if not, we seek to know the cause to try to solve it.
In those moments it has not been unusual to observe that someone bought a stocking that does not match their size, thus spotting a flaw in the treatment that we are able to solve by reorienting them towards the ideal size and model.
Considerations before shopping for stockings
It is not difficult to know the size of our stockings, however it has a secret:
In other words, the degree of compression that you want goes hand in hand with the correct size and the latter is not exactly the same from one brand to another.
Before choosing stockings it is important that we take some measurements of our lower extremities (we will use these later). Note that if our limbs are remarkably asymmetric, as happens for example in patients with localized lymphedema, the measures to be taken must be done and considered separately for each leg, for this I recommend reading my post about buying one compression stocking or both as it contains some more information on this matter. If your measurements between limbs differ significantly, you may have to use a different size stocking on each leg, it is the least frequent case of use but we cannot rule it out entirely.
Don’t wait too long before shopping after measuring!
It is not recommended to write down the measurements and save them to use in a few weeks or months as our bodies constantly change, and that can cause errors due to inconsistency.
One factor to consider before measuring is planning to do it when the lower extremities are as contracted (shrunken) as possible, so it would be advisable to measure them in the morning or after having had them held up high for an extended period.
I am going to explain how to take the measurements to know your size, these measurements can be compared with the ones provided by the size tables that are usually provided in the packaging of the stockings and we can even see them online on the websites of the different brands or in many of the stockings that we show here.
For didactic purposes we will use a size table for compression stockings corresponding to the following model of one of the most requested stockings:
Below you will see the table of sizes and measurements of this compression stocking, below it is the Spanish translation of the terms that appear there.
In this table we are going to look for stockings that correspond to an imaginary patient for which we will have example measures for us to practice with.
What steps to take before buying stockings for varicose veins
Minor ankle circumference
The ankle is the area to compress that is closest to the ground, therefore it is the one that sustains the greatest amount of pressure of the blood column due to the effect of gravity. This is precisely the fundamental cause of the first changes in the skin of people with venous insufficiency to be seen around the ankle area (spots, areas of atrophy, edema or swelling, ulcers, etc.). That is why the stocking should fit properly there and never be too loose in this area, the size should be precise or as precise as possible.
As we know there are people with very thin ankles and others with thick ankles. So adjusting the stocking at the ankles is accomplished by measuring the exact perimeter of the ankle (often called “circumference” by the stockings’ manufacturers). The circumference of the ankle should be measured in its smallest portion.
I will use as an example a patient who has an ankle with a circumference of 21 cm as you can see in the photograph:
Greater calf circumference
The perimeter (circumference) of the calf is the second important measurement to take to know the size of the stockings. Some brands only ask for this value and that of the smallest ankle circumference, especially if the stockings are short and reach below the knee.
Our example patient has a greater circumference in her calf of 34.5 cm as shown in the photograph:
Depending on the length of the stockings, some additional measurement of the areas that will be covered by them will be necessary.
It is a very important measure, especially when looking for stockings that reach below the knee. This dimension is obtained by measuring the length of the calf from the ground, with the foot firmly planted, to below the knee. In our example patient, this measurement is close to 37 cm.
The perimeter of the thigh should be measured at its widest portion, usually the one located below the buttocks. This dimension is justified to obtain it in the stockings that cover the thighs. Our example patient has a circumference of 54 cm.
The length of the leg is measured from the sole of the foot, with the foot resting entirely on the ground, up to approximately 5 cm below the groin.
Our example patient has a top height for the average in the thigh of 71 cm.
Hip and waist circumference
For compression pantyhose models, the measurement of the perimeter or circumference of the hip (in the widest part of the buttocks) and at the waist is requested. Our example patient has a circumference of 82 cm.
It is important to consider patients whose buttocks and / or waist exceed the standard measurements, in these cases it is recommended to avoid pantyhose and instead opt for thigh length stockings, since if they choose pantyhose the proportions are likely to align with sizes larger than theirs, so they would get lower compression than they need for their treatment.
If the thighs are large and the stockings tend to fall you can find several solutions for that in our post on how to prevent stockings from falling.
Size Resulting in our example patient
If we see the measurements obtained in our example patient:
- Ankle circumference 21 cm
- Calf circumference 34.5 cm
- Calf Length: 37 to 38 cm
- Thigh circumference 54 cm
- Leg length 71 cm
- Hip circumference 96 cm
… and we go to the table of measurements of the desired model of stockings:
… we will see that his ideal size for this model is SS.
The non-concordance between measures
However, we are not all perfectly alike. Should there be different recommendations based on the measurements taken on legs, using the largest size among those considered is recommended, in favor of a more comfortable fit that is easier to put on, as long as they fit well at the ankles.