Compression, nutrition, and exercise
selecting and using compression
Compression is considered the gold standard in lymphedema treatment. There are so many types of compression wraps, stockings, and other garments, making it difficult to know where to start. Our hope is this page will provide a beginning reference point from which to build your knowledge.
Compression garments treat many conditions, including vascular disease, post-surgery, injuries, and Lymphedema. There are pressure gradients or different levels of pressure with each garment type. The pressure is listed in mmHg, which stands for millimeters of mercury and describes the intensity of pressure associated with wear. The higher the number, the more intense pressure to the affected area.
Selecting a garment with higher pressure isn't always the best choice, and you should consult your physician or Lymphedema therapist before purchasing a high-pressure garment on your own. A complete list of compression retailers is provided at the bottom of this page for your convenience.
- 0-18 mmHg. This is the lowest pressure grade available, and stockings or socks with this pressure gradient can be found easily at pharmacies and major retailers. This compression grade is generally best suited for individuals who have mild swelling not associated with Lymphedema or vascular disease.
- 10-15 mmHg. Is the next level of pressure available. This grade of compression is not usually available at major retailers but can be purchased at pharmacies and are found at Durable Medical Equipment (DME) retailers or online compression stores. Like the 0-18 mmHg, these are generally not suitable for individuals with Lymphedema or vascular disease as they do not offer enough support to manage swelling effectively.
- 20-30 mmHg. The 20-30 mmHg pressure range is often the standard post-operatively and is commonly used with vascular patients. Although 20-30 may be prescribed for Lymphedema patients, a higher gradient is usually more effective.
- 30-40 mmHg. The 30-40 mmHg pressure point offers firm compression and is ideal for individuals with Lymphedema. Because this compression level is very intense, donning and removing stockings may be challenging for some; however, there are devices to assist with applying and removing garments.
- 40-50 mmHg is the highest level of compression available and is often prescribed for patients with Lymphedema, varicosities, ulcers, or deep vein thrombosis (clots).
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Donning gloves
Gator or donning sleeve
Gator or donning sleeve
Donning gloves are gloves with a course or sticky side that allows the compression wearer to grip the compression material without piercing or snagging.
Gator or donning sleeve
Gator or donning sleeve
Gator or donning sleeve
Sometimes called a gator or donning sleeve, this device helps people with putting on their compression by creating a smooth surface.
Rubber Donners
Gator or donning sleeve
Metal Donning Devices
Rubber or silicone donners are another type of assistive device that helps compression wearers apply their garments more easily. The garment is applied to the dinner and rolled on.
Metal Donning Devices
Metal Donning Devices
Metal Donning Devices
Metal donning aids like these are ideal for individuals with limitations in flexibility or mobility. This device can be used by the compression wearer or caregiver.
Slippies
Metal Donning Devices
Slippies
Often referred to as slippies, this donning aid can be used for upper or lower extremity compression application.
Cones
Metal Donning Devices
Slippies
The cone's rubber bottom adheres to surfaces so a stocking can be applied with minimal dexterity. Simply roll the stocking over the cone and remove. The cone helps prevent excessive bending making the donning process easier.
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Stockings and night time
Do not wear compression stockings for upper or lower extremities at night, unless otherwise directed by your doctor or therapist. Stockings can wrinkle and pinch skin leaving marks that may lead to blisters or wounds.
There are special garments designed for night time use which are explained in the next section.
Skin care
Always keep the skin moisturized with compression wear. Compression can impact your skin's hydration level and create dryness. Dry skin can lead to skin breakdown.
Wounds and compression
Compression together with wound management needs to be discussed with your physician, therapist, or wound specialists as they may recommend alternatives.
No Creases Please!
Creasing, folds, or anything but a smooth surface in compression can cause trouble. Creases pinch the skin which may lead to skin breakdown
Take care of your garments
Compression garments are very expensive and should be treated with care to get the most use of them. Wash your garments by hand or using the handwash cycle on your washing machine. It is best to use a washing solution designed for these garments but Woolite and delicate garment soap will suffice in the short term.
Never place garments in the dryer. Always line dry and make sure that any creases or rolls are smoothed out before hanging to dry.
Measure for the right fit
A compression garment should be specific to your needs. That means the size, type, and material are all best suited to you. Your provider or Lymphedema therapist will usually measure AFTER a series of the wrapping when your size is usually more stable.
If you would like to determine how to measure for yourself, please see our videos here.
Keep your skin healthy
Continuous compression wear, while best for your health can dry out the skin. Take care of your skin by using care when shaving, using soaps that are gentle to the skin, and applying moisturizers every day.
Skin that is moist is less prone to breakdown and generally feels better.
Stay put
Compression wearers often complain of stocking or sleeves rolling and becoming uncomfortable. Rolling is not only uncomfortable; it may also create irreversible damage to the garment.
Rolling can be prevented with skin-sensitive adhesive. The adhesive is sold by many brands and is usually in roll-on form. Most adhesive comes off easily when showering or with a warm washcloth.
To use an adhesive, roll the solution onto the part of the body where the compression ends; for many garments, this is where silicone may be present to keep the garment in place. With the solution still tacky, roll-up the garment and press firmly in place. You may have to hold the garment in place for a few minutes to achieve optimal adhesion.
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Sizing compression
Lower Extremity Measurements.:
Lower extremity compression includes knee highs, thigh highs, pantyhose. Measurements are most accurate when standing, but there are times when standing is not practical. If you are worried about stability when you stand or have limitations bending, have someone help you get good measurements or try the suggestions we have for you.
Upper extremity compression includes gauntlets for arm swelling and is typically measured from the top of the bicep to the fingers.
Trunk Lymphedema garments require measurement of the abdomen circumference, without tension or from the hip to the crotch.
Here are some videos that demonstrate proper measurement techniques.
Lower extremity:
https://www.youtube.com/watch?v=9SZM9kOS44A
Upper extremity:
https://www.youtube.com/watch?v=kZ6yW4UsgYE
Compression Pumps
Additional Information
Compression pumps are designed for the upper, torso, and lower extremity lymphedema. There are many manufacturers with a wide range of price points. Talk to your provider and insurance company to see what machine might be best for you.
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Kinesiology taping (KT TAPING)
Kinesiology tape is a skin-safe tape applied to an extremity to create lift for improved lymph flow. To determine if kinesiology tape is safe for you, please discuss it with your provider.
Below are resources to help you with taping techniques and location. Never apply tape on broken skin or skin that has a rash, eczema, or other breakouts. KT tape is often used in conjunction with other lymphedema therapies and usually stays on the body for a few days.
Tape can be purchased from sports stores,major pharmaceutical retailers, and Amazon.
Some retailers have pre-cut KT tape such as the one below:
Taping technique video:
https://www.youtube.com/watch?v=7tGypQK-q40