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Three rounds of deep vein thrombosis forced some changes in my recreational activity. The short story is that since the mid-90s I can't count on my legs returning all of my blood to the heart effectively. Since I don't make a very good couch potato, I needed to find ways to minimize the problem. The first step is understanding what behaviours magnify the problem. Standing is bad, so I move around or find opportunities to sit down. Movements that use the calf muscles result in a pumping action. Elevating the legs lets gravity do the work - what a great excuse to put your feet on your desk. Then there is technology. There are a number of flavours of leg compression available. I'm going to talk about the ones I've tried: both by type and specific products. I haven't tried everything, but I'm trying to give a number of products a chance to prove themselves. I'll add new things I try to the list and am open to suggestions. A bit of background on my perspective might be useful. I've been wearing compression on my left leg during most waking hours for close to 20 years. In recent years I've also worn compression on the right leg at times when I am highly active or going to be on my feet for extended periods of time.
I've tried several brands, but quite a few years ago settled on Jobst custom fit stockings. They are made specifically for one leg and fit very snug. I'll get to the details in a minute, but first let me comment on other things I tried along the way. I found the off the shelf stockings lacking in two regards. First, the compression was fairly low, to the point where they seemed like glorified, overpriced panty hose. Second; the compression wasn't very well balanced. By that I mean that the compression isn't even throughout. Some spots might not have any real compression at all. Ideally, the compression should be graduated from the ankle to the thigh. They are; however, much cheaper than custom fit. I think they might be a reasonable choice for someone who isn't very active. I tried other custom fit stockings that were made based on half a dozen measurements on the leg. I found this insufficient to provide a balanced, graduated compression for an active leg. The Jobst custom fit I have is based on measurements every 4-5 cm (1 ½ - 2 inches) up the leg. The result is a product that provides a noticeable benefit to blood flow. As an active person, I find these stockings have to be glued at the top of the thigh to stay in place. A water soluble glue used for theatre style makeup works like a charm. I did notice a huge difference in the way that the measurements are taken. The first set of measurements were taken by a person used to fitting elderly people who are the most likely to need such things. The second set was taken by someone who is used to working with athletes. The stockings made from the second measurements provide much better compression - to the point that I can easily ride a bicycle twice as long without needing to take a break. The first measurements reflected the circumference of my leg at rest - a tape measure around the outside. The second measurements compressed the soft tissue slightly - a few millimeters - not enough to feel like it was squished, but enough to reflect the size under compression. If the stocking is easy to put on, it is too big. Get measured again before you buy another batch.
There is a growing variety of offerings in this market and it is a bit hard to keep up with them. Since the market is moving fairly quickly, I'll only comment on things I've tried in the last couple of years. This includes Zoot, Skins, Sugoi, 2XU. I use these in two circumstances: 1) when I'm not expecting to be highly active which would require the prescription compression or 2) as double compression on very long bicycle rides (over 3 hours). I believe just the compression tights would do the job for most people. For all of them, sizing is important. If you are on the threshold of a size, get the smaller size to get a good measure of compression. Zoot tights are far and away the best from a compression point of view. There are two things that I find less than ideal with them. First, the material is the most abrasive of the ones I've tried. This is due at least in part to the number of seams, which I grant are a big part of how they manage the compression as well as they do. Second, the waist is incredibly short, to the point where I need to give them some assistance to stay up. The simplest aid is to wear bib shorts over them, though I have also used suspenders. I can comfortably walk for an hour using these as my only compression. Sugoi has a good balance of compression and comfort. They are a bit tricky to get over the heel, but that isn't unusual for any good compression. The compression is much better in the calf area than in the thigh. These work quite well for me around the house or taking the car out to the store for a quick errand. Skins tights are quite comfortable and in my opinion look the least like underwear of the ones I've tried. I find the compression pretty good, but after a few hours find the seams get a bit abrasive. I use these in much the same way as the Sugoi. The Skins are a bit warmer and, for me, the compression isn't quite as good - though it is close. 2XU offers pretty modest compression, barely noticeable in comparison to the others I've tried. They are very comfortable and can easily be worn all day. I mostly wear these as an extra layer. The compression is just enough to keep my prescription compression from slipping without needing to glue it, which is nice when I'm trying to sneak in a quick ride after work. Keep in mind that a different leg profile, or size or a different sensitivity to touch might make a different brand work better for you.
A number of new products have come on the market in the last year (2012). I use these in limited situations on my right calf. I've used sleeves from Zoot, Zensah, Skins and CEP and socks from Sugoi. As with the tights, go with the smaller size if you are on the threshold and don't buy the size you think you need without actually measuring your calf. Most people will wear a smaller size than they expect. Because the compression is localized to a relatively small part of the leg, I don't use them for significant activity. I am most likely to use them while driving long distances or in social situations with lots of sitting. The sleeves are very convenient to use. I keep a couple in my car and brief case. You can pop them on to get a bit of compression without having to strip down and re-dress. Often a bit of convenient compression is better than none at all. If you are also going to be wearing socks, make sure that they are not under the compression. The Zoot sleeves offer the best compression. As with their tights, the fabric is a bit course so they can be abrasive when worn for extended periods (7 hours or so), particularly with dry skin. I think this is a fair trade for the compression offered. They might slip down the upper part of the calf a bit during activity, but it does take quite a while for this to happen and they are easy to pull up. The Zensah sleeves have decent compression and come in a brilliant range of colours, which I find very appealing. The fabric is courser than some, but not quite as much as the Zoots. As noted with the Zoots, I think this might be part of the cost of good compression that takes muscle placement and action into account. They are comfortable to wear all day. The CEP sleeves have decent compression and are available in several colours. I got them in bright yellow-lime green with reflective stitching on the side. The fabric is much like that used in the Zensah, but they are styled quite differently. I haven't had them for very long, but haven't noticed a tendency to slip down the upper calf. I find these and the Zensah the easiest to wear for extended periods. The Sugoi socks have pretty good compression with no pinch points. I prefer sleeves to socks, mostly because I am quite fussy about what is on my feet. The socks do tend to slip a bit down the upper calf during activity. They are quite a good choice for long plane rides or long drives. The Skins A400 sleeves offer good compression and are quite comfortable for short periods. They are not prone to slipping, but that is achieved at the cost of pinch points at the ends of the sleeve. The effect is a bit like having a rubber band at the top and bottom of your calf, which is counter to the ideal of having graduated compression. I will wear them a bit more, but restrict it to short term usage (an hour or two) in situations with a low level of activity. |
