fitness · Guest Post

Adaptive exercise: When medical compression garments get in the way of working out (Guest Post)

A line drawing of a pair of legs, running towards the right side of the screen. The legs are wearing a pair of tan-coloured, thigh-high stockings, and the stocking on the right-hand leg seems to be slipping down towards the knee.

I started wearing thigh-high, medical-grade compression stockings a year ago; here’s what I’ve learned about trying to work out while wearing therapeutic compression clothing.

The discomfort started during the first shift of a new job. I’d just moved to a different part of the province, and I’d taken a temporary survival job to pay the bills. I was working on the sales floor of a large book retailer, and I Ioved being surrounded by books while I worked. What I didn’t love, however, was how much my feet hurt by the end of the day.

I tried cushioned shoes, which really helped, but I also decided to try compression socks (15-20 mmHg), figuring they couldn’t hurt. (Sam and Catherine have written in the past about the various benefits of wearing low-grade compression socks, here and here.)

Indeed, for the next couple of years, the knee-high stockings that I bought over the counter every few of months from my local drugstore seemed to do the trick. My foot pain immediately improved, and I was able to continue working 40 hours per week in retail (eventually at a fabric store, after my bookstore contract ended).

Then I noticed something troubling: I was beginning to get a bulging varicose vein on the inside of my right knee, above where my drugstore compression socks ended. It looked really gross… and on top of that, it eventually started to ache and throb badly – especially by the end of an eight-hour shift at the store.

My family doctor referred me to a vein specialist, and he recommended vein stripping, but I couldn’t afford the treatment at that time, since I was making minimum wage as a casual employee, without extended healthcare benefits. In fact, I couldn’t even afford the thigh-high prescription compression stockings that were his alternate suggestion. At nearly $200 per pair (and knowing I would need to buy at least 6 pairs per year), I gave up on that treatment plan, and continued with the over-the-counter knee-high stockings that I was already using.

(Even those were expensive, given my budget at the time. I usually had five or six pairs on the go, and they cost about $25 per pair. They had to be replaced every six months or so, when the heels wore through.)

Fast forward to the fall of 2020, when I was home quarantining after getting COVID-19. I was isolating in my bedroom, so that my housemate wouldn’t get sick, and I spent a lot of time lying down on my bed, or sitting cross-legged on the floor.

The bulging varicose vein on the inside of my right knee developed full-blown thrombophlebitis, or a blood clot in one of my superficial veins (which is thankfully less serious than deep vein thrombosis; but still painful, and requiring medical attention).

My family doctor eventually prescribed thigh-high, medical-grade (30-40 mmHg) compression stockings, and I resigned myself to both the expense and the awkward inconvenience of having to wear compression garments all day, every day – probably for the rest of my life.

(Chronic veinous insufficiency and chronic superficial thrombophlebitis are irreversible, progressive conditions that cause stagnant blood flow and swelling in the superficial veins of the legs, and are an occupational hazard for people who stand for long periods. The condition affects a diverse range of occupations, from retail workers and cashiers, to healthcare professionals (nurses, doctors, surgeons, pharmacists), teachers, chefs, food service workers and food servers, police, hairstylists and barbers, and industrial workers.)

I’m almost 55, and my retail career coincided with the most vulnerable age (50 and older) for developing problems with superficial leg veins. I eventually found work that didn’t involve standing all day, but sedentary workers (office staff, programmers, writers, drivers) are also vulnerable to chronic venous insufficiency. Sitting is the new smoking, right?

I’m at peace with wearing compression garments by this point. I genuinely feel better when I wear them regularly. (Which is not to say that I haven’t occasionally pushed back against my circumstances, and flirted with removing my stockings when I’m not actually working. The results have been resoundingly negative: I get a flare-up of phlebitis (vein inflammation) whenever I ditch the stockings, even for a few hours.)

One thing I’m really struggling with, though, is how to fit exercise into my life, when I have to wear my medical compression garments every waking moment.

Here’s the thing. (Actually, here are several things.) They’re hard to get on and off – especially if your skin is damp (from having recently showered, for example). It takes me a good two or three minutes to get them on first thing in the morning, and I have to be lying down (and wearing special, rubberized gloves) when I do it. Even if I were inclined to want to change them at some point during the day (which I most decidedly am not), they’re a royal pain to put on more than once per day.

They’re also really expensive. At nearly $200 per pair, I can only afford to have two pairs in circulation at any given time, alternating them every other day, and hand-washing them after each use. Each pair, worn every other day, lasts about four months, before I get holes in the heels. Sometimes the stockings wear out even faster, ripping at the area where the silicone band at the top (which helps keep them in place) meets the knit hose. (Thankfully, I can repair them myself with my sewing machine, but the tears definitely shorten their lifespan.)

They’re tight, but they also tend to slide down at inconvenient times when the silicone at the top of each thigh starts to lose its stickiness. Anything that dislodges the silicone cuff is annoying as heck. Hi-impact activities like running and jumping are impossible, if I don’t want to end up with my stockings fallen (and uncomfortably bunched-up) around my knees. Even deep leg bends and stretches can cause the stockings to slide down towards the knees, and I often find myself darting to the bathroom several times per day, to yank them back up.

They’re made out of synthetic materials, which means they don’t breathe. They’re hot… and when you sweat, they feel even hotter. They make my feet smell – every single day. Long, sweaty workouts in compression stockings would mean hot, damp, sticky and smelly body parts that can then develop other lovely conditions like fungus infections.

So after a lot of trial and error over the past few months, here are the conditions that I’ve decided I require for my physical exercise, while wearing compression stockings:

  1. Workouts that aren’t long enough to make me break into an uncomfortable sweat.
  2. Low-impact workouts, without a lot of extreme leg movements (unless I’m working out somewhere where I can continually be pulling my stockings back up).
  3. Workouts where I can wear loose, comfortable pants that don’t fit snugly on my legs, because the compression stockings cause serious “muffin-top” at thigh level, making it glaringly obvious that I’m wearing some kind of supportive hose.

Here are the acceptable-to-me adaptations that I’ve landed on, that allow me to work out without too much disruption to my life, or too much mental frustration from having to adjust the stockings, pull them on and off more than once per day, or sit around in damp, smelly stockings for long stretches.

  • I like taking casual, 15-20 minute walks, not far from home. I yank up my compression stockings as high as they will go before I leave the house, and I avoid walking too briskly, so that the stockings don’t start to drift down my legs during the walk.
  • I like working out inside my home, especially in my basement where it’s coolest, especially in the warmer months.
  • The other benefit of working out at home is that it doesn’t matter what I look like. I can wear close-fitting leggings without worrying what other people might think about the artificial lumpiness of my legs.
  • I prefer not working out at the beginning of my day, before I leave for work, so that I don’t have to wear sweaty compression stockings all day, or change my stockings. (I commute to my office job every day, although I will temporarily have a hybrid working arrangement when some office renovations begin shortly.)
  • When I’m working at the office, I like to add a lot of extra movement into my day – especially since I now have a very sedentary job where I work on the computer nearly 100% of the time. I take frequent trips up and down our office stairs – to visit the coffee machine (where I get hot water for herbal tea), or ask my colleagues questions in person, instead of emailing or phoning them.
  • I want to experiment with doing short bursts of movement in my office – things like wall pushups or desk pushups, or even a set or two of squats or lunges beside my desk.
  • For many years I’ve enjoyed taking short “dance breaks” at home, which last the length of one or two upbeat songs, and make me feel happy. Even if I get a little “bouncy” (and my stockings slide down my legs), I can pull my stockings back up without fear of being seen.
  • I did a lot of qigong exercises during my cancer treatment several years ago, and it’s recently occurred to me that they would also be good movements to do in my current circumstances.

I realize that, in the grand scheme of things, having to wear compression stockings is not the worst thing that could happen. But if you’d asked me when I was in my 20s or 30s if I could visualize myself wearing medical compression garments in my future, I probably would have been appalled and dismayed. (Cue the ageism of youth.) As with a lot of aging experiences, I’ve been really humbled by the changes I’ve had to make in my life as my body grows older. But I’m also glad that I have options, when it comes to moving my body and being healthy.

Michelle Lynne Goodfellow works in the nonprofit sector by day, and also enjoys writing, taking photographs, sewing flowered dresses, and making illustrations. You can find her on Instagram, here.


Sam discovers compression socks

For years I’ve been struggling with swollen ankles after long flights. Not two hour flights or even four hour flights but six or more, yes.

After my last trip to Europe it took a long time for my calves and ankles to get back to normal. Sarah has a bit of a problem with this too and jokingly suggested that now that compression socks are cool among endurance athletes (thank you ultra marathoners!) we could buy some and try them for flying.

The first bunch I bought didn’t fit me at all. I’ve got very serious calves. And they weren’t tight enough to work as compression for Sarah. They’re funky though.

This trip I actually bought the kind of compression socks I’d previously thought were too impossible old and nerdy to wear. No cool sayings. They’re just black tight and stretchy.

However, low and behold, they work. Fourteen hours of flying to Tahiti and no swelling at all. I’m amazed. And I’m also feeling a bit like an idiot for letting considerations of cool get in my way.

I’ve become that person, flying in yoga pants, compression socks, and bright orange running shoes. On the bright side, I felt great after flying. Whatever, I’ll take it. Bring on the compression socks. They work.

See Try compression socks to relieve circulation problems while flying.

See also How do compression socks work?