“Ted hose vs JOBST stockings Part 2”

There are two types of Compression stockings; Gradient and anti-embolism. Gradient compression stockings are designed to remedy impaired “Musculovenous pump” performance due to incompetent leg vein valves. They are woven in such a way that the compression level lessens towards the top of the hose. Doctors will typically recommend these stockings for those who are prone to getting blood clots, edema, and blood pooling in the legs and feet from prolonged periods of sitting or inactivity. Unlike TED hose, they are worn by those who are ambulatory, however, in some cases, they are worn by diabetics whose legs are prone to excessive swelling. Chronic Peripheral Venous Insufficiency caused by incompetent perforator veins is a classic example for prescribing such medical hosiery. It can forestall the formation of the “venous stasis ulcers” which are some of the most difficult wounds to treat and to heal in medicine! This type of compression stocking is non-prescriptive in many places and can be purchased at a pharmacy or medical supply store. Nonetheless, there are several crucial cautionary steps that need to be taken before self-prescribing such medical hosiery! No.1 is the person’s ABI (Ankle Brachial Index) for both legs. It must be >1.0 to wear such stockings. Otherwise, they may obstruct the patient’s arterial flow (the ABI indicates how unobstructed one’s leg and arm arteries are. Any competent Doctor or nurse can measure & calculate one’s ABI). No.2 Fit. It’s crucial that such hosiery (Stockings) be properly sized! The compression at the smallest part of the ankle must be the highest with a 70% reduction of pressure just below the knee! In top clinics, vascular doctors & nurses use special pads to insure uniform higher pressure around the circumference of the ankle (smooth out the irregular cross-sectional profile.) So long as the compression gradient is 15-20 mmHG, the ABI (for both legs) is >1.0, and the stockings are the proper fit, self-prescribing is reasonably safe. Even healthy athletic persons, runners & swimmers, boxers, etc. can benefit from such stockings. The “Firm” gradient stockings (20-30 mmHG and certainly 30-40 mmHG) really should be worn only after getting medical advisement.

Anti-embolism compression stockings are commonly referred to as TED (Thrombo Embolic Deterrent) hose. They are used to support the venous and lymphatic systems of the leg.[1] Unlike gradient compression stockings, anti-embolism hose deliver an equally distributed amount of compression at the ankle and up the leg. This compression, when combined with the muscle pump effect of the calf, aids in circulating blood and lymph fluid through the legs (in non-ambulatory patients).

Compression wear has also been adopted by the sports science industry. Various garments have been developed to improve the efficiency of muscles by stabilising muscles and improving circulation/ lactic acid removal. A notable product range is the Skins range of products. Today, compression stockings are available in a wide range of opacities, colors, styles and sizes, making them virtually indistinguishable from regular hosiery or socks.

 PTA & Clinical Manager of the Therapy Department

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