Putting compression socks on another person takes a specific technique. The fabric is intentionally tight, which makes it resist sliding up the leg. The trick is to turn the stocking mostly inside out first, position the heel, then work the fabric up in small increments rather than trying to pull the whole thing on at once.
Before You Start: Positioning and Skin Prep
Have the person lie flat on their back with their legs extended. If they’re in a bed, raise the bed height so you’re not hunching over. Compression socks go on easiest in the morning, before swelling builds up throughout the day. If the person has been sitting or standing for a while, have them lie down with legs slightly elevated for 15 to 20 minutes first.
Make sure their legs are completely dry. Moisture makes the fabric grip the skin and bunch up. If they’ve just bathed, pat the legs dry thoroughly. Avoid applying any lotions or creams before putting the socks on, as emollients make the fabric nearly impossible to slide into place. Save moisturizer for nighttime, after the stockings come off.
While you’re handling their bare legs, take a moment to look at the skin. Check for any open sores, redness, or areas of broken skin. These need attention before compression is applied over them.
The Inside-Out Method, Step by Step
This is the standard technique used by nurses and caregivers, and it works far better than trying to scrunch the stocking up like a regular sock.
- Turn the stocking inside out to the heel. Hold the top of the stocking with one hand. With the other, reach inside and grab the heel pocket. Pull your hand back out through the stocking, turning it inside out down to the heel. You should now be holding what looks like a short foot-shaped pouch with the rest of the fabric folded neatly around it.
- Slide the foot in. Guide the person’s toes into the foot portion as far as they’ll go. Make sure the heel lines up precisely with the heel pocket. A misaligned heel is the most common reason compression socks feel uncomfortable or bunch up.
- Pull the fabric over the heel. Once the toes and heel are seated correctly, pull the turned-out fabric up and over the heel so it sits snugly around the back of the ankle.
- Work up in small sections. Grasp the folded fabric about 5 centimeters (roughly 2 inches) below the fold line and pull that section up over the ankle. Then re-grip another 5 centimeters below the new fold line and pull again. Continue this process, working up the calf in short, even increments.
- Smooth the fabric. Once the stocking is in its final position, run your hands over the entire surface to smooth out any wrinkles or bunched areas. Even small folds can dig into the skin and create pressure points over the course of a day.
For knee-high stockings, the top band should sit about two finger widths below the bend of the knee. For thigh-high stockings, it should reach the buttock fold. Never roll or fold the top of the stocking down to shorten it. This creates a tourniquet effect that actually blocks blood flow, the opposite of what compression is supposed to do.
Donning Aids That Make It Easier
If the person you’re helping has very swollen legs, fragile skin, or if you’re finding the process physically difficult, donning devices can help significantly. There are two main types.
Foot slips (also called silk sliders) are slippery fabric sleeves that go over the foot first. You pull the compression stocking over the slip, and once everything is in position, you slide the slip out through the open toe. The low-friction material lets the stocking glide on instead of dragging against skin. These work for both open-toe and closed-toe stockings.
Metal or plastic frames hold the stocking open in a stretched position so you can guide the person’s foot straight into it, then pull the frame away as the fabric grips the leg. Frames are especially helpful for higher-pressure stockings that are difficult to stretch by hand. Research on elderly patients with severe venous insufficiency found that these devices made independent or assisted application possible for people who otherwise couldn’t get their stockings on at all.
Rubber donning gloves (textured dishwashing-style gloves) also give you a much better grip on the fabric and help you smooth out wrinkles without the stocking slipping through your fingers.
Getting the Right Size
A poorly sized stocking is harder to put on and less effective once it’s in place. Measurements should be taken in the morning when swelling is minimal.
For knee-high stockings, you need two measurements: the calf circumference at its widest point, and the length from the back of the heel to the bend of the knee. For thigh-high stockings, add the upper thigh circumference at the buttock fold and the full leg length from heel to buttock fold. Use these numbers against the manufacturer’s sizing chart, as sizes vary between brands.
Compression levels are measured in millimeters of mercury (mmHg). Light compression runs 15 to 20 mmHg and is typical for mild swelling or long flights. Moderate compression falls in the 20 to 30 mmHg range and is commonly prescribed for varicose veins or after procedures. Strong compression, 30 mmHg and above, is used for more serious venous conditions. Higher pressures mean stiffer fabric, which means more effort to get them on.
Signs of a Bad Fit
Once the stockings are on, check the person’s toes. They should remain their normal color and feel warm. Bluish or white discoloration, numbness, tingling, or increased pain are signs that the stockings are too tight or positioned incorrectly and should be removed right away.
A top band that’s too tight at the thigh or calf creates a tourniquet effect that slows circulation rather than supporting it. Over time, stockings that don’t fit properly can cause skin redness, dryness, itching, minor bruising, or even skin breakdown. If you notice deep indentation marks after removal, or if the person consistently complains of discomfort, the size or compression level likely needs to be reassessed.
When Compression Socks Shouldn’t Be Used
Compression therapy is not safe for everyone. People with severe peripheral artery disease (poor blood flow to the legs from narrowed arteries) should not wear compression stockings, particularly when ankle blood pressure is very low. If the person has weak or absent foot pulses, their circulation should be evaluated before starting compression.
Other situations where compression is not appropriate include severe heart failure, significant diabetic nerve damage with loss of sensation in the feet, and confirmed allergies to the stocking material (though true allergic reactions to modern compression fabrics are rare). If the person you’re caring for has any of these conditions, their prescribing clinician should be involved in deciding whether compression is safe.
Daily Care and Stocking Maintenance
Compression stockings should be washed after every use. Body oils, sweat, and dead skin cells accumulate in the fabric and gradually break down the elastic fibers that provide compression. Use cold water and a gentle detergent. Avoid hot water, bleach, and fabric softeners, all of which degrade the compression material. Air dry them flat or on a drying rack. Heat from a dryer will damage the fibers and reduce the stocking’s effectiveness.
Most people need at least two pairs so they can rotate while one is being washed. Even with proper care, compression stockings lose their therapeutic pressure over time and typically need replacing every three to six months.
Apply any moisturizing cream or emollient to the person’s legs at night after the stockings come off. This keeps skin healthy without interfering with the next morning’s application. Establishing this routine protects skin integrity, especially for people who wear compression stockings long-term.