Putting on TED hose is easiest when you turn them inside out first, then roll them up over your foot and leg. This “inside-out” technique prevents bunching and ensures the compression distributes evenly. It takes a bit of practice, but once you learn the method, the process gets significantly faster.
TED hose (thrombo-embolic deterrent stockings) are lightweight compression garments typically prescribed after surgery or during bed rest to prevent blood clots. They apply gentle pressure of 20 mmHg or less, with the strongest compression at the calf, helping blood flow back toward the heart when you’re not up and moving.
Get the Right Size First
TED hose only work if they fit correctly. A stocking that’s too tight can cut off circulation, and one that’s too loose won’t provide enough compression to prevent clots. You’ll need a few measurements before choosing a size.
For knee-high stockings, measure two things: your ankle circumference just above the ankle bone, and your calf circumference at the widest point. Then measure the length from the back of your heel to the bend of your knee. For thigh-high stockings, you’ll also need your thigh circumference at its fullest point and the length from your heel up to the crease where your buttock meets your leg. Most brands include a sizing chart that maps these measurements to a specific size, so write your numbers down before ordering or picking up a pair.
Step-by-Step Application
The key to getting TED hose on smoothly is to never try pulling them on like a regular sock. That leads to bunching, uneven pressure, and a lot of frustration. Instead, use this method:
- Lie flat on your back. TED hose go on most easily when you’re lying down, ideally first thing in the morning before your legs have had a chance to swell. If you’re in a hospital bed, raise the bed height so anyone helping you can work comfortably.
- Turn the stocking inside out down to the heel. Reach inside the stocking, grab the heel pocket, and pull the fabric back over itself. You’ll end up with a small “cup” of fabric shaped like a foot, with the rest of the stocking turned inside out around it.
- Slip it over your toes and foot. Place the foot portion over your toes, easing the fabric over your foot until your heel sits snugly in the heel pocket. Check that the heel marking on the stocking lines up with your actual heel.
- Unroll the stocking up your leg. Gently roll or pull the inside-out fabric up over your ankle, then your calf, smoothing as you go. For knee-highs, stop just below the bend of the knee. For thigh-highs, continue up to the upper thigh.
- Smooth out every wrinkle. Run your hands along the stocking from ankle to top, pressing out any folds or bunches. This step matters more than it seems (more on that below).
- Check your toes. Most TED hose have an open-toe design with a small inspection hole. Look at your toes to make sure they aren’t pale, blue, or numb. They should look and feel normal.
If the fabric feels stuck or is dragging against your skin, try applying the stockings over slightly damp skin, or use a light dusting of talcum powder on dry skin to reduce friction. Rubber dishwashing gloves also give you a better grip on the fabric and make pulling much easier.
Why Wrinkles and Rolling Are Dangerous
The single most important thing to get right is a smooth, wrinkle-free fit. When TED hose fabric folds over itself or rolls down at the top, it creates a band of concentrated pressure at that spot. This acts like a tourniquet, restricting blood flow instead of improving it. In older patients or anyone with thin, fragile skin, that focused pressure can actually break down the skin and cause ulcers.
A clinical case report documented a patient who developed a wound because the stocking had rolled at one point on the leg, creating excess pressure in that exact area. The lesson: if your stocking rolls down or bunches up during the day, stop and fix it immediately rather than leaving it. Pull the fabric taut and smooth it back into position. If the stocking won’t stay up, it may be the wrong size.
How Long to Wear Them
Your care team will give you specific instructions, but a common post-surgical schedule looks like this: stockings stay on continuously for the first 48 hours after your procedure. For the next two weeks, you wear them day and night, removing them only to wash. After that, you switch to daytime-only wear for another two weeks. By week four, most patients no longer need them.
During the period you’re wearing them around the clock, you can take them off briefly to bathe and inspect your skin, then put them back on. Try to keep the time they’re off to a minimum, especially in the early days when clot risk is highest.
Monitoring Your Skin and Circulation
That open-toe design at the front of the stocking isn’t a manufacturing quirk. It’s there so you (or a caregiver) can check your toes without removing the stocking. Look for color changes, swelling, numbness, or tingling. Healthy toes should be warm and their normal color.
There’s no official guideline on exactly how often to inspect your skin underneath the stockings, but checking at least once or twice a day is a practical approach. When you do remove them to bathe, look at your legs for any red marks, irritation, or areas where the skin looks damaged. Pay special attention to bony areas like the shin and ankle bone, where pressure tends to concentrate.
Who Should Not Wear TED Hose
TED hose are not appropriate for everyone. People with severe peripheral artery disease, where blood flow to the legs is already compromised, should not wear them because the compression can further restrict arterial flow. The same applies to people with severe heart failure, significant diabetic nerve damage with loss of sensation in the legs, or a known allergy to the stocking material. If you have any of these conditions, your medical team will use alternative methods to prevent clots.
Washing and Replacing Your Stockings
TED hose need regular washing to maintain their elasticity and hygiene. Hand washing with mild soap in lukewarm water is ideal. If you use a machine, place them in a mesh laundry bag on the gentle cycle. Skip the bleach, fabric softener, and harsh detergents, all of which break down the elastic fibers that provide compression. Air dry them flat rather than putting them in a dryer.
Even with careful washing, the elastic material gradually loses its stretch. Compression stockings typically maintain their effectiveness for three to six months of regular use. If your stockings feel noticeably looser or slide down more easily than they used to, they’ve lost too much compression to be effective and need replacing. Since most post-surgical prescriptions last only a few weeks, this is mainly a concern for people wearing them long-term.