Classification

Compression stockings are divided into different classes according to the pressure exerted by the stocking on the leg tissue. This means that compression stockings can always be prescribed in variable strengths according to requirements. A total of 4 classes are distinguished: moderate with pressures of 18-21 mmHg, medium (23-32 mmHg), strong (34-46 mmHg) and extra strong (at least 49 mmHg).

Although the classification is based on the different compression pressures, it also allows a classification of the indications according to class. Those patients who complain of a feeling of heaviness with discreetly pronounced varicose veins are prescribed compression class I. Further criteria are the absence of oedema and as a varicose vein prophylaxis during pregnancy.

Medium-strength stockings, i.e. class II stockings, are necessary when the symptoms increase, i.e. when varicose veins develop with simultaneous edema. Class II compression stockings are also prescribed in the treatment of deep vein inflammation of the legs (thrombophlebitis), ulcerations or after surgical interventions due to varicose veins.

Class III compression stockings are indicated for severe edema, secondary varicose veins, extreme skin changes, recurrent ulcerations and severe venous insufficiency, since only higher compression pressures have an effective effect in these symptoms. The last class IV with pressures of at least 49 mmHg represent the last possible instance of compression stocking therapy.The indication is therefore limited to therapeutic aspects and less or not at all to prophylactic measures. Lymphedema with extreme swelling and edema requires class IV compression pressures.

Putting on compression stockings is a difficulty for some patient groups because they fit extremely tightly and become less elastic as the class increases. Special donning aids are available for these cases. It is also possible to achieve a cumulative pressure by wearing two stockings of a lower class on top of each other.

Of course, there are different sizes and lengths, so that the fit can be individually selected according to the leg circumference and leg length. Patients should be aware that although compression stockings promote blood circulation and have a decongestive effect, the prerequisite for putting them on is that the legs must be “deflated” and decongested. Compression stockings can only maintain the condition or have a preventive effect; they are therefore not an active medical aid.

Active deflation requires other measures to be taken first. When running, the muscle pump is active and promotes blood return, but other factors may nevertheless make it necessary to wear compression stockings or have a positive effect on athletic performance. Due to the compressive effect of the stockings, an obvious effect is to prevent swelling of the legs caused by water retention.

Compression stockings are becoming more and more popular in sports because of the following two aspects in particular: Firstly, the leg muscles can be supplied with more oxygen and nutrients via the arterial vascular system. On the other hand, there is a significant reduction in muscle ache. The improved oxygen supply is achieved because the pressure exerted by the compression stockings offers a certain amount of resistance, which means that the muscles (in the sense of the muscle pump) have to apply less.

The smaller increase in muscle diameter means that the arteries have more room to expand. This is accompanied by an increased blood flow and consequently better oxygen supply. The second aspect is based on the theory that compression stockings can absorb the smallest movements in the form of shocks or vibrations during sport.

These are one of the causes of the smallest lesions in the muscles, which ultimately manifests itself as muscle soreness. Since compression stockings also have a positive effect on muscle regeneration, they should not be taken off immediately after sport but should be kept on to support the regeneration phase and to fully exploit the functional effect of compression stockings. It is important to know that compression stockings do not have such high pressures as the therapeutically indicated stockings. Therefore, the wearing comfort is much higher and the stocking is not perceived as constricting.