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At my physical therapy practice, I promote the use of medical quality compression socks to control swelling that causes pain and limits activities. I sell athletic compression socks at my running store for the same reason. To control swelling, the socks have to have enough pressure gradients to cover the whole foot and calf with more pressure at the bottom and less pressure towards the top. The medical quality compression socks are manufactured to specific FDA guidelines for fit and pressure. Some other athletic compression socks are not. I very carefully test the compression socks we sell. If it does not give enough pressure it will not control swelling. However, if the fit and pressure are not correct it can cause blood to be backed up in the calves and feet, and that can lead to a type of blood clot known as deep vein thrombosis (DVT).

75% of the public does not know what DVT is. If left untreated, DVT can lead to pulmonary embolism (PE) which has a high death rate. Runners need to be aware that strenuous leg exercise such as running is a risk factor for DVT. For a period of time, maybe up to a day after a long, hard workout, runners are at greater risk of DVT than the general population – maybe as high as the elderly population.  When combined with other DVT risk factors such flying in a plane, dehydration, using birth control pills, or an injury that causes swelling or internal bleeding, the risk for DVT multiplies. Runners can get this potentially deadly condition if they don’t know the risks of DVT and don’t know what to look out for before it happens. Most runners don’t know that calf pain can be DVT. Most of my patients never knew to check for swelling until I taught them.

I do use compression socks at work because I mostly stand and often work 10 hour shifts. In recent years, my ankles and feet tend to swell by the end of a shift without compression.  While vendors claim that compression socks improve recovery from exercise, I find no difference when using compression socks to control swelling except when standing all day or during air travel. I do not use them for running because I have no swelling even on my longest runs and, I prefer running in regular socks.

However, I do not use or sell calf compression sleeves. I often wear test the products we sell in my store, and whenever I wear test compressive calf sleeves that have enough pressure to give support, I have increased swelling in my feet and ankles. My shoes feel tight by the end of my shift and my regular socks create lines that dig into my skin.  Compressive calf sleeves make my symptoms much worse than if I wore no compression to work at all. In my PT practice, I also see this swelling in injured runners that use calf compression sleeves. This backup of fluid in the legs creates a risk factor for DVT.

Here’s another reason why I will not sell compressive calf sleeves: Imagine a female runner who has just raced the marathon of her life, who is taking birth control pills, and who is flying right home after her run while wearing calf sleeves because she has a calf injury. All those factors multiply her risk of triggering DVT and PE.  But the calf sleeve vendors do not inform their customers of this risk in their marketing or packaging. I would hate to have a customer buy these products from my store and have it contribute to such a life-altering condition.

[caption id="attachment_3516" align="alignleft" width="300"]compression-sock1 Compression sleeve and regular sock at end of work day. Notice swelling building up between sleeve and sock.[/caption]

[caption id="attachment_3517" align="alignleft" width="300"]compression-sock2 Notice swelling when sleeve and sock removed that built up during the day.[/caption]

[caption id="attachment_3518" align="alignleft" width="300"]compression33 Compression sock worked all day. The sock and calf sleeve are the same exact pressure , size and from the same vendor.[/caption]

[caption id="attachment_3519" align="alignleft" width="300"]compression44 Compression sock worked all day. The sock and calf sleeve are the same exact pressure , size and from the same vendor.[/caption]
















This post is written in part by Bruce Wilk, author of the The Running Injury Recovery Program. Bruce is also a board certified physical therapist and the director of Orthopedic Rehabilitation Specialists, a private physical therapy practice located in Miami, FL, and the president of The Runner’s High, a specialty running store also located in Miami. He is also the RCAA certified head coach of the Miami Runners Club, and has completed multiple road races himself, including 26 full marathons and four Ironman races. For more information, please visit, and to purchase the Running Injury Recovery Program, please visit