Hi friends!
Let me start off by saying this is a conversation for your doctor, but here’s my opinion based on personal experience and research that I’ve been doing.
There is a lot of research on several conditions showing that wearing compression garments can be beneficial for not only lipedema, but other conditions. I love it on most days. It helps control swelling, which turns into fibrosis if left unattended. Good fitting compression feels supportive and good, it’s like wearing a warm hug, and it looks socially acceptable when paired correctly with clothing. Oh, and it smooths out my curves for a nicer look – so that’s a bonus. Because of these things, a lot of ladies have different reasons why they want to wear their compression full-time and have been asking, “Can I wear it around the clock?” Sometimes I wonder what their reasons are in addition to what I mentioned above. Here are a few I’ve heard recently:
- It hurts my legs when they’re loose (without compression) so I prefer to keep my compression on at night
- I’m afraid my lipedema will get worse if I don’t wear my compression at night
- It just feels so good on, that I want to keep it on all the time
- I can’t be seen by my partner with my bare legs (!)
I’ve been a compression wearer for about three years now. There are times when wearing it is an absolute must and times when it’s an absolute no for me. I believe you should not wear compression around the clock. Several articles and papers I reviewed indicate that compression is intended for part time use. In general, I wear and recommend wearing compression when the benefits outweigh the possible physical and mental (yes, I said it) harm.
Times When Compression is Needed
Obviously, if you’ve recently had surgery and your doctor orders around the clock compression, go with your doctor’s advice. Compression can help in healing and reduce what we call, “SWELL HELL.” This was the case for me each time I had lipedema reduction surgery for several weeks post op and even though the compression was, well, quite disgusting, by the time I was able to change it, it was the right choice every time.
I try to wear my compression for about half the hours in a day. For me, compression is most important when it’s hot (boo!) and humid, when I’m going to be on my feet a lot, and when I’m doing physical activity outside of the water. The difference it makes in swelling is impressive, and more importantly, my leg and feet pain can be controlled when I know I’m going to be on my feet. I remember days of making the big family Easter or Christmas dinner, barefooted, in my pajamas. At the end of the day my feet would throb, and ache so deeply that it’d ruin me for a couple of days after the holiday is over. Now I know, before putting that turkey in the oven and then being busy for hours, stop and put on my best over the heel compression and good shoes – my legs and feet thank me for it.
Heat and humidity are a recipe for my legs to blow up. It’s a double edged sword because I’m pretty miserable in full length compression in the heat. A good tip from me is to wear loose and very light dresses over compression, or even opt for compression socks instead of full body on those really hot days. (PS: many women recommend spraying compression with water to keep cool – I do not do this because it’s a recipe for a random infection, and chafing, and I do not have time for chafing!)
Times When I Choose to Not Wear Compression
Yes, there are times when I just feel like I cannot do compression now, today, whatever. Mental health is the number one reason. There are times (very far and few apart) when I want to wear a pair of shorts or capris to go to an event and frankly, I don’t want the unhappy attention of wearing compression socks where the tops show – I think it looks stupid and I can’t get over it. I’m also not a socks and sandals appreciator, so there’s that. I’d rather go to the event in my shorts, enjoy myself, and then hop in the pool for an extra hour to sort of make up for it. I know this isn’t recommended but I’m being real honest here. Really though, I’ve found that maxi dresses are so flattering and come in so many pretty styles, that I’d rather wear a flowy and cool dress with compression and get positive attention for looking nice, rather than wearing a ridiculous outfit with socks hanging out the top. Again, just me, I have a hangup, can’t do it. Anyway, I digress.
Not that I’ve had any reason to lately, but yes, there will be dress up times when compression just doesn’t fit the occasion and some ladies will forgo their traditional compression for a two hour formal event. I’ve found that when this happens for me (SO RARELY), I’d rather wear my circular knit compression that looks like black panty hose and make it be part of the outfit. Circular compression for me, is miserable and hot, and restraining, and has even been thrown in the TRASH in event bathrooms in a moment of clearly not thinking straight because I cannot take another second of the squeezing and random ya know, Tourniquets of Doom. By the way, this is a sign, the compression is not a good fit. I prefer my flat knit Bioflects to any compression hands down, because it doesn’t make me feel like I need to waddle to the bathroom in my formal, hover over the toilet and peel off my compression to throw it in the personal receptacle in the stall.
I do not wear compression in the water at all. Water’s compression is much stronger than what garments can offer (see my book Aqua Therapy for Lipedema and Lymphedema on Amazon for a table showing compression levels at various depths) and I want my legs to be free to shake and move lymph without it getting hung up due to a restriction placed on it by compression. For me, I also prefer to use my vibration plate without compression. This is totally a personal preference, but for me, it actually feels better when my legs are loose and free to move and jiggle more openly when I’m sitting in my chair using the plate. They feel more tingly and alive when I don’t use compression for my vibration therapy. I’ve tried it many times with and without and I just prefer vibration without compression.
Compression is Not for Everyone, So Quit Feeling Guilty
There are people who cannot and should not wear compression.
For all kinds of reasons from arthritis, to big bellies, some folks are physically unable to get compression on, due to the bending, pulling and stretching required to don it. Some folks need a hand and may live alone, so cannot get their compression on.
Some folks cannot tolerate the lack of thermoregulation that happens when you wear compression and cannot wear it because of het issues. This is the case for me personally in certain compression so I’m better off with what I will wear than beating myself up for compression that I throw in the trash after an hour – got to quit doing that!
Compression is contraindicated for people with some conditions. For lipedema patients, the one thing to really watch for is cellulitis (an infection deep within the skin that causes fluid build up, redness and pain – it’s unusual and you know something’s up. Take that compression off and call the doctor for help with meds to clear up the cellulitis).
Other people who have certain conditions like circulation disorders in arteries, certain kinds of nerve conditions (peripheral neuropathy), and serious heart conditions shouldn’t wear compression because compression can prevent proper flow if it’s pressing too hard on pathways necessary for proper blood flow, or nerves. Wearing compression can impact your blood pressure negatively as well, and some people cannot wear it due to the rise in pressure. Obviously, there will be people who are actually allergic to the components in compression, and cannot wear it due to reactions. I mean it, if any of this is you, talk to your doctor.
So Here’s My Answer on Around the Clock Wear
I don’t do it, and I don’t recommend it. Around the clock wear is really, really tough on the skin and can cause irritation, chafing, and excess sweating. This makes us ripe for infection and skin breakage, and God forbid, yeast infections. And wearing the SAME compression for too long can actually cause other problems, like it being hard to remove because it sticks to the skin after a bit.
Our skin needs time to heal and breathe. Also, we need time to moisturize and repair. I don’t recommend every putting any kind of product on your body under compression because 1) it will damage and shorten the life of your compression, and 2) unless it was designed to be used under pressure and heat, the product might actually cause damage from friction, chemical reactions and so on. So take your compression off at night, clean up, moisturize and let your skin heal and repair!
I also believe that our bodies respond to what we’re telling it, and if we over use compression, it can impair lymphatic and blood function, to where the body depends on compression to perform what functions it could have done (albeit impaired sometimes) on its own. We need to tell our bodies YOU CAN DO IT, by letting the lymph flow freely.
Final thought. If you feel you just have to have compression on overnight, change it, and switch to a nighttime garment with very very low compression (think old navy type leggings or sleep slimmers). DO NOT EVER leave the same compression on for 24 hours without removing it to inspect and clean skin, even after surgery, you need to clean up, take a look and inspect to make sure your compression isn’t actually making things worse.
Sources:
Daylong Direct. Compression Therapy – A Guide. https://www.daylong.co.uk/info/compression-guides/contraindications/#when-not-to-wear-compression-hosiery
Watson, Kathryn. Healthline. “Can Wearing Compression Socks be Harmful?” May 22, 2020. https://www.healthline.com/health/can-wearing-compression-socks-be-harmful
mediUSA. “When not to wear compression socks?” https://www.mediusa.com/help-center/when-not-to-wear-compression-socks/#:~:text=A%20compression%20garment%20should%20not,and%20neuropathy%20(nerve%20damage).
Talk Lipoedema. “Cellulitis in people with Lipoedema.” https://www.talklipoedema.org/the-blog/cellulitis-in-people-with-lipoedema/
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