FAQ FAQ for the fitter

Is the leg edematous? These wrinkles give a distinct constriction with deeper grooves on the instep. You see this more often in people who don’t move much. Advise your patient to wiggle their feet regularly while sitting. Padding is also a solution, as this has a relieving effect. Ask yourself the following questions: Is the stocking not too long? Is the stocking pulled on properly? Is the foot too short, too wide or is it creeping back due to a hollow foot or wearing the wrong shoes? All these signs can be the reason a stocking ripples on the instep. Always have patients put the cuff in place first and then, using a rubber gripping glove, spread the stocking well over the leg. Often, people with type 3 lip edema (ankle pockets) who wear a round-knit stocking will develop wrinkles in the stocking. Advice: switch to a flat-knit stocking and pad the ankle/instep.

For this, again, see if the leg is edematous. Padding around the instep and ankle can provide relief. If the patient has foot position deviations such as severe flat feet, extreme hollow feet or a splayed foot, use a stocking with a toe piece. A toe piece prevents creeping back and thus wrinkling on the instep. People with foot position deviations do not wrap their feet properly while walking. As a result, the foot and calf muscles are not used properly. You will often see edema start to manifest on the back of the foot and around the ankles. You can refer the patient for orthotics and you yourself can make the choice for a firmer stocking, such as the Eurostar 2 or the Euroform 3.

In this case, wrinkles may appear and the stockings may sag. The rule is: pulling up the stockings up to four times a day is normal. If this has to be done more often or if the stockings are already hanging halfway down the leg after half an hour, it is wise to find another solution. Where stockings drop off quickly, it is important to check several things: are the stockings washed regularly, is the stocking put on and distributed correctly, have the legs/arms become smaller in size, has the patient lost weight and at what time of day do the stockings drop off.

If you feel that the stocking presses too much at the level of the little toe, you can order a stocking with a toe piece next time. Placing a felt ring can reduce the pressure locally. Be careful not to place the ring all around, in connection with vacuuming the corn. The seam of a flat-knit stocking can be torn off under the foot over a length of one inch. The pressure will disappear acutely. Also, always look at the shoes the patient is wearing. It is often the shoe that presses against the edge of the stocking that causes a corn to form right there. Good shoes with a last at the correct size are a godsend.

• Blue discoloration: this is a sign that too much blood remains in the extremities. Advise your patient to exercise more to promote circulation.

• White discoloration: this is a sign of arterial failure or lymphatic congestion. White skin means that no blood flow is visible.

• Red discoloration: there is good blood flow and nothing is wrong.

This often means that too little pressure is given by the stocking. The blood cannot be sufficiently drained and edema is in danger of breaking through the stocking. Tingling is often a precursor to breaking through edema. Choose a firmer stocking (Eurostar 2 or Euroform 3) or increase the pressure class.

Cold feet while wearing stockings is a common occurrence and is not a cause for concern. Advise the patient to exercise more. This will work the foot and calf muscles, stimulating blood flow. If the patient is immobile, it may help to move the feet and avoid holding the legs at a 90° angle. On the contrary, it is better to elevate the legs. Did you know that just moving the big toe gives muscle contractions in the foot and calf that help improve blood flow? This moving of the big toe can be done by people by themselves or by the caregiver. Just one minute three times a day works wonders.

It makes sense that the compression stops where the stocking stops. In legs made thin by bandages and in legs that are not completely edema-free, you will see the knee above the stocking become thick. Whole discs of hardened fluid can begin to form around the knee. In many cases, this can be resolved, for example, by bandaging with a VaroCare knee bandage or by using an under stocking with light compression over the knee. The use of a long stocking is not always necessary. A sports knee brace can also solve the problem. If congestion occurs above an AG stocking, the choice of a stocking with knit pants (ATFT) or bermuda shorts (flat-knit custom pants, TinkFit or Curetex compression pants) worn in addition to the AG is more advisable. If there is congestion above an arm stocking, additional bandaging above the stocking may be chosen, but this requires a great deal of technique on the part of the caregiver as well as the patient.

Tip: buy a heavy quality lycra sports shirt with sleeves one size too small. Compression shirts are also available under the name Curetex upper-body bandages.