Compression therapy is a cornerstone in the effective management of lipoedema, and understanding the nuances of each modality can give you clarity on which options you should integrate into your lipoedema management program. But there’s a lot of information out there, and I found some of it was quite conflicting. This article aims to cut through the noise, and give clear information on the benefits of the two key modalities, and strategies for integrating them into your day to day life.
But first… What is Compression Therapy?
Compression therapy describes the use of an external device or garment to pump fluid around our body. Our lymphatic system in particular needs this support as it doesn’t have a ‘pump’ of it’s own, it relies on movement and muscle contraction to push lymph around the body. And when it’s compromised (such as when lipoedema is present), it needs additional support to clear and pump fluids, especially out of the legs.
What does the science say?
Research supports the efficacy of compression therapy for lipoedema. This 2023 study found that compression therapy significantly improved quality of life, reduced pain intensity, and decreased the feeling of heaviness in the legs for individuals with lipoedema. The research also suggests that combining compression with exercise yields even greater benefits. This 2020 study also demonstrated that the combined approach (compression therapy + exercise) effectively reduced pain, improved quality of life, and significantly decreased limb volume.
Common Types of Compression For Lipoedema
Medical grade compression stockings are specialised garments that provide graduated pressure, with the highest compression at the ankle and gradually decreasing up the leg. This design promotes blood flow and lymphatic drainage by squeezing the the veins and muscles, gently pushing fluid out of the tissues and towards the heart.
Pneumatic compression pumps work similarly. They have padded inflatables sleeves or stockings that are attached to an external pneumatic pump that applies intermittent pressure to the affected areas to reduce swelling and stimulate lymph flow.
Compression Stockings: The Benefits
Regular use of compression stockings can lead to a reduction in the heavy feeling often associated with lipoedema, reduced pain, improved mobility, and can help maintain the shape of your legs. I also found that my bruising reduced significantly after I started wearing compression stockings consistently. Medical grade compression stockings are an excellent therapy for chronic venous insufficiency, which is a common condition in lipoedema patients. This condition is marked by a weakening of the walls and valves in the deep leg veins, and can lead to spider veins, skin color changes, aching, itching and serious swelling in the legs.
Which Compression Stockings Are The Right Ones?
Finding the right compression stockings can be overwhelming. There doesn’t appear to be a ‘gold standard’ so to speak, particularly for early stage lipoedema sufferers. In fact, there’s contention about whether compression stockings are even beneficial for early stage sufferers. When I first started researching, I quickly began to feel like the only way forward was to see a clinician for specialised fitting. But the more I dug into the research, the more I was able to find some common threads:
There is consensus that the compression stockings / tights should be:
- Medical grade
- Class II (25-30 mmHg)
There are two types of fabric that compression stockings can be made from:
- Flat knit
- Round knit
The general rule seems to be: flat knit for odoema, and round-knit for veins.
Flat knit are made to measure according to your exact body measurements, and the fabric is knitted in rows with a flat knitting machine. They are quite expensive, and it seems that later stage lipoedema sufferers benefit more from these products than early stage.
Round-knit ‘off-the-shelf’ compression garments are easier to find, much more affordable and seem to be recommended often for early stage lipoedema sufferers who may not have so much oedema.
I personally use round knit tights because I’m early stage (1), and I know I have veinous insufficiency and not a lot of oedema. I purchase mine from Amazon for about $30. I always have at least 3 pairs on rotation at any time; at the moment I have two pairs of full pantyhose style with open toe, and one pair of thigh highs with open toe.
There are a number of well-known brands that specialise in medical grade compression stockings: CzSalus, Jobst, Bioflect to name a few. If you’re looking for athletic leggings, 2XU has a great reputation for compression tights, although I haven’t tried them personally.
Pneumatic Compression Devices Explained
Pneumatic compression devices are clever systems that consist of inflatable garments connected to a pump. The pump rhythmically inflates and deflates the garments, creating a massaging effect on your limbs. It’s the most relaxing feeling! The cyclical pressure mimics the natural muscular contractions that help move lymph fluid through the body. By enhancing lymphatic flow and reducing fluid buildup, pneumatic compression devices can significantly alleviate swelling and discomfort associated with lipoedema. They’re particularly beneficial for those who find it challenging to wear compression stockings consistently or need additional support.
Regular use of pneumatic compression suits can improve circulation and reduce pain. A lot of users report feeling a sense of lightness and increased mobility after sessions – I have to agree. I’ve only used pnuematic compression a few times, and after each session I felt incredibly relaxed, and light in the legs. I found that the effects only lasted a day or so though; but you might experience the benefits for a longer period of time, everyone is different.
Although I don’t have any recommendations for a pneumatic compression pump / suit to purchase for home use; the few times I had the Normatec Compression Therapy it was at CryoSpa Clinic in Sydney, combined with cryotherapy and infrared sauna and I can definately recommend it as a relaxing profesisonal treatment.
Incorporating Compression into Daily Life
Make Self-Care a Priority
Start by making compression wear a part of your morning ritual, putting on stockings or activating your pneumatic device as you begin your day. I have a habit – dry brush, shower, moisturise and compression stockings on. Consistency is key so if you can, aim to wear compression garments for most of your waking hours – start with a few hours a day and build up from there. If you’re in a hot and humid climate this can be challenging – I have spent the past year in Fiji, Thailand and humid parts of Australia, so I’ve often resorted to wearing compression at night. It’s not ideal, but at least it’s 10-12 hours if I put them on when the sun goes down, and I find I still get the benefits. I’ve also found that putting my stockings in the freezer for 5 minutes before donning them is helpful, as is sponging them with cold water (whilst wearing them).
Remember to take breaks and care for your skin, use a good hydrating moisturiser to prevent dryness. Combine compression with gentle exercises like walking or swimming to enhance its benefits. Listen to your body and adjust your compression routine as needed, especially during changes in weather or activity levels. Don’t hesitate to reach out to healthcare professionals for guidance on optimising your compression therapy.
For me, prioritising compression therapy was a no-brainer – when I first started researching and building out my treatment plan, the only thing ahead of compression on my list of immediate priorities to start trialling immediately was the anti-inflammatory diet.
Recovery Tips
After wearing compression garments or using pneumatic devices, take time to gently massage your limbs to promote circulation and reduce any residual swelling. Elevating your legs when resting can further enhance the benefits of compression. Stay hydrated throughout the day to support lymphatic flow and incorporate gentle stretching exercises to improve flexibility and reduce stiffness. Compression stockings can dry out your skin, so pay attention to your skin health and use hypoallergenic moisturisers to prevent dryness and maintain skin integrity. I make my own body butter to nourish my skin with natural, hydrating ingredients without toxic ingredients and endocrine disruptors. If you have 30 minutes, give it a try!
If you experience any discomfort or unusual symptoms, as always – consult with your healthcare provider to adjust your compression strategy.
Want to know more? Visit the ‘Lymphatics, Compression and MLD’ section of our Research Library for research and resources.
A note: The product links in this article are not affiliate links – I don’t receive any financial benefit by sharing them. They are simply products I either use myself, or have found in my research.
