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Why wear open-toed compression socks with closed toes?

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Doctors often prescribe compression stockings or socks to treat conditions including lymphedema, leg fatigue, peripheral edema, deep vein thrombosis (DVT), phlebitis, varicose veins, spider veins, venous ulcers, and other blood vessel problems.

With trendy compression stockings available to buy online, you may be wondering what factors you should consider before choosing new compression stockings. Are the socks you buy from a medical supply supplier similar to the socks you buy from a fashion retailer?

To answer this question, we'll look at some of the key elements of compression socks: style, size, strength, and material. The scientific literature should guide your decision, so we'll share current research on what matters (and what doesn't) when choosing compression stockings.

Most importantly, we'll learn about open-toe compression stockings and explain how they differ from closed-toe compression stockings.

Open Toe vs Closed Toe Compression Stockings: What's the Difference?

Choose a sock style

Compression socks and stockings come in a variety of styles.

You may see the following options:

  • ankle length
  • knee-length
  • thigh high
  • full length 
  • open toe
  • closed toes
  • footless sleeves

The length of a sock does matter to its function, so it's best to stick to the length prescribed by your doctor. If you wear compression socks for performance and recovery or to prevent vascular problems, we recommend that you choose a knee-length style. This length gives you medical benefits while being easier to put on than thigh-high or full-length garments.

Next, you need to choose between open-toed and closed-toe compression stockings. Footless compression sleeves don't provide the same ankle support as closed or open-toe options, so we don't recommend them.

There are benefits to both open-toed and open-toed styles, so you must consider your lifestyle and how to wear socks or stockings when making a decision.

The benefits of closed toe caps are:

  • Reduce the risk of blisters.
  • The fabric is less likely to wrinkle.
  • Relieve foot joint pain.
  • Reduce swelling of the toes.

Toeless socks, on the other hand:

  • Can be worn with sandals and flip flops.
  • Allows greater freedom of movement.
  • Keep your feet cool during the warmer months.
  • Does not aggravate bunions, ingrown nails and hammertoes.

In the British Journal of Community Nursing, clinical nurse specialist Mary Todd weighed these options, writing: "Open-toed garments may be easier to put on and, to a certain extent, cooler in hot weather, but less It is possible to ride up your feet and cause swollen toes." She went on to explain the benefits of full foot coverage, adding: "In the author's experience, open-toed stockings can also exacerbate pain in the distal joints of the foot, such as hallux valgus or Inflammation of the base of the fifth metatarsal" (318).

Like traditional socks, open-toed compression socks cover the entire arch, including the ball of the foot and the base of the toes. Compressing these areas can help prevent injury to the plantar fascia and arch.

On the plus side, both the open and closed toe caps provide full heel coverage, ensuring your ankle veins are supported. For the most part, both styles offer similar functional benefits to the ankle and calf.

If you're likely to wear tights with open-toed shoes, open-toed socks will probably give you the most practical coverage. Also, if you know you're prone to joint pain in the distal end of your foot, open-toed socks or stockings may be a better option for you.

Choose the right size

When you choose a pair of socks or stockings, you must buy the correct size. In a review of the scientific literature, researchers Chung Sim Lim and Alun H. Davies emphasized that "graded compression stockings need to be properly measured and fitted when used (E397)." This usually involves two measurements: The socks must fit your foot size and calf circumference.

Of course, foot size measurement is extremely important for open-toed socks and stockings. Open toes may give you some wiggle room, but toe socks must fit snugly without pinching your toes. For both styles, the heel cup of the sock should line up with your natural heel.

For maximum comfort, it's important to lay the sock flat against the skin so that the tightest part of the sock fits the narrowest part of the ankle. To ensure a perfect fit, ZSZBACE offers socks that fit women's shoes in sizes 4-10 and men's shoes in sizes 4-15.

The second measurement, calf width, should be taken with a tape measure at the widest point of the calf muscle.

By wearing the correct width, you can ensure that the sock exerts the expected compressive strength. If your calf is the wrong size, you run the risk of over-tightening, cutting off blood circulation to your calf and foot. At ZSZBACE, we offer extra wide options to accommodate calf sizes up to 20 inches.

Choose the best intensity

When a doctor recommends compression stockings, he or she usually provides guidance on the appropriate strength. Pressure is measured in millimeters of mercury (mmHg), and the pressure range is indicated on the label of most medical pressure suits.

This is because medical compressions are usually done on a gradient, with more pressure at the ankle and less pressure at the calf. The technical term for this gradient compression is gradient compression.

For example, ZSZBACE's best-selling Companions offer true stepped compression of 15-25 mmHg. This means that each sock applies 25 mmHg near the ankle bone and 15 mmHg at the widest point of the calf. We label socks based on precise measurements and test each sock for accuracy using industry standard machines.

If your doctor has not recommended a specific compression level, you can choose the compression strength that best suits your needs. For help choosing the right strength, check out this article: "What Level of Compression Socks Do I Need?" In general, most over-the-counter compression socks provide 15-20 mmHg. Companions provide an extra 5 mmHg of pressure at the ankle, allowing you to enjoy additional medical benefits without sacrificing comfort.

Does material matter?

In a brand new pair of compression socks, the material does not affect compression strength. After all, every sock or stocking with a mmHg label is measured for compression accuracy.

For this reason, you can choose socks made of any fabric—nylon, spandex, cotton, wool—and expect to get the level of compression described on the label.

You may want to consider any skin sensitivities when choosing fabrics for your new support garment. Todd noted that "some patients may develop skin sensitivities and allergies to apparel fabric components..." But ultimately, she concluded, "...there is currently no empirical evidence to support the choice of socks.. ...." (320).

A 2013 study of athletic compression garments confirmed this assessment. The researchers stress that the fabric does not affect functional compression: "There is no clear relationship between the percentage of material composition and the resulting pressure transfer" (Troynikov 162).

That said, all compression socks eventually lose their elasticity over time. Anything you can do to reduce the number of times you need to wash your socks will extend the life of your socks.

That's why we bond silver ions to the threads when we make ZSZBACE socks. Keeps your socks fresh and odor-free for longer, increasing the number of wears between washes.

Disadvantages of the open toe option

The only way to get medical benefits from compression stockings and stockings -- including reducing the risk of deep vein thrombosis and relieving leg pain -- is to wear them regularly. That's the problem with stockings made of beige compression hose material. Because they look bland, you're probably unlikely to wear them.

It turns out that researchers Lim and Davies cited lack of patient compliance as one of the main challenges to effective compression therapy. They state that “…changing the stocking material or reducing the degree of compression often helps improve compliance” (E391).

Since most open-toed styles are made from stocking material, they are less likely to feature bright colors and bold designs. Also, if you want to wear open-toed stockings with regular shoes, you'll need to wear a second pair of socks. Both of these factors may make your exposure to open-toed stockings less likely.

When choosing socks, be sure to consider your style preferences and habits. Are you more likely to pair stockings with flip-flops or socks with regular shoes? If you're more interested in a classic sock and shoe combo, be sure to check out all the designs we have on offer. We're sure you'll find a pair (or two) that will have you reaching for your sock drawer in the morning.