More Questions You Have Asked

Our clients have certainly given us some questions that need to be addressed. One of the main concerns seems to be that of being able to don and doff (put on and take off) their own compression stockings. Staying independent is important to all of us. One question that was asked is if there is a donner for support pantyhose similar to the one for knee high or thigh high support socks. Yes there is. However I do not recommend using it. I believe it is one thing to have one leg in a donner trying to pull up a support sock, but to have both legs involved in a donner I feel could lead to a nasty fall.

It seems everyone wants to know the easiest way to put on support pantyhose. I would like to share with you how I put my panty hose on. I wear 20-30 pantyhose and it takes me about 5 minutes and a bit of patience to put my stockings on in the morning. While it is not an easy task, it is really no more difficult than putting on a pair of knee high stockings. The hardest part of putting on any lower extremity compression garment is getting it over the heel. First I will repeat what I said last week, never gather the stocking. I use the Sigvaris Donning Gloves to put on my support pantyhose. I call them my “magic green gloves”. They enable arthritic hands to have better grasp. I use the little “nubbies” to pinch and pull the stockings up. They also protect my stockings from my fingernails. Even when I have the Sigvaris Donning Gloves on, I use only the balls of the finger tips to grasp the stockings.

First I sit down and with out my “magic green gloves” I pull the stockings on one leg as far as I can.  (For me, it is easier to start with the left leg.) Then I put on my gloves and pull the stocking up and over my heel and then up my leg as high above the knee as I can by pinching the garment and pulling it up. Then I start the other leg into the stocking and use the gloves in the same manner to pull the stocking up to the same level.

When I have them as high up my legs as I can get them while sitting down I remove the gloves, stand up, and pull the stockings up and over my tummy. Once this is accomplished, I put the gloves back on and start at the ankle of each leg and re-stretch the stockings by pinching and pulling all the way up the leg.

Then I take the gloves off and place my hands in the back of the stockings with my palms out. I push away from the body and lift up without grabbing the stockings. This seats the crotch of the pantyhose.

If the color or appearance of the stockings is uneven, I put on the gloves and use the flat of the hand to rub gently up or down the leg to adjust the stocking so it has an even appearance.

peel a banana3

Now that we have managed to put on stockings or socks, how are we going to get them off? I have had clients become so frustrated and panicked that they cut (yes, cut) a very expensive garment off. Same thing applies here as when putting on a compression garment…never gather the garment (or allow it to roll) when removing it. It becomes like the rubber band again and extremely difficult to remove. Instead start at the top and pull the garment down allowing the garment (it does not matter if it is a knee high, thigh high, or pantyhose) to slid on itself until you are able to pull it off your foot. The stocking slides on itself.  Peel your socks off just like you peel a banana.

If the “Peel a banana” method is not working for you, we have another option the Mediven Butler Off. The Butler Off looks similar to a shoe horn. There is a handle on top for pushing and a “tooth” to help push the garment off. The Butler Off is not meant for use with sheer support hose, but with more substantial garments. The Butler Off is not to be used to help push yourself up from a sitting position.

How to Use the Medi Butler Off for Removal of Stockings or SocksHow to use Medi Butler Off

  • Slide the tip of the horn under the top band of the stockings.
  • Now push the handle gently downwards: the far end of the horn slides down your calf and then over your heel. During the whole process the inner surface of the horn should remain in contact with your skin. At the same time the “tooth” helps push the stocking downwards. In order to regain contact with your skin you can start again with the horn a little higher and then continue with the downward movement if necessary.
  • As soon as you reach your heel lift your heel up. Then tilt the stick downwards a little to guide the horn along the underside of your foot. Caution: Make sure you do not press the stocking against the ground with the doffing aid. Otherwise the stocking may be damaged. Now push the handle forwards gently: the stockings slides off your foot, but stays on the horn.

There are more ways to don and doff compression stockings or support socks that these, but perhaps this will get you started. If you have comments or more questions, please click on the title of this newsletter, More Questions You Have Asked, scroll to the bottom of the blog, and leave your message as a guest.


Wear the Right Socks or Stockings with the Right Shoes

Socks are high on the list of everyday items we take for granted. Socks can make a huge difference in the health and comfort of everyday life. Socks and stockings can make a difference to not only to those with venous insufficiency, but also to those with diabetes and arthritis. People who wear the wrong socks can develop blisters, infections, and a bundle of assorted other maladies of the foot. Compression socks and stockings have many properties to keep the foot healthy; including increasing the circulation and keeping the feet dry. All have moisture–wicking ability. They wick the moisture from the inside of the sock to the outside to keep the foot nice and dry. Many socks have extra padding and cushioning which decreases shear and friction to the foot.

There has been a great misconception that cotton socks were best for the feet, but several studies have shown that although the cotton absorbs the moisture well, cotton does not wick the moisture away from the foot. Cotton when wet, looses its cushion, stretches out, and wrinkles causing blisters. More durable synthetic blended fibers wick moisture away from the foot and maintain the cushioning affect.

No other part of the body has more sweat glands per square inch than the feet. Wet feet can lead to maceration, sometimes skin that experiences long periods of maceration becomes vulnerable to fungal and bacterial infection. As opportunistic organisms affect the area, it may become itchy or develop a foul odor. What’s more, because the skin is so much softer, it’s also more susceptible to injury from rubbing or friction. The solution is to keep the feet dry.

Jobst Mens CasualWool is an excellent fiber to regulate moisture as well as temperature. Synthetic fibers has very good insulation qualities as well as its ability to absorb moisture. There are many other products which are used in the wicking and anti-fungal and antibacterial properties of socks. Among them are silver. Even in ancient times these silver was used as anti-fungal and antibacterial materials. Silver is woven into the garments and does not wash out.


Along with the myth of wearing cotton socks, we have the myth of wearing white socks. It was thought that the dyes used in the garment could leach and harm already compromised feet. While white socks do allow those who have diabetes or neuropathy to keep a closer eye on their feet, the dyes of today are greatly improved.

The fit of stockings and socks can and is most important. Loose fitting socks as well as socks that fit too tight can be equally detrimental. Loose fitting socks in shoes can cause wrinkles and sores. If you have shoes that were fit with thin socks, don’t try to switch to a thicker sock thinking you can give your feet a treat. This can make the shoe fit to tightly and decrease circulation.

Care of the legs is equally important as care of the feet. Good circulation in the legs is critical to healthy legs and feet. Compression stockings help in control of venous insufficiency. The stockings increase the blood flow by assisting the venous valves and help decrease edema.

So wear the right socks or stockings with the right shoes.

Remember, support socks and support stockings can make great stocking stuffers.

Hang the Stockings by the Chimney with Care and


Living With Arthritis Part II

Consult with your physician to determine a treatment plan for you

How is Arthritis Diagnosed?

Proper diagnosis, early detection, and treatment are important in successfully managing arthritis. Diagnosis is usually made following an evaluation of medical history and a physical exam.

X-rays may be used to help confirm a diagnosis or determine how much bone damage and cartilage loss exists.

A family doctor or primary care physician may be able to diagnose and treat common types of arthritis. You may eventually be referred to a rheumatologist, or arthritis specialist, for further treatment.

Consult your physician to determine a treatment plan that best suits your needs.

Can Arthritis be Treated?

    While there is no cure, arthritis is manageable and symptoms can be minimized. Early treatment results in less joint damage and pain.

  • Each individual may respond differently to various treatment options, but starting a combination of therapies as soon as possible seems to have the best effect.
  • A good treatment plan considers the severity of the condition, the joints affected, your age, activity level, and other medical conditions.
  • You and your physician should determine a treatment plan that best suits your individual needs.

By taking an active role in the treatment of arthritis, you can alleviate symptoms, prevent progression and improve the function of your joints.

Arthritis Therapy Options

Weight Control and ExerciseWeight Control and Exercise Help to Control Arthritis

Perhaps the best thing you can do! Control your weight to reduce strain on joints. Every pound gained means added pressure on the knees and hips (and more pain!). Exercise strengthens muscles and keeps the joints flexible to increase range-of-motion. Stretching also increases flexibility. Strong muscles help support joints. Range-of-Motion exercises, muscle-strengthening exercises and low-impact activities such as walking, bicycling or swimming are ideal.

Rest during periods of pain and support joints with braces and supports

Rest and Joint Care

During periods of pain or inflammation, joints are unstable and more prone to injury. Rest and limited activity will help prevent further damage to affected joints. Avoid repetitive motions when possible. Support and protect your joints with the use of over-the-counter braces. Assistive devices make work easier and prevent strain and stress on the joints.

Protect your joints with supports and braces

Arthritis Therapy Options

Pain Relievers

    • Drug therapy* may ease symptoms. Some drugs aim to reduce pain while others target
    symptoms and slow progression.

  • Analgesics relieve mild-to-moderate pain but do not relieve swelling or inflammation.

    Topical Analgesics help relieve pain of arthritis and other symptoms

    Topical Analgesics help relieve pain of arthritis and other symptoms

  • Topical analgesics are creams or rubs applied to the affected area to help
    relieve pain and other arthritis symptoms.

      There are three main types of topical analgesics:

    • Counter-Irritants – These topicals contain ingredients such as menthol, eucalyptus oil, or camphor that mask the pain by producing a warm or cool sensation to the skin. Some of these products may be combined with the other two types:
      salicylates or capsaicin.
    • Salicylates – Topical salicylates reduce inflammation and pain by blocking the release of a certain fatty acid that causes swelling. Since they work in the same way as aspirin, people who are sensitive to aspirin should consult a physician before use.
    • Capsaicin – Capsaicin is a natural substance found in hot chili peppers. In topical creams it gives warmth to the skin and surrounding area However, the real benefit is that Capsaicin works past surface pain to the molecular level. Capsaicin relieves pain by blocking the transmission of a pain-relaying substance called Substance P to the brain. Best results typically occur with 2 to 4 weeks of continuous use. Capsaicin is the most recommended topical for arthritis sufferers.
  • Non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, help reduce swelling, inflammation and moderate to severe pain.
  • Prescription medications may be incorporated into a treatment plan to treat a wide variety of symptoms.
  • Local steroid injections such as injectable glucocorticoids are injected directly into the affected joint for immediate and targeted pain relief.

Note:Medication should be taken as directed by a physician.

Thermal TherapyHeat or use of hot packs relax muscle around stiff muscles and helps relieve arthritis pain.

Heat, or the use of hotpacks, relaxes muscles around stiff joints and helps relieve deep, aching pain. A warm bath may help loosen joints and ease pain and stiffness.

Arthritis Therapy Options

lwa-braces-and-therapeutic-heatCertain supports and splints provide therapeutic heat directly to the tender, aching joint. Cold packs applied for no longer than 20 minutes will help reduce any inflammation and swelling.

Reduce Stress

Stress leads to fatigue, muscle tension and increased pain
that can intensify arthritis symptoms. Relaxation techniques
such as meditation or activities like yoga may help
relax muscles and release tension and stress.

Alternative Therapies

Vitamin C and other antioxidants may possibly help prevent
progression of osteoarthritis. A massage can decrease pain
and increase circulation. Other options may include yoga or


Surgery may be considered when other treatment options are not successful.

Remember, a treatment plan may need to change over time with any changes in the condition (such as progression or an improvement in the condition).



Living with Arthritis (Part 1)

Cartilage deterioration


There are currently 46 million arthritis patients in the U.S. today. This will grow to 67 million by the year 2030!! One in every 3 American adults has either been diagnosed with arthritis or has chronic joint pain and stiffness. As we get older arthritis becomes more prevalent.

So, what is arthritis and how does it affect us?

A healthy joint has cartilage surrounding the ends of the bones.
A joint is where two or more movable bones meet. Each joint is a complex structure made up of ligaments, cartilage, fluid and the synovium. The synovium is the thin layer of tissue that lines the joint and lubricates the tendons.

Cartilage is the spongy material that covers and cushions the bones and acts as a shock absorber for easy joint movement.
Arthritis slowly destroys the cushioning cartilage around a joint. The cartilage begins to break down, causing the bones in the joint to come into contact with one another. This causes inflammation, pain and stiffening as bones rub against one another.


    • Rheumatoid Arthritis is an autoimmune disease in which the immune system attacks healthy joints causing inflammation and damage.
      • Hands and feet are most commonly affected, though the wrists, ankles, knees and shoulders may be affected as well.
      • More common in women
      • Typically develops between the ages of 30 and 50
      • Approximately 1-2% of the population is affected by Rheumatoid arthritis.
    • Osteoarthritis is a chronic, degenerative form of arthritis where cartilage between the bones in a joint breaks down, causing friction (bone rubbing on bone) and pain. It is the most common form of arthritis.
      • Osteoarthritis typically affects more than one joint and is most often in the weight bearing joints such as the hips, knees and lower back. The neck, fingers, thumb joints, feet and the big toe can also be affected. Wrists, elbows, shoulders and ankles are usually affected only in cases of injury or overuse. There are two types:
        • Primary osteoarthritis is associated with aging or “wear and tear”.
        • Secondary osteoarthritis is caused by a specific condition or event that damaged the joint, such as an injury or obesity.

        Ninety percent of people age 40 and over have signs of osteoarthritis in weight-bearing joints; the associated symptoms (pain and stiffness) often do not develop until years later.

Over 100 types of arthritis exist, all of which affect the joints. Osteoarthritis is the most common form of arthritis. Rheumatoid arthritis is also very common. While these two forms have different risk factors, causes, and symptoms, they do share one common symptom – joint pain.

Joint with Osteoarthritis

How Osteoarthritis Develops

Osteoarthritis develops gradually and starts with stiffness or soreness and moderate pain that does not interfere with daily tasks.
As it progresses, cartilage loses elasticity and is more easily damaged by repetitive use or injury. Cartilage breakdown causes the ends of the bones near the joint to change and deform – bone may thicken and growths called bone spurs may develop. Small fragments of cartilage or bone may break off and float in the space around the joint leading to pain and irritation. The lining of the joint may become inflamed resulting in further damage.
Damage to cartilage in the joint and the surrounding tissues leads to instability, weakness, pain, and stiffness.
Eventually basic daily activities such as walking, typing, brushing teeth, and tying shoelaces become more difficult.

Symptoms of Osteoarthritis

Symptoms may develop suddenly or slowly over time, and include:

      • Persistent joint pain
      • Inflammation (swelling, redness, warmth, and/or stiffness)
      • Joint pain aggravated by activity
      • Joint stiffness in the morning or after a period of inactivity
      • Loss of flexibility in a joint
      • Joint deformity
      • Fatigue or weakness
      • Poor posture or coordination

Note: Osteoarthritis is most prevalent in people age 60 and older

Causes of Osteoarthritis

Osteoarthritis cannot be attributed to a single/specific cause; however, several risk factors exist that increase the risk of its development:

      • Wear and Tear. Repeated overuse or repetitive motions injure and add stress to joints.
      • Age. Increased age increases the risk. The joints have endured many years of use. Cartilage may deteriorate due to prolonged “wear and tear.”
      • Heredity. Inherited bone abnormalities can affect the shape of joints or cause joint instability.
      • Obesity. Obesity increases stress on weight bearing joints. A strong correlation exists between obesity and significant joint pain.
      • Injury. A previous serious injury to a joint, nerve injury or surgery, leads to joint pain.
      • Muscle Weakness / Lack of Physical Activity. Weak muscles around a joint will increase the wear on the joint itself.

Any one or a combination of these factors may put one at higher risk of developing osteoarthritis. Controlling some of these risk factors may minimize risk or prevent the development of the disease altogether.