Foot & AnkleWhat I Do



Do you find the overabundance of socks in stores a little confusing? Besides fashion socks, there are all sorts of sports socks, with different kinds of cushioning, different degrees of support in key areas, different materials, and a special sock for every activity. There are some which wick away moisture…

A lot of my patients are wearing compression socks. Originally, they were used to decrease swelling, or to prevent blog clots after surgery. But now I see them used for pain and tired legs. For those who really need them, there is a science to the selection of these socks.

But do we always need compression? No. In fact, most of the time compression socks are quite unnecessary, and if worn the wrong way, they can actually be painful, ineffective and a little harmful. Suffice it to say, if you have severe swelling or lymphedema, you should be under the care of a physician, and have specific instructions on what type of compression socks to wear and how to wear them.

If you choose a compression sock because you think it might help you in some way, just remember, if it wrinkles up around your ankle, calf or knee, it is actually creating a tourniquet effect, and not serving its purpose at all. They must fit properly, and you have to keep them pulled up to prevent creasing.

Diabetics must be careful with compression socks.  Unless diabetics have severe edema, I rarely recommend compression socks. They are tight and stiff. Diabetics often have peripheral neuropathy and poor circulation. Compression socks can actually contribute to numbness and the formation of pressure sores. Skin changes or burning in the foot while wearing compression socks, can be an indication of excessive pressure, and diabetics should consult their physicians regarding their continued use.

But this brings me around to my favorite sock, and the one I wear almost every day: the diabetic sock. I don’t have diabetes, but it’s the right sock for me to wear at work and when exercising or riding my horse. You can score a pair of these for around four bucks at your local drugstore. The purpose of a diabetic sock is to put less pressure on the skin and the compromised circulation to the nerves of the foot in diabetics. They are loosely woven, and from the get-go feel like socks you probably wore when you were a kid.  Socks were relatively expensive back then, and we didn’t have 35 pair of them. They simply wore out after so many uses and washings. I remember that, in addition to very scuffed up Bass Weejuns and saddle oxfords, we considered a saggy sock to be fashionable…probably out of necessity.

The elastic on athletic socks today is tenacious. These things last forever and can go through the washer and dryer a thousand times, never showing the wear. But the loose weave of diabetic socks puts less pressure on your foot and allows you to stretch your toes. What good is that wide shoe you bought to give room to your bunions and hammer toes when under it, you’re wearing a tight sock? This is particularly important as we age and our circulation isn’t as good.

At the end of the day, do you notice your socks creating an indentation around your ankle or foot? This means they’re too tight. They are restricting the venous and lymphatic return from your toes and feet to your heart. It’s like a weak tourniquet. Try a pair of diabetic socks. Next time you’re in the drug store, you will find them in the diabetic section, and not the fashion sock rack. They come in…black or white. It’s an easy choice and you will feel the difference.

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