Last reviewed: October 14, 2026 · Compression Socks Canada Team
Compression therapy is one of the oldest treatments in medicine. The principle — that external pressure on a swollen, painful limb relieves discomfort and supports healing — has been recognised for thousands of years. The technology has evolved enormously, from linen bandages soaked in wine in ancient Greece to precisely engineered graduated medical hosiery manufactured to specific pressure profiles, but the underlying mechanical insight has remained constant. This article walks through the broad strokes of how compression therapy developed, the key milestones that shaped the modern category, and how the field has arrived at where it is today. It is general educational content and a brief historical overview, not a substitute for medical advice.
Ancient origins
References to leg bandaging for swelling and pain appear in ancient Greek, Egyptian, and Roman medical writings. Hippocrates, often cited as the father of Western medicine, described the use of tight bandages on the legs to treat swelling and varicose veins. The methods were practical: linen strips wound around the leg, sometimes soaked in herbal or medicinal preparations, providing external pressure that supported drainage and reduced symptoms. The mechanism was not understood in modern terms — venous return, valves, and the calf-pump were centuries away from being identified — but the clinical observation was clear. Pressure helped.
The Middle Ages and early modern era
Through the medieval period and into the Renaissance, leg bandaging persisted as a treatment for varicose veins, ulcers, and other lower-limb complaints. Surgeons of the period continued to use cloth and leather bindings. The underlying anatomy of the venous system remained poorly understood until the 17th century, when William Harvey described the circulation of blood in his 1628 work De Motu Cordis. Harvey's framework allowed later clinicians to begin connecting the practical observation of bandaging with the mechanics of venous return.
The 19th century: bandaging becomes more sophisticated
The 19th century saw substantial advances in bandaging techniques. Surgeons developed specific bandaging methods for venous ulcers and varicose veins. Materials improved with the development of vulcanised rubber. The first elastic stockings appeared in this era. By the end of the century, manufacturers were producing rubber-based compression hosiery designed for daily wear, although the products were heavy, hot, and uncomfortable compared to modern standards.
The early 20th century: knitting technology improves
The development of finer elastic threads and improved knitting machines in the early 20th century allowed the production of more comfortable compression stockings. The materials remained imperfect — early elastane and rubber blends degraded quickly and had limited recovery — but the products were closer to what modern wearers would recognise.
The mid-20th century: Sigvaris and JOBST establish the modern category
Two companies whose products are still widely used today were founded in this period. Sigvaris, founded in Switzerland, began manufacturing graduated compression stockings with the explicit principle of higher pressure at the ankle decreasing up the leg — the design that defines modern medical compression. JOBST, named after Conrad Jobst, an American engineer with a personal interest in the problem (Jobst himself had varicose veins), developed compression products in the United States from the 1950s onward, focusing on clinical applications including post-thrombotic syndrome and venous ulcer management.
The two brands established the modern category of graduated medical compression. Browse the Sigvaris collection and the JOBST collection.
The development of elastane
The invention of elastane (sold under various trade names including Lycra and Spandex) in the late 1950s transformed compression hosiery. Elastane offered the stretch and recovery that compression products needed without the bulk and degradation of older rubber-based materials. Modern compression hosiery relies on elastane as its structural fibre to this day.
The late 20th century: clinical evidence accumulates
Through the 1970s, 1980s, and 1990s, the clinical evidence base for compression therapy grew substantially. Randomised trials and clinical studies established the role of compression in venous insufficiency, post-thrombotic syndrome, venous leg ulcers, lymphedema, and DVT prevention. Multilayer compression bandaging emerged as the standard of care for venous leg ulcers. Compression for travel and DVT prevention became more widely recognised.
The early 21st century: athletic compression and broader awareness
From the early 2000s onward, athletic compression products emerged as a distinct category. Compression socks and sleeves became common in running, cycling, triathlon, and other endurance sports. The athletic category has its own evidence base, distinct from medical compression — the performance evidence during exercise is mixed, but recovery and edema-reduction effects are more consistent. See our medical vs athletic compression article.
Public awareness of compression grew during this period as well. Travel compression for long flights became broadly recommended. Pregnancy and postpartum compression entered mainstream awareness. Compression for occupational use became standard in many healthcare and service settings.
The Canadian context
Compression therapy has long been part of Canadian vascular and wound care. Major Canadian centres established protocols for venous leg ulcer management based on multilayer compression bandaging. Canadian extended health benefits typically cover compression hosiery when prescribed. The Canadian Lymphedema Framework and similar organisations have built infrastructure for certified lymphedema therapy and compression garment fitting across the country. Wounds Canada publishes clinical and patient resources for chronic wound care that include the role of compression.
What has changed and what has stayed the same
Across the long history of compression therapy, the core insight has remained: external pressure on a swollen, struggling limb relieves symptoms and supports healing. What has changed is everything else:
- Materials: from linen and rubber to elastane blends with cotton, merino, microfibre, and bamboo.
- Knit construction: from coarse bandaging to precision round-knit and flat-knit fabrics.
- Pressure profiles: from approximate to graduated and precisely characterised in mmHg.
- Sizing: from one-size-fits-all to size charts based on specific leg measurements.
- Variety: from a single category to knee-high, thigh-high, pantyhose, armsleeves, gloves, gauntlets, wraps, and specialty configurations.
- Evidence: from clinical observation to controlled trials and meta-analyses.
- Accessibility: from artisanal manufacture to global brands available through authorized retailers.
Where the field is now
Modern compression therapy is a mature, evidence-based field with established clinical applications across:
- Chronic venous insufficiency.
- Varicose veins.
- Post-thrombotic syndrome.
- Venous leg ulcers.
- Lymphedema and lipedema.
- Post-procedural recovery from vein procedures.
- DVT prevention during travel and post-surgery.
- Pregnancy and postpartum support.
- Occupational standing and sitting.
- POTS and autonomic conditions.
- Pressure therapy after burn injuries.
- Athletic recovery and specific sport contexts.
The product category includes everyday hosiery, athletic recovery products, custom flat-knit garments, and specialty wraps. The brands include long-established names like Sigvaris and JOBST alongside newer entrants in athletic and lifestyle compression.
Where the field is going
Ongoing development continues in several directions:
- More precise fabric blends for specific conditions.
- Better integration with smart-device monitoring of swelling and adherence.
- Improved donning aids and accessibility features.
- Expanded research into specific conditions including POTS and athletic recovery.
- More sustainable fabric and manufacturing options.
- Better data on long-term outcomes across diverse populations.
The mechanical principle that Hippocrates observed remains at the centre. The methods, materials, and evidence base around it continue to evolve.
Putting it together
Compression therapy connects modern Canadian patients to an unbroken tradition of mechanical medicine that stretches back thousands of years. The earliest practitioners did not understand the venous valves, the calf-pump, or graduated pressure profiles. They observed that pressure helped. Centuries of clinical experience, accumulating anatomical and physiological understanding, and the development of modern materials and manufacturing techniques have produced today's category of precisely engineered graduated medical compression. The products on a Canadian retailer's shelf today — knee-high stockings, thigh-high hosiery, custom flat-knit garments, athletic sleeves, post-burn pressure garments — are the latest expression of that long-running insight. Used consistently and matched to the right situation, daily compression continues to do what it has been doing since the time of Hippocrates: relieve symptoms, support the body, and help the leg do what gravity makes hard.
Frequently asked questions
How old is compression therapy?
References date to ancient Greek and Egyptian medical writings, more than two thousand years ago.
When did modern graduated compression begin?
Mid-20th century, with the establishment of brands like Sigvaris and JOBST.
Why is graduated pressure important?
It supports venous return mechanically without creating a tourniquet effect. See our graduated vs uniform compression article.
How has the evidence base grown?
From clinical observation to randomised trials, meta-analyses, and condition-specific protocols established across decades of research.
Is the technology still improving?
Yes. Fabric blends, sizing, and integration with care continue to develop.
What is the underlying principle?
External graduated pressure supports venous return and reduces venous pressure in the affected limb.
Related reading
This article is general educational content. For diagnosed conditions, work with a physician or trained compression fitter.