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Muscle Atrophy From Compression Hose?


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I'm a POTS patient for 11 years and until last June, I HAD to wear Jobst pantyhose for TEN YEARS to function at all. For a while, I was well enough to work and off and on was able to walk 30 minutes a day IN THE HOSE.

This summer, after I lost my income and my POTS was lots better, I quit wearing the pantyhose.

In November, I found out I had osteoporosis (probably from Prevacid) and started walking 1.3 miles a day. In four weeks I was in terrible pain. Ends up I messed up my knees from extremely weak quadracep muscles and now have degenerative joints in BOTH knees.

Rested five weeks and tried to do minor walkng and exercising WITHOUT the hose. Terrible pain. Osteo dr. diagnosed me with severe deconditioning and/or fibromyalgia (which I probably have), telling me that I would need PT and gradual exercise for TWO YEARS before I could exercise enough to stop the joint deterioration.

ANYBODY know anything about MUSCLE ATROPHY FROM COMPRESSION HOSE? Should I put them back on and try to exercise with them?

Can somebody with a good doctor, like Dr. Grubbs, check this out, for the sake of ALL OF US who found relief with the pantyhose?

Would appreciate any advice; I can't afford the PT, as my insurance is reduced and I am trying to live on a small fixed income. Want to WARN Y'ALL.

THANKS SO MUCH for a quick response - Elegiamore in Atlanta

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Hi Elegiamore,

sorry to hear you're having such a tough time.

Compression hose shouldn't cause muscle atrophy. All they do is compress the veins and push the blood back up your legs to stop it pooling in your lower legs.

What has probably caused your quadricepts weakness is the reduced amount of exercise us POTS sufferers generally do. Simple things like taking the lift instead of the stairs (not out of choice but need) and walking less distance will gradually cause your quads to atrophy. Even just a week or two laid-up ill can cause a big drop in your muscle mass.

I wear below knee stockings (don't think I could tolerate the full ones) and I am developing quads weakness after a bad chest infection and POTS flare.

Is there any way you could manage one physio appointment? They should be able to give you a load of simple exercises to do at home. Here in the UK on the NHS you usually only qualify for 2 or 3 physio appointments so they give you exercises to do at home and then review your progress.

A good quads exercise to start with is straight leg raising. Sit or lie on your bed with your legs out straight in front of you. (Don't worry if knee pain stops you from getting your knee fully extended). Lift your leg so that your heel is about 5cm off the bed. If you can, hold it elevated for 5 seconds then relax.

If you put your hand on your thigh you should feel your quads contract as you lift your leg.

Try to do ten lifts with each leg a couple of times a day - it will make you ache so start slowly and build up.

I don't know if you can manage going to a swimming pool but swimming / kicking your legs holding on to a float board is really good for building leg muscles without stressing joints. Also because you are horizontal I get much fewer POTS symptoms than when I walk.

Don't worry about the compression hose - if they help the POTS keep on wearing them. You may find that they compress your patella (knee cap) which can cause pain but they won't atrophy your muscles.

good luck,


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Dear Flop,

Thank you so much for taking the time and effort to answer my message.

Since they are basically "support" hose, I thought that they were supporting my muscles all these years, instead of my own legs. I DEFINITELY felt muscle strain that I never felt before when I wasn't wearing them.

Yes, that was one of the leg exercises I tried, but just 10 minutes of stretching and five of strengthening, plus five minutes of walking, there was so much pain after 11 days that I could not stand to sit up (pain in my hips). This is why the doctor has no idea how to get me started to recover quad strength, as well as other muscle strength.

I am considering the water approach before I go to get therapy by joining the YMCA where I can swim in a heated pool. But I have read repeatedly that hot water is makes your veins swell, which would be REALLY BAD for POTS. I am VERY cold intolerant and couldn't swim in a cool pool.

Open to any suggestions - again, many thanks,


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My favorite knee exercise is the following:

Terminal knee extension. Loop a theraband or tubing behind and above your knee. Secure it also to something sturdy, like a railing. Stand back from the railing till there is mild tension on the band. Keeping your glutes tight, ever so gently straighten and bend your knee ever so slightly. Start with a very small bend and very low resistance. As you get stronger you can increase the bend and tension.

I like it because it's "closed chain," meaning your foot is on the ground, making everything more stable. This exercise really stopped the constant popping, clicking , and grinding of my kneecaps.

But it's key to start slow and gentle to see how your body is responding.

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Sorry to hear about this problem--it is so hard to figure out what causes what!

I am about to buy compression hose and I wondered what level of compression you used? I have never tried them and I have read that 30-40 might be good, but that might be so uncomfortable I wouldn't wear them.

Hope you figure out how to deal with this problem. I too have fibromyalgia and some of my dysautonomia meds have helped the fibro a lot. I am now able to go back to exercise, but do have to start slowly.

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Many thanks for the thoughtful reply. If is stopped the popping, etc. for you, I'd love to give it a try, once I can stop the immediate muscle pain. Hope your problem wasn't degenerative like mine....


I would be remiss if I didn't say follow your doctor's advice on hose strength, as you have to have a prescription from her/him for 30-40 strength hose.

But, from my ten years of experience, let me just say...I tried the 20-30 weight about five years ago, and they didn't seem to do anything for me.

Yes, the 30-40 hose are almost unbearable at times; when it was 102 degrees, 90% humidity one Atlanta summer, I ALMOST took them off. It is truly a test of bravery and determination to go this route, but in time they became like contact lenses; I just didn't notice I had them on.

My biggest fear is that one's legs adjust to wearing them, and it's difficult to get rid of them, at least I still fear naked without them, even though I have stopped syncoping. But if you can afford them, and you have a prescription, and your POTS is serious, I'd buy one pair of pantyhose (for me, the full effect was missing with the thigh highs) and give it a try.....a REAL effort, testing it a little at first, and then once you've gotten used to them, trying standing or doing something that usually gets to you....and see what's what.

Get more than one prescription from the doc, get fitted properly locally, and in the future you might can buy them cheaper online. I paid $95 for three pair at the local health store. Send me a PM for advice on putting them on, or buy one of the metal devices they sell, as getting those suckers on your legs is the hardest part of each day.

The good news....everybody asked me if I had lost weight once I had them on....

Good luck and thanks so much for the reply,


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