Compression therapy is the central pillar in managing lymphedema. But compression is not a one-size-fits-all solution. Two of the core categories are adjustable wraps (inelastic or low-stretch wrap systems) and knit compression garments (flat-knit or circular-knit). Each has distinct properties, advantages, and ideal use cases.
In this guide, we’ll explore:
- What adjustable wraps are and how they differ from flat and circular garments
- How flat knit and circular knit garments differ (structure, stretch, stiffness)
- Situations in which each option tends to perform best
- Practical tips for combining them, switching between them, and maintaining them
- Key product examples
- A FAQ section to answer common questions
Whether you’re new to compression therapy or reevaluating your regimen, this article will help you make informed choices—and point you toward the right products for your needs.
1. Core Differences: Adjustable Wraps vs Compression Garments
What are Adjustable Wraps?
Adjustable wraps (sometimes called compression wraps, wrap systems, or short-stretch wraps) are modular, strap-based compression systems designed to be applied and adjusted by the user or caregiver. They are typically low-stretch or inelastic, meaning they resist extension and provide containment through friction and strap tension rather than elasticity.
Key Characteristics:
- They often feature Velcro® or hook-and-loop closures or similar fastening systems, allowing incremental adjustment.
- Because they are not highly elastic, they can maintain higher working pressures when muscles contract, and reduced resting pressure, which can enhance venous/lymphatic return dynamics.
- They provide flexibility: you can tighten or loosen during the day as swelling fluctuates.
- They can be easier to don/doff for people with limited joint mobility, especially if there are pull tabs or grip features.
- They are often used both during the day and sometimes at night (depending on design) because they can adapt to changing limb volume.
In a study comparing adjustable compression wraps (ACWs) and flat-knit garments, the wraps offered comparable effectiveness in managing limb volume, with benefits in ease of application and adjustability.
A clinical white paper from AVLS notes that inelastic adjustable wraps are designed to provide compression across folds in the skin without constriction, and because they are low-stretch, they deliver stiffer containment than many elastic garments.
What are Compression Garments (Flat Knit and Circular Knit)?
Compression garments are made by textile knitting machines and come in two principal styles:
Circular Knit (Round Knit):
A tubular, seamless knit produced in a continuous cylindrical fashion. These are generally more elastic, lighter, and conforming. Many off-the-shelf (ready-to-wear) compression garments are circular knit.
Flat Knit
Fabric is knit flat (row by row) and then sewn or linked into a garment. This allows for variation in stitch density, customized shaping (e.g. lobes, cones), and stiffer containment properties. Flat knit garments are almost always custom or made-to-measure for each limb.
Some key differences:
| Property | Adjustable Wraps | Flat Knit Garments | Circular Knit Garments |
|---|---|---|---|
| Stretch / Elasticity | Low-stretch / inelastic (high stiffness) | Moderate elasticity but stiffer than circular knit | High elasticity, more conforming |
| Customizability | Adjustable across the limb, straps can adapt | Fully custom to limb dimensions, shapes, folds | Mostly standard sizes; limited custom options |
| Containment power | Very high when applied correctly; good working pressure | Strong containment, especially for complex shapes | Good for mild swelling, less effective for advanced edema |
| Ease of donning/doffing | Easier to adjust, loosen, retighten mid-day | More challenging if swelling fluctuates | Easier to pull on/off but may slip or bunch if sizing is imperfect |
| Comfort / aesthetics | Bulkier, visible straps | Thicker material, visible seams | Sleek, low-profile under clothing |
| Suitability for irregular limbs | Very good, can adapt | Excellent (custom) | Limited, may struggle with lobes or folds |
In the S.T.R.I.D.E. guide, compression garments are seen along a continuum—from elastic (more stretch) to stiffer wrap systems. Wraps (and decongestive garments) are on the stiffer end of the continuum, while circular knit lies on the more elastic end.
Also, while evidence comparing flat-knit and round-knit garments specifically for maintenance of lymphedema is limited, expert consensus generally leans toward flat knit for more complex or advanced cases.
2. When to Use Adjustable Wraps vs Flat / Circular Garments
There is no one-size-fits-all prescription. The best choice depends on your stage of lymphedema, limb shape, tissue quality, mobility, and comfort / lifestyle needs. Below is guidance on when each tends to work best, and how they can complement each other.
Use Cases: Adjustable Wraps
Ideal for:
- Fluctuating limb volumes: If your limb size changes during the day (e.g. swelling after prolonged activity), wraps let you loosen or tighten as needed.
- Post-intensive therapy / maintenance: After completing phase 1 decongestion (bandaging), wraps can help maintain results while giving you flexibility.
- Patients with limited mobility or dexterity: Wraps with pull tabs, finger grip straps, and easy fastening can reduce struggle in donning/doffing.
- Use during travel or in varying climates: If you expect swelling changes (e.g. flights, long car rides), adjustable wraps give you the flexibility to adapt.
- Nighttime or supine settings (depending on wrap design): Some wraps are suitable to wear lying down; others have lower-profile designs for sleeping.
When wraps may not suffice (or may need reinforcement):
- Advanced fibrosis or extremely firm tissue may exceed wrap’s containment (or require very careful application).
- If you need discreet compression under dress clothing, wraps tend to be more conspicuous.
- In cases where a custom, continuous gradient is needed (e.g. conical shapes, fixed tapering), a custom flat knit may give more consistent pressure.
Use Cases: Flat Knit / Circular Knit Garments
Flat Knit Garments – ideal for:
- Moderate to advanced lymphedema, especially when limbs have irregular contours, folds, lobes, or require strong containment.
- Stable volume: When your limb has reached a maintenance size, flat knit provides consistent coverage.
- Longer-term wear: They tend to be more durable over time (less strain from repeated strap adjustments).
- Better aesthetics under clothing: For patients who prefer a smoother profile (though flat knit has seams).
Circular Knit Garments – ideal for:
- Early-stage lymphedema or mild swelling, especially when limbs fit standard sizes.
- Maintenance or supportive use, rather than aggressive containment.
- Comfort / compliance priority: Because they’re lighter and stretchier, some users will wear them more consistently.
- Budget / fast delivery needs: off-the-shelf circular knit garments are typically less expensive and shipped quickly.
Combined or Hybrid Strategies
Many patients achieve the best results using a hybrid approach: use wraps when volume is variable or as a “backup,” and flat/circular garments for daily wear. For example:
- After decongestion, wear a custom flat knit garment during the day, and use an adjustable wrap during travel or exercise.
- Keep a wrap handy for flare days when swelling spikes; switch to the garment when swelling stabilizes.
- Use wraps at night (if comfortable) and garments by day, or vice versa, depending on your routine.
3. Practical Considerations & Tips
Measuring & Fitting
- For flat knit garments, precise measurements (often in multiple anatomical segments) are essential. Fittings should be done when the limb is decongested (i.e. after therapy) to avoid ordering undersized garments.
- For wraps, you’ll want to ensure strap length, coverage area, and the ability to tighten sufficiently across your limb. Many wraps come in different sizes (e.g. calf vs thigh, foot pieces) to match limb region.
Application Technique
- Apply wraps smoothly, overlapping straps consistently (e.g. 50 % overlap) to avoid gaps or pressure points.
- Recheck tension after standing and walking—some adjustment may be needed.
- For garments, use donning aids (gloves, cones) to reduce stress on fabric and prolong life.
Maintenance & Care
- Wash garments daily using a gentle detergent, cool or lukewarm water, and line-dry (do not tumble dry).
- Rotate two garments (or two wraps) to allow elastic/Velcro to recover.
- Inspect regularly for wear (stretching, loss of compression, worn straps or fasteners).
- Re-measure limb periodically (every 3–6 months, or after major events such as weight change, surgery, or pregnancy).
Compliance & Comfort
- A garment or wrap that is comfortable and wearable may lead to higher adherence, which often outweighs theoretical performance differences.
- Choose wraps or garments with breathable, moisture-wicking fabrics if you live in warm climates or sweat easily.
- If a wrap digs or causes pressure points, consider padding or adjusting strap overlap.
4. See How Different Products Compare
The following examples highlight some of today’s most popular compression wraps and garments—each designed to meet specific needs in lymphedema care. Explore the links below to see how these products perform and find options that align with your patients’ or customers’ goals.
Compression Wraps
Solaris ReadyWrap Calf delivers effective, adjustable compression through easy-to-use Velcro® straps that ensure a secure, personalized fit. Its short-stretch design provides firm support while allowing comfortable movement. Ideal for managing fluctuating swelling, this breathable, low-maintenance wrap offers reliable compression and everyday convenience.
Juzo Calf Compression Wrap provides adjustable, high-working compression for effective edema and lymphedema management. Its short-stretch fabric and reversible design ensure firm support and easy coordination with any outfit. Strong Velcro® tabs make self-application simple, while the comfortable, breathable material promotes consistent compression throughout the day.
CircAid Juxta-Lite HD offers customizable, inelastic compression with durable banding for effective management of moderate to severe edema. Its patented Built-In Pressure System™ allows precise compression adjustments, while the short-stretch material supports active movement. Easy to apply and remove, it’s ideal for daily wear and long-term lymphedema control.
Compression Garments (Flat & Circular Knit)
Juzo Soft Arm Sleeves provide gentle, effective compression with a smooth, breathable knit that feels soft against the skin. Designed for all-day comfort, they deliver consistent pressure to help manage arm lymphedema and swelling. The lightweight, seamless fabric allows easy movement, making it ideal for everyday wear and discreet under clothing.
Mediven Harmony Armsleeve with Gauntlet combines effective compression with exceptional comfort and flexibility. Its innovative knit design ensures even pressure distribution while allowing natural movement. Featuring breathable, moisture-wicking fabric and discreet styling, it provides reliable lymphedema management and all-day wearability for lasting comfort.
Solaris ExoStrong Flat-Knit Arm Sleeve delivers firm, therapeutic compression with a durable, structured fabric designed for long-term lymphedema management. Its flat-knit construction provides excellent containment for swelling while remaining comfortable and breathable. Custom-like shaping ensures a secure fit, promoting consistent compression and everyday ease of wear.
Custom Compression Garments
We accept custom sized garment orders from patients and therapists for all brands including BiaCare, BSN Jobst, CircAid, Farrow Medical, JoViPak, Juzo, Medi, ReidSleeve, Sigvaris, and Solaris.
If you require a custom size or simply would be more comfortable in one, you have come to the right place! We can guide you through the whole process from start to finish.
Shop Trusted Compression Brands
Discover high-quality compression solutions from the most trusted names in lymphedema care. Explore innovative designs, superior comfort, and proven results from leading brands like Juzo, Solaris, CircAid, and Mediven. Click each logo below to browse products that support your compression therapy journey.
5. FAQ
Q: Can I replace all my garments with wraps?
A: Possibly, for some patients with more flexible limbs or moderate edema. But in many advanced or anatomically complex cases, wraps alone may not provide the consistent gradient or smooth coverage that flat knit garments offer.
Q: Which option is best for travel?
A: Wraps are often more adaptable during travel (e.g. flights, long periods of sitting) because you can loosen or tighten them as swelling changes. Keeping a compact wrap in your luggage as a backup is smart.
Q: Do wraps stretch out over time?
A: The inelastic or low-stretch materials used in quality wraps resist stretch, but hook-and-loop straps or bindings may wear. Replacing worn straps or rotating wraps helps maintain performance.
Q: Will a circular knit garment work for me?
A: Yes—if your swelling is mild, your limb shape is fairly regular, and you fit within standard sizes. Circular knit garments are comfortable and aesthetically pleasing, but may lack containment in more severe cases.
Q: How often should I re-measure or re-fit my garment or wrap?
A: Every 3–6 months is a good rule of thumb, or sooner if you experience significant swelling changes, weight shifts, surgery, or pregnancy.
Q: Can adjustable wraps be used at night?
A: Some wraps are specifically designed for supine use or are lower-profile enough for nighttime wear. Always check manufacturer guidance. If a wrap isn’t comfortable lying down, a lighter night garment or wrap version may be better suited.
Q: What should I talk to my fitter about to choose the right option?
A: Ask about limb shape complexity, fluctuation patterns, your dexterity in donning garments, your intended activity level, aesthetic preferences, climate, and your budget vs longevity priorities.
