Compression sleeves are the most important tool to ensure preservation and improvement of the therapeutic success achieved during treatment with Complete Decongestive Therapy (CDT). To select the correct garment (ready-made or custom made), compression level, and, if necessary, fastening systems, the patients age, physical abilities (and limitations), lifestyle, type of lymphedema and any other conditions must be taken into consideration. It is necessary that a compression garment is chosen that meets the patient’s individual needs.
Most manufacturers provide various styles of compression sleeves in a variety of sizes. Custom sleeves should be ordered if the extremity is either too large or too small for standard size garments.
Who should measure?
While it would be best that a trained individual with a thorough understanding of lymphedema and its implications takes the measurements (lymphedema therapist or certified fitter) and teach patients how to wear them properly, it is sometimes necessary that patients measure on their own if ready-made sleeves are acquired from an online retailer for example. If this is the case, the measurements should be taken by a friend, or spouse and the measurements should be written down on a notepad.
When should the measurements be taken?
At the end of the intensive phase of CDT (phase I), when the extremity is at its most reduced state. Ideally, the measurements should be taken early in the morning when the arm is smallest, at the end of a treatment or after the compression bandages have been removed.
How to measure
Sizing for medical compression sleeves is based on the circumferences at specific points and the length of the arm. Measurements are taken with a tape measure, which should be applied in a straight fashion; a twisted or crooked tape measure will result in inaccurate measurements. If a tape measure is unavailable, a string and a ruler may be used. The circumferential and length measurements can be taken with the string and the individual lengths of the string then measured with the ruler.
It is recommended to mark the arm with a non-permanent, non-toxic marker at each circumference measurement made. The length measurement is taken along the front the arm between the respective circumference points. The individual measurements are then compared with the sizing chart of the manufacturer of choice to determine size and length of the compression sleeve.
Measuring for a ready-made arm sleeve
Wrist Circumference
This is the point of greatest compression and therefore a very important point. Place the measuring tape at the narrowest part of the wrist, at the transition from the hand to the forearm and measure the circumference. Write this measurement down and label it as wrist measurement.
Elbow Circumference
Measure the largest part around the elbow with the arm slightly bent; the objective here is to get the largest measurement. Write this measurement down and label it as elbow measurement.
Upper Arm Circumference
This measurement is taken around the upper arm in the axillary fold. To determine the correct location of this point, it is often helpful to place a book into the arm pit area. The measuring point will be even with the top end of the book. Write this measurement down and label it as upper arm measurement.
Length Measurement
Measure the distance between the wrist circumference measuring point to the upper arm circumference point along the front of the arm.
This measurement determines the length of your arm – write it down.
You can now compare your measurements with the sizing chart of the manufacturer of your choice to determine the size and length of your sleeve.
If an additional compression gauntlet is required, here is how to measure:
Measuring for a ready-made compression gauntlet with thumb stub (no finger swelling)
Wrist Circumference (same point already measured for sleeve)
This is the point of greatest compression and therefore a very important point. Place the measuring tape at the narrowest part of the wrist, at the transition from the hand to the forearm and measure the circumference. Write this measurement down and label it as wrist measurement.
Palm Circumference
Measure the width of the palm along the finger joints. Place the measuring tape around the palm with the palm up and the fingers slightly spread and measure the circumference. Write this measurement down and label it as palm measurement.
Length measurements are not required for standard sized compression gauntlets. You can now compare your measurements with the sizing chart of the manufacturer of your choice to determine the size of your gauntlet.
Picture credit in this post: Absolute Medical, Inc. www.absolutemedical.net
Additional Resources:
http://www.lymphedemablog.com/2011/05/12/compression-garments-for-lymphedema-custom-or-ready-made/
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Joachim Zuther, Lymphedema Specialist. 



Estimado Dr Zuther:
Le envio saludos y le pido me informe sobre su experiencia en el uso de la manga de compresion en las pacientes en etapa cero o subclínica del linfedema.
Gracias
Dra.Blanca A. Meza-León
Estimado Dr Zuther:
Leenvio saludos y le pido me informe sobre su experiencia en el uso de manga de compresión para pacientes en etapa cero o subclinica de linfedema pos tratamiento de Ca de mama.
Gracias
Dra Meza-León
Dear Blanca: I am sorry but I am unable to read or respond in Spanish. Is it possible for you to submit your comment in English?
Dear Dr Zuther:
I send greetings and i would like you to informe about your experience in the use of the compression sleeve in patients with stage zero or subclinical lymphedema.
thanks,
Dra.Blanca A. Meza-Leon
I was trying to help Dr. Blanca with her reserch…Thanks
Wearing compression sleeves in stage 0 lymphedema is certainly one modality to safeguard against the onset of lymphedema. However, most patients are not much inclined to wear sleeves without having visible lymphedema.
Dear Joachim,
I use three different compression garment suppliers and have found that all three have a different way of measuring for garments. Something that I have found to be really helpful though is that thhey are all happy to send out someone to show you how to measure for their garments. A good relationship with your garment supplier is really beneficial. Thank you for your blog, its great to see measurements that make sense
Hola Blanca,
Yo solo indico el uso de la manga de compression para pacientes com grado II o más grande de linfedema. Siempre acredito que las mangas no son para tratamiento, pero para manutencion del tratamiento.
Por otro lado, utilizo el drenage linfatico para eses casos, como tambien los ejerc´cios, con buen resultado.
Desculpe me los errores del espanol
Salutos
Angela Marx – São Paulo Brasil
Could you do something similar for leg garments? I live out in the country and there’s no one near to do my measurements. I tried once using a form, but it didn’t work – I couldn’t picture where the measurements were.
Thanks for all of your good work!!
Yes, the next blog post will be on lower extremity garment measuring techniques
Good day,
The Solaris ready wrap do you get it for arms,i am from South-Africa and purchase from overseas.Thank you Charlotte.
A number of Solaris products are available for the upper extremity – please take a look at the Solaris website at http://solarismed.com/products
Please show how to measure head/neck patients especialy neck waddle.
Ann – please send me a message to jzuther@acols.com and I will forward you a measurement work sheet
As a lymphedema patient I can not stress how beneficial it is to have a qualified fitter. I find my self going back into PT after a stable arm for many years due to 9 plus months of an inexperienced supplier and their fitters. I refused to keep sleeves that were too large, long, tight and then some.
Even the manufacturer of one of my sleeves type/brands just can not understand what was happening with measurement sent in as they had past years mesurements which were stable.