Socks and Foot Health: What Matters and Why

I have practiced as a foot and ankle specialist and surgeon for over 20 years and one issue I have seen time and time again is patients coming into the office with terrible socks. I’m not talking just a little worn;I mean terrible. Torn, worn out, beaten up, old, stretched out, and just appalling.

It got me thinking, why do so many of us neglect our feet? Even worse, why do we give so little regard to our socks? Socks are an essential item in our wardrobe for many reasons, but we care more about aesthetics. The same is true for many other types of clothing and shoes, they may be pretty but they have very little function and do nothing to help us. 

Believe it or not, socks have a major impact on the way we walk and our foot comfort. They can even impact our mood. A bad pair of socks scratching, itching, and rubbing the wrong way can be a source of great pain all day.

Socks do matter. They matter a lot. They are essential to our comfort. And we need to pay socks some respect. That being said, what should we look for in a sock? What is fact? And what is made-up marketing?

Material Matters

Socks come in all types of material, from cashmere to wool to cotton to polyester and nylon. The question is, what is the ideal material? That is tough to answer simply because the perfect material will differ for each type of use. 

Here are my thoughts on some of the common materials:

I have found wool to be a good material but a bit tough to work with. It can add warmth, but It frays, gives off fluff, and is not great for exercise and activity. 

Cotton is an excellent all-natural material. However, it stretches and doesn’t hold its shape, which isn’t great.

Polyester and nylon are newer materials for socks and are very good for moisture-wicking, stability, and compression. However, they tend to smell and be a bit too tight on their own without a blend.

Is a blend better?

Because each material offers pros and cons, socks are often created with a blend of materials for the ideal scenario. The machines that produce socks can easily combine multiple materials, and the proper blend can make or break the sock.

A combination of nylon, polyester, and cotton or wool is excellent. The natural spun cotton and wool are a great base for a quality sock, and the addition of polyester adds structure and stability. Blended in the right proportions of natural and synthetic materials, you will get an amazing soft sock with the ideal support.

In an athletic sock, greater percentages of nylon and polyester are used, while in a dress sock the percentages can be reversed. For additional warmth, a thicker cotton sock works about as well as one with a wool blend and thickness makes more warmth than the material chosen. Additionally, antimicrobial material can be added to sock blends to help with odor and foot protection. Usually, this is done with a silver thread placed into the sock blend. Although silver works well, a great deal of the sock material needs to be silver to make a difference. Most sock companies add a few strands for marketing. What seems to work better for smell and antimicrobial function is to dye the sock yarn in a special material to make any sock antimicrobial throughout the entire sock.

Seam or no Seam

The worst feeling in the entire world is when you have a little nub of sock on the side of your big toe that keeps rubbing. It can cause a blister or sore and affect the way you walk. You take off your shoe and adjust the sock only to have the nub come back again.

Socks should not have little nubs. Low-quality socks are closed with an older style that creates a poor closure on the sock’s edges. Higher quality socks have an automated toe closure with no seam. There are no nubs, and the toe seam is soft and not visible. Therefore, there is no rubbing, and your toes will be happy. Remember to look for a sock with no toe seams.

Arch Support: The Old and The New

As a foot and ankle surgeon, I have been looking into the right arch support for my whole career. Over-the-counter insoles and custom orthotic arch supports are a major part of what we recommend. Both have their place, but there is more we can do to better stabilize the foot and arch. And it can be done with a sock.

The Old

In the past 20 years, arch support came in the form of a patented elastic band that went around the mid-portion of the sock circumferentially at the arch area. The band gave the feel of support by squeezing the midfoot but has no additional support feature to it. After the patent for this elastic band expired, all sock companies placed it in their socks and marketed their socks as having arch support. This is truly false. The band gives no true arch support.

The New

I began to experiment with arch support ideas and found that when I taped a person’s foot with a band that ran along the sole of the foot for support, they often felt less foot pain. We began taping the arch of patients with foot pain. After a few days, this would indicate if an orthotic would be helpful. I got to thinking, how can I make a sock that has the same feel as the tape and offers enough arch support that an insole is no longer needed?

After about five years of research and working with sock manufacturers, I got two patents on a revolutionary sock support system. The system includes five layers of combined material in a proprietary weave that supports the arch but feels like a normal sock. For athletics, the weave was made denser for greater support. For everyday dress shoes, the material was made less dense but still very supportive. This became the start of my sock company: Archtek Socks.

Compression: The Good, the Bad, and the Ugly

The latest trend in socks is compression. Everything talks about compression. It is all over the place.

Do we need compression, how much, and why?

Compression socks come in one length, and that is knee-high. This is an old style that was designed for people with varicose veins and poor vein drainage. These folks required socks that were knee-high or even thigh-high. If you have varicose veins or bad venous drainage, stay with knee-high socks.

However, for all the nurses, doctors, and athletes who wear knee high compression socks, you may be hurting yourself more than helping. Let me explain why. 

The calf muscle is the single best pump in the body. The body uses compressions of the calf muscle during walking and activity to help move fluid out of the legs. However, the calf muscle may not work as well when it is compressed. So why not add compression in socks to just below the calf and allow the calf muscle to be free to pump? That is what I did with my Archtek socks, and I believe it is the best of both worlds. You have compression in the foot, ankle, and lower leg and a functioning calf muscle in the upper leg.

What level of compression do you need?

Again more compression is not better. If you have bad veins and circulation, go with true compression levels based on a doctor’s recommendation. Otherwise, compression should be enough to reduce swelling. When you remove the sock, you should see a mild indentation showing swelling has been reduced. 

What Else Can a Sock Do?

Think about the dynamic squeeze machines used by athletes to reduce lactic acid buildup and muscle fatigue during recovery. Now think about that in a sock. Standard compression is really more of a constant squeeze and not a start and stop squeeze mechanism. This does not allow the body to remove lactic acid well. 

Can a sock reduce lactic acid build-up through a dynamic squeeze mechanism? This was the last piece of a sock design that I worked on. It is called our Y-Strap Energy Return System. It is a series of strategically placed straps on top of the foot portion of the sock. These straps relax and compress with every step. This Y-strap technology and patented arch support reduces foot fatigue and soothes aching muscles in the foot during walking, which means more comfort for a longer period of time.

Finally. The Perfect Sock!

So here is the perfect sock detailed to you. Much like clothing went through a revolution when athletic leisure brands changed the dynamic, socks are ready for this change.

Look for socks that are a blended material. Cotton and polyester/nylon blend is ideal. Wool blend is also good but will not last as long. Antimicrobial coating and silver blend are good for smell and foot health. No toe seam is a must; toe seams hurt your soul. Compression is great, but too much compression and a very tight sock to the calf is not always best. Try compression to below the calf. You can get true arch support in a sock, and it may be the best thing ever.

Our Archtek socks have what we call our five pillars:

• Most important is our patented arch support system.
• Y-strap energy return technology.
• Antimicrobial proprietary blend of material.
• Seamless toe.
• Compression below the calf. 

So next time you consider pulling on an ugly, torn, frayed, or loose sock, please take a second and reconsider. Much like high-quality clothing, underwear, and shoes, a sock is critical to your health and well-being. A pop of style and color is great, but make sure you also get the functionality that your poor feet and legs deserve.

Dr. Bob Baravarian is an Assistant Clinical Professor at the UCLA School of Medicine. He is the creator and CEO of Archtek Socks (www.archteksocks.com). Dr Baravarian is the Director and Fellowship Director at the University Foot and Ankle Institute in Los Angeles (/podiatrist/dr-bob-baravarian). He has also been named one of the top Foot and Ankle Specialists six years running by Los Angeles Magazine.