Objective: To quantify the influence of posture and exercise on the interface pressure obtained under elastic stockings with compression pads. Design: Interface pressure measurement and plethysmographic evaluation of elastic stockings with and without compression pads. Setting: Department of Surgery, Aichi Prefectural College of Nursing, Nagoya, Japan. Main outcome measures: Pressure measurements in 24 volunteers were obtained beneath elastic stockings, elastic bandages and short-stretch bandages during supine resting, standing, tip-toe exercise and walking, and the effect of elastic stockings on the muscle pump of the leg was evaluated by strain-gauge plethysmography in 40 limbs with varicose veins. Results: Without compression pads, only short-stretch bandages showed a significant increase in pressure during standing and exercise. When pads were used, however, elastic stockings and bandages also showed a significant increase. With pads, significant improvement in the expelled volume during exercise was observed by strain-gauge plethysmography. Conclusions: Interface pressure under elastic materials during posture and exercise is similar to that under short-stretch bandages when compression pads are used, and pads effectively augment the muscle pump.