by Kam Howard

Borrowing from the 90-year history of its parent company, Kansas City–based orthotic and prosthetic textile designer Knit-Rite, Inc., the Therafirm compression design team has been focused on creating better outcomes for patients who use gradient compression hosiery.

“Over several decades, Knit-Rite has worked closely with groups of orthopedic, prosthetic and orthotic researchers who were developing new procedures in areas such as fracture management, post-amputation prosthetic care and infant cranial remodeling, as well as other areas,” said Mark Smith, president and CEO of the companies. “In each case, these clinicians wanted light compression interface garments for their procedures which afforded improved fit and donning attributes. To help solve that challenge, our development team identified a category of yarns, which via the spinning process, creates extremely high elongation characteristics. The garments made with these yarns have yielded such significant performance improvements that over the past four decades, this ‘core-spun’ yarn type has revolutionized virtually every category of orthotic, prosthetic and compression product we offer, from interfaces for cranial remodeling orthoses to prosthetic compression garments, all the way to our seamless sensitivity socks for kids with sensory challenges. When we combine the yarns from this spinning process with the appropriate fibers and technologies to address other requirements for comfort and performance, the outcome has been an exceptional product for patients,” he added.

Fast forward to 2006 when Smith and others reacquired the former family business. “Therafirm had been around since the early ’50’s, when it was started by Parke-Davis,” said Smith. “The company made a good quality gradient compression line, but there hadn’t been much innovation, and there were a few shortcomings in the line. As a result of our background in O&P textiles, we had this idea to send a few spools of core-spun yarn from Kansas City to our compression plant in North Carolina. We thought we might get a compression garment with greater cross stretch, but it was not an obvious benefit because the tension yarn would naturally still provide the same measured gradient compression. And even if that worked, the burning question was, ‘Would wearers notice a difference?’ As it turned out, virtually every wearer found the new compression socks made with core-spun yarn to be easier to put on and more comfortable to wear. We were very excited—because donning and comfort are the factors affecting compliance with compression therapy. And we knew this was unique. It turned out the US Patent Office agreed with us. Since then so have thousands of other patients and providers.”

Despite this success, the company has had its work cut out for them. Chris Vering, chief operating officer, shared, “The Therafirm production facility was running well, but there were improvements needed if we were going to grow and move forward. Our plant was older and had limited capacity. As a result, since we reacquired the business we have invested several million dollars in state of the art knitting, testing, dyeing, and boarding equipment, as well as achieving ISO certification. Finally, last April, we moved the Therafirm operation into a state-of-the-art production facility in Hamlet, NC,” Vering continued. “The new plant is only about 15 miles from our former location. We could have moved anywhere, but our team of associates at Therafirm is our most important resource and we didn’t want to lose anyone if we could help it. Instead, we have added a lot of great people to our team, and our entire organization has been working very hard, integrating into our new state-of-the-art facility and continuing to excel to the highest standards in manufacturing and quality while implementing lean production techniques such as ‘kaizens’ and ‘kanbans’—basically repeating what we have done at our Knit-Rite facility in Kansas,” he added. “We think the results are evident in quality and delivery that exceed our customers’ expectations.”

Ron Hercules, executive vice president of sales, added, “Now that we are finally getting the infrastructure of this company where it needs to be, we want to communicate that. The Core-Spun by Therafirm® compression sock is a great product and a great story, but there is a lot more there,” he added. “We are trying to consider every facet of our customers’ needs to help vascular patients be more compliant with compression therapy. We know our customers include the physicians who are looking for better outcomes, the providers who want outcomes but who also are challenged to survive and grow in the current healthcare environment, not to mention patients who need the benefits of compression but won’t wear it unless they can get it on and also afford to pay for it. We think we offer all of that.”

Smith added, “At the same time we have been working to expand and upgrade our operation, we knew we needed to upgrade the whole product line. The field has responded well to the Core-Spun benefits…but it has been challenging to replicate that in a more sheer compression line. As of February 2014, we are finally ready to launch an opaque compression product that will mirror the attributes of the Core-Spun sock,” Smith announced. “The new line, which we have named Ease by Therafirm®, combines a new highstretch yarn with moisture-wicking Coolmax® fiber. Our significant wear testing has demonstrated the Ease product mirrors the donning and wearing comfort, as well as the durability, of Core-Spun. At the same time, we are focused on affordability for patients because we consistently hear as the biggest complaint from doctors that compression often costs so much it impacts patient compliance. We are pricing Ease to help address that, like we have with Corespun. We are also offering a maternity line called Preggers by Therafirm®” with the same attributes and in compression levels up to 20-30 mmHg” he added.

“The worst compression garment is the one that doesn’t comfortably fit a patient and is hard for them to get on. We’ve given Ease a flexible sizing system and made it easier to get on, as well as more comfortable to wear,” says Evan McGill, national sales manager for Knit-Rite and Therafirm. Ease offers both short and long lengths to accommodate a wide array of heights, has a broad color selection, and is priced very affordably for most patients.”

Along that line, the company promotes comprehensive solutions to each group of stakeholders. Kam Howard, the company’s marketing director added, “Unless we help doctors who help providers help patients, the most innovative products in the world won’t make a difference. We try to serve them all with resources to make the process succeed. We are working to give doctors and providers all the patient information and effective merchandising resources they need to help patients connect the dots.”

“Knit-Rite has always been about helping others in everything we do,” says Vering. “When Knit-Rite was introduced to Therafirm, we saw an opportunity to extend innovation in compression hose that was not only sold into our traditional orthotics and prosthetics market, but also one that allowed us to reach the other compression markets and provide new solutions that fit patients’ needs.”

“We are just getting started bringing new innovation to the marketplace,” says McGill. “Our goal is to continue to bring out new compression solutions that change patient’s lives. We want to offer products in the compression field that retailers, physicians and patients haven’t seen before. It’s definitely an exciting time for us.”

“With our roots in the medical field, all Therafirm products are developed with appropriate design and testing for consumers’ health at top of mind. Some products claiming to offer ‘compression’ are not true gradient compression products and may contain little to no compression or actually offer reverse compression. Therafirm’s ability to combine healthy, true gradient compression with the most up-to-date technologies available results in superior, quality compression garments,” said McGill.

“We are proud of our 90 years in the medical textile business and our continued commitment to producing American made textiles, along with being grateful for the opportunities we have to contribute to innovative solutions for our customers and good jobs for our people and the US economy,” Smith stated. “Everything we make helps every group we serve, and all Knit-Rite products are developed and manufactured in the USA,” he continued. Knit-Rite and Therafirm employ approximately 175 employees between their two locations in Kansas City, KS, and Hamlet, NC. Therafirm is the original Parke-Davis brand of compression hosiery and was later sold to Warner-Lambert. In the 1990s, a former Warner-Lambert executive purchased the gradient compression medical stocking division and relocated production to Ellerbe, NC. Knit-Rite purchased Therafirm in 2000.

Knit-Rite has been in Smith’s family for three generations. Smith grew up working at Knit-Rite, then practiced as a clinical prosthetist and orthotist before rejoining in 1991 and has served as president and CEO since reacquiring the business along with Hercules and Vering in 2006. Ronald Hercules, executive vice president of sales, has been with Knit-Rite since 1986 and Christopher Vering, COO and CFO, has been with Knit-Rite since 1999. Kam Howard, director of marketing joined in 2007. Evan McGill, national sales manager joined in 2012.