Phlebological Insoles are insoles, foot orthotics or foot supports that are marketed as being useful to help with venous and lymphatic disorders of the lower limb and during pregnancy. It is claimed that they can limit swelling and the heaviness of legs and feet, improve venous and lymphatic drainage and reduce varicose veins.
Example:
The commercially available Herbitas Phlebological Insole
Research:
De Michele et al (2023):
These authors’ scoping review concluded that: “Two quasi-experimental studies and one randomised cross-over study were included. The results of the examined studies confirmed the positive effects of insoles usage and foot and ankle mobility on the venous return.“
Uhl et al (2015):
This study looked at changes in quality of life and symptoms achieved when using medical compression stockings or inner soles in subjects with symptomatic chronic venous disease in the presence of foot static disorders. They found significant improvements in quality of life scores when only medical compression stockings were used (p < 0.005), only inner sole were used (p < 0.01) and also when both treatments were used together (p < 0.001). They further concluded that their study suggests that a number of leg symptoms occurring in varicose veins patients are not likely to have a venous origin. They are frequently related to a foot static disorder, which is responsible for postural changes. This study also strongly demonstrates the need for correction of the foot static disorder if such a disorder is present in any patient with chronic venous disease. The use of the inner sole will improve the symptoms and also the quality of life with an efficiency that is almost equal to that provided by the medical compression stockings and the combined use of both treatments is recommended.
López-López et al (2018):
These authors demonstrated an improvement in venous return with the use of foot orthotics.
Lerebourg et al (2020):
These authors looked more at the effect of shoe type on venous parameters, concluding that “Evidence was found that unstable shoes or shoes with similar technology, sandals, athletic or soft shoes, and customized foot orthotics elicited more improvement in venous variables than high-heeled shoes, firm shoes, ankle joint immobilization and barefoot condition. These venous changes are probably related to the efficiency of muscle pumps in the lower limbs, which in turn seem to be dependent on shoe features associated with changes in the kinetics, kinematics and muscle activity variables in lower limbs during gait and exercise.“
Commentary:
- Looking at the commercially available “phlebological insoles”, they are no different to a typical foot orthotic and they do not have any design features that would be considered specific to venous or lymphatic disorders.
- It appears that foot insoles, orthotics or supports can help venous return, however the mechanism of action for the improvement of foot and leg symptoms may be more likely due to biomechanical or musculoskeletal reasons rather than changes in the venous or lymphatic status.
- The use of the terminology ‘phlebological insole’ and such devices appears to be more common in Spain and Italy than elsewhere.
- ‘Phlebological insoles’ are more of a marketing term than a specific foot orthotic or insert design.
Related Topics:
Foot Disorders and Venous Disease | Circulatory Problems in Podiatry
External Links:
Phlebological insole (Podiatry Arena)
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