Heel lifts (also called heel raises) are simple inserts placed under the heel inside a shoe. They can reduce pain by changing how forces travel through the foot, ankle, and lower limb—often by slightly plantarflexing the ankle and decreasing tensile load on certain tissues. Used well, they’re a low-cost, low-risk intervention. Used poorly, they can aggravate symptoms or create new ones. This guide explains when heel lifts help, how to choose and fit them, and how to progress safely.
What heel lifts do (and why they can reduce pain)
A heel lift elevates the rearfoot relative to the forefoot. That small change can:
- Reduce Achilles tendon strain by decreasing ankle dorsiflexion demand during walking, particularly in late stance.
- Reduce calf muscle tension (gastrocnemius–soleus complex), which may lower pulling forces on the Achilles and the plantar fascia.
- Alter rearfoot and midfoot loading by shifting pressure slightly forward and changing the timing of heel-off.
- Change knee and hip mechanics subtly, which can be helpful for some people but problematic for others.
The key is that heel lifts don’t “fix” tissue damage by themselves—they typically modify load. If pain is load-related (most overuse foot/ankle pain is), load modification can create a window for healing and for strengthening to take effect.
Who may benefit most
Heel lifts are most commonly used for:
- Mid-portion Achilles tendinopathy (pain 2–6 cm above the heel bone)
- Insertional Achilles pain (pain right at the heel bone insertion)
- Calf tightness with limited ankle dorsiflexion contributing to symptoms
- Plantar heel pain (often labelled plantar fasciitis), particularly when calf/Achilles tightness is a driver
- Post-acute flare-ups where temporarily reducing tensile load helps settle symptoms
They can also be useful in short-term management after a sudden increase in walking, running, or standing.
When to be cautious (or avoid)
Heel lifts are not ideal for everyone. Use caution if you have:
- Forefoot pain (metatarsalgia, Morton’s neuroma) that worsens with increased forefoot load
- Significant leg length discrepancy (you may need a targeted approach rather than bilateral lifts)
- Balance issues or unstable footwear
- Severe midfoot arthritis or symptoms that worsen with altered shoe pitch
If you have diabetes with reduced sensation, vascular disease, or a history of ulcers, get clinician guidance before changing in-shoe devices.
Choosing the right heel lift
Height: start small
Most people do best starting with 5–8 mm. Larger lifts (10–15 mm) can be helpful in stubborn Achilles pain, but they also increase the chance of new symptoms.
A practical rule: use the smallest lift that meaningfully reduces pain during your key aggravating activity (walking, stairs, or running drills).
Material: firm vs soft
- Firm or semi-firm lifts tend to be more stable and predictable for Achilles-related problems.
- Very soft gel lifts can feel comfortable but may compress unevenly and irritate some tendons.
Shape: full-length vs heel-only
- Heel-only lifts are common and easy to trial.
- Full-length wedges (raising heel and midfoot/forefoot gradually) can reduce the “step” inside the shoe and may feel smoother, especially in snug shoes.
Fitting heel lifts correctly
Poor fit is a major reason heel lifts fail.
- Place the lift under the insole if possible. This improves stability and reduces slippage.
- Keep the heel centered. If the lift shifts laterally, it can irritate the peroneal tendons or change knee tracking.
- Check heel counter height. Raising the heel can cause rubbing at the back of the shoe.
- Ensure enough volume in the shoe. If the lift makes the shoe too tight over the midfoot, you may compensate with altered gait.
- Use the same lift in both shoes unless you’re specifically addressing a leg length difference under professional guidance.
How to use heel lifts: a step-by-step plan
Step 1: Use them for the activity that hurts
Start by wearing heel lifts during the activity that reliably triggers pain—often long walks, work shifts, or exercise. You don’t necessarily need them at home in bare feet.
Step 2: Monitor pain response (24-hour rule)
A useful approach is the 24-hour response:
- If pain is better or the same during the activity and not worse the next morning, the dose is appropriate.
- If pain is worse later that day or the next morning, reduce time on feet, reduce lift height, or use them only for shorter periods.
Step 3: Pair with strength and capacity work
Heel lifts are most effective when combined with progressive loading. Examples:
- Isometric calf holds (pain-modulating early on)
- Slow calf raises (double-leg progressing to single-leg)
- Eccentric or heavy-slow resistance programs for Achilles tendinopathy
- Foot intrinsic strengthening and hip strength if gait control is an issue
The lift reduces provocative load while you rebuild tissue capacity.
Step 4: Progress activity gradually
As symptoms settle, increase walking/running volume by small increments (often 5–15% per week, depending on baseline). The goal is to rely less on the lift over time.
Weaning off heel lifts
Heel lifts are often a temporary tool. Once pain is stable and strength is improving:
- Reduce lift height (e.g., from 10 mm to 6 mm).
- Alternate days: lift days vs no-lift days.
- Keep them for higher-load days only (long shifts, hikes, sport).
If symptoms return, step back to the previous successful level for 1–2 weeks before trying again.
Common mistakes
- Starting too high (jumping straight to 12–15 mm)
- Using only one lift without a clear reason
- Assuming pain relief means you can suddenly do more (load still matters)
- Ignoring shoe choice (a flexible, low-drop shoe may counteract the lift’s effect)
- Not addressing the driver (strength, training errors, recovery, or footwear)
When to get help
Seek assessment if:
- Pain is severe, sudden, or associated with a “pop” (possible tendon rupture)
- You cannot do a single-leg heel raise
- There is significant swelling, redness, or night pain
- Symptoms persist beyond 6–8 weeks despite sensible load management
Bottom line
Heel lifts can be a smart, evidence-informed way to reduce load on the Achilles–calf–plantar fascia complex and calm foot pain—especially when symptoms are driven by tensile overload and limited ankle dorsiflexion. Start low, fit them well, use them strategically for painful activities, and combine them with a progressive strengthening plan. The best outcome is not lifelong dependence on lifts, but a gradual return to comfortable movement with improved tissue capacity.
