# Heel cups and heel lifts > Heel cups and heel lifts are inserts that sit at the base of the heel inside a shoe, used for heel pain and to make up for a leg length difference. The benefit is modest and often short-term, so they work best as one part of a wider plan. Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/heel-cups-and-heel-lifts Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **They go inside your shoe.** A heel cup sits under the heel, and a heel lift raises it. - **The benefit is modest.** Results are small and often short-term, so they work best as one part of a plan. - **A lift needs a confirmed reason.** Only use one for a leg length difference after a clinician has measured it. - **Check your skin.** New devices can mark skin or make feet sweat, and numb feet need extra care. ## What are heel cups and heel lifts, and how do they work? A heel cup is a rubber, thermoplastic or firm-foam device that sits under your heel inside a shoe [1]. A heel lift raises the heel. It's designed to reduce the pull of the soft tissues that attach to your heel bone, and it can add some cushioning [2]. Lifts are also used to make up for a leg length difference [3]. Both go at the base of the heel inside your shoe, and differently shaped ones do much the same job [2]. They're types of foot orthoses (shoe inserts). A podiatrist or physiotherapist can help you choose between a heel cup, a heel lift and a full-length insole. ## What are they used for, and how well do they work? They're mainly used for pain under the heel (plantar heel pain) and for leg length differences. The benefit is modest, and it's weak for both. How well heel cups work on their own for heel pain isn't clear yet [4]. Foot orthoses in general weren't better than sham inserts or other simple treatments for adults [5]. Even so, simple advice plus a heel cup is a reasonable place to start, because adding exercise or an injection didn't give clearly better results after 12 weeks [6]. In adults with a leg length difference and a painful condition, shoe lifts may ease pain and improve function, but the quality of the evidence is low [3]. For Achilles tendon pain, heel lifts may ease pain a little more than calf exercises, though the difference may be too small to notice [7]. In children with heel pain (calcaneal apophysitis), the options made no difference by 6 and 12 months, and children's results don't necessarily apply to adults [8]. Expect a small benefit that may be mainly short-term. In adults with plantar fasciitis, orthoses improved function at 3 months compared with sham inserts, but not at 12 months [9]. ## Are heel cups and heel lifts right for me? A heel lift may suit you if a clinician has confirmed a true leg length difference [3]. Don't use one for a suspected difference that hasn't been confirmed, because a lift you don't need can cause pain [10]. For heel pain, clinicians are advised to be cautious about giving inserts to everyone, and to take your preferences and whether you'll keep wearing them into account [5]. If you have reduced feeling in your feet, talk to a podiatrist before you start [11]. In young children, corrective footwear doesn't help developmental flat feet [12]. ## What happens when I start using them? Heel pain is mostly diagnosed from an examination of your foot [13]. If a leg length difference is suspected, it's measured and confirmed first [14]. No proven guideline sets the best material or height for a lift, so a podiatrist or physiotherapist will set it for you [7]. You'll then wear the device in a cushioned, stable shoe, such as a trainer or walking shoe, and avoid flat or slip-on shoes [2]. > [!tip] Try this > Wear a new heel cup or lift for short periods at first, then build up as your foot tolerates it. Check your skin after each wear. ## What are the risks and side effects? Problems are usually minor. You may notice aching in your feet, legs, thighs or lower back when you first wear them, which should settle quickly if you build up gradually [11]. Heel cups may make your feet sweat more, so wash your feet and change socks more often [1]. Take the device off and ask a podiatrist to review it if you notice blistering, bruising or marked skin. A lift you don't need has been linked with hip and groin pain [10], and new pain in the back, hips, knees or feet, and blisters, can occur with lifts [7]. If new pain appears in your hip, groin, knee or back after starting a lift, stop using it and ask a podiatrist to review it. If you have neuropathy (loss of feeling in your feet), start with only 15 minutes of use and check your feet after every wear. Stop straight away and contact a podiatrist if you see damage, redness, blistering or bruising [11]. How often side effects happen isn't clear yet. ## How do they compare with other options? Heel cups may help more than stretching in the short term for adults with plantar heel pain [5], but contoured full-length insoles relieved symptoms better than heel cups [15]. Combining night splints or rocker shoes with insoles worked better than any one alone [15]. Ready-made and custom-made orthoses seemed to work similarly [9]. Orthoses also take less effort to stick with than stretching [5]. Corticosteroid injections can help in the short term but may have negative long-term effects, so discuss them with your doctor [5]. If a heel cup isn't helping, ask about a full-length insole. ## When to see a podiatrist See your GP or a podiatrist the same day if: - you have diabetes and notice a wound, sore, blister or colour change on your foot; - you have spreading redness, heat, swelling or pus in your foot; - you can't put weight on your foot after an injury; - you have sudden severe pain or numbness in a leg or foot, or numbness or weakness that's new or getting worse. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. See your GP soon if you have severe pain that doesn't ease or keeps you awake at night, or a fever or weight loss along with heel pain. See a podiatrist if: - your heel pain hasn't improved after 3 months of self-care [16]; - you have diabetes, tingling or numbness along with heel pain, so it can be assessed [11]; - you suspect a leg length difference and want to try a lift. See a podiatrist or your GP if a child's symptoms are new or getting worse. A heel cup or lift isn't a substitute for assessment. ## Common questions ### How long does it take to get used to a heel cup or heel lift? Wear it for short periods at first, then build up as your foot tolerates it. Some aching in the feet, legs or lower back is common early on and usually settles if you increase wear gradually. If the aching doesn't ease, or you get blisters or marked skin, take it off and ask a podiatrist to review it. ### Should I wear heel cups in every pair of shoes? It helps to use them in cushioned, stable shoes such as trainers or walking shoes, and to wear them consistently. They won't suit every shoe, particularly flat or slip-on ones. A podiatrist can tell you which of your shoes are suitable and how much to wear them. ### What is the difference between a heel cup, a heel lift and a full-length insole? A heel cup sits under the heel and holds it. A heel lift raises the heel, and is also used to make up for a leg length difference. A full-length insole runs under the whole foot. A podiatrist or physiotherapist can help you choose which suits your problem. ## Further reading - [Heel cups and heel lifts on Clindice](https://clindice.com/heel-cups-and-heel-lifts) - [Guide for wearing insoles or heel cups - Resource Library - Sheffield Children's NHS Foundation Trust](https://library.sheffieldchildrens.nhs.uk/guide-for-wearing-insoles-or-heel-cups/), NHS - [Heel Pain](https://111.wales.nhs.uk/encyclopaedia/h/article/heelpain), NHS - [A Guide to Wearing Heel Cups/Insoles - Bedfordshire Hospitals NHS Trust](https://www.bedfordshirehospitals.nhs.uk/patient-information-leaflets/a-guide-to-wearing-heel-cups-insoles/), NHS - [Pain in the bottom of the foot](https://www.nhs.uk/symptoms/foot-pain/pain-in-the-bottom-of-the-foot/), NHS - [Plantar fascia pain - My Joint Health Hub](https://myjointhealthhub.bnssg.nhs.uk/foot-ankle-pain/plantar-fascia-pain/), NHS ## Sources 1. A Guide to Wearing Heel Cups/Insoles · Bedfordshire Hospitals NHS Trust. https://www.bedfordshirehospitals.nhs.uk/patient-information-leaflets/a-guide-to-wearing-heel-cups-insoles/ 2. Plantar fascia pain · Muchall R · My Joint Health Hub. https://myjointhealthhub.bnssg.nhs.uk/foot-ankle-pain/plantar-fascia-pain/ 3. Shoe Lifts for Leg Length Discrepancy in Adults With Common Painful Musculoskeletal Conditions: A Systematic Review of the Literature · Campbell TM, Ghaedi BB, Ghogomu ET et al. · Archives of Physical Medicine and Rehabilitation · 2018. https://doi.org/10.1016/j.apmr.2017.10.027 4. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values · Morrissey D, Cotchett M, Said J'Bari A et al. · British Journal of Sports Medicine · 2021. https://doi.org/10.1136/bjsports-2019-101970 5. Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis · Rasenberg N, Riel H, Rathleff MS et al. · British Journal of Sports Medicine · 2018. https://doi.org/10.1136/bjsports-2017-097892 6. Does a corticosteroid injection plus exercise or exercise alone add to the effect of patient advice and a heel cup for patients with plantar fasciopathy? A randomised clinical trial · Riel H, Vicenzino B, Olesen JL et al. · British Journal of Sports Medicine · 2023. https://doi.org/10.1136/bjsports-2023-106948 7. Efficacy of heel lifts for lower limb musculoskeletal conditions: A systematic review · Bourke J, Munteanu S, Merza E et al. · Journal of Foot and Ankle Research · 2024. https://doi.org/10.1002/jfa2.12031 8. Effectiveness of footwear and foot orthoses for calcaneal apophysitis: a 12-month factorial randomised trial · James AM, Williams CM, Haines TP · British Journal of Sports Medicine · 2016. https://doi.org/10.1136/bjsports-2015-094986 9. Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial · Landorf KB, Keenan AM, Herbert RD · Archives of Internal Medicine · 2006. https://doi.org/10.1001/archinte.166.12.1305 10. Chronic psoas syndrome caused by the inappropriate use of a heel lift · Rancont CM · The Journal of the American Osteopathic Association · 2007. https://pubmed.ncbi.nlm.nih.gov/17908834/ 11. Information about your insole or foot orthoses · NHS. https://www.esht.nhs.uk/wp-content/uploads/2020/09/0840.pdf 12. Effectiveness of therapeutic footwear for children: A systematic review · Hill M, Healy A, Chockalingam N · Journal of Foot and Ankle Research · 2020. https://doi.org/10.1186/s13047-020-00390-3 13. Heel pain: A systematic review · Agyekum EK, Ma K · Chinese Journal of Traumatology = Zhonghua Chuang Shang Za Zhi · 2015. https://doi.org/10.1016/j.cjtee.2015.03.002 14. Clinical assessment and treatment of leg length inequalities · Danbert RJ · Journal of Manipulative and Physiological Therapeutics · 1988. https://pubmed.ncbi.nlm.nih.gov/3049890/ 15. Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review · Schuitema D, Greve C, Postema K et al. · Journal of Sport Rehabilitation · 2020. https://doi.org/10.1123/jsr.2019-0036 16. Foot and Heel Problems · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/western-locality/musculoskeletal/foot-and-heel-problems --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.