Heel raises — also called heel lifts or shoe heel elevators — are one of the simplest and most effective conservative treatments for Achilles tendon pain, and one of the most commonly recommended interventions by Australian podiatrists. Yet many people either use them incorrectly or don't understand why they work. Here's a complete guide.
What is Achilles tendinopathy?
Achilles tendinopathy is the clinical term for pain, stiffness, and dysfunction in the Achilles tendon, the large tendon connecting the calf muscles to the heel bone. It typically causes morning stiffness and pain with the first steps of the day, pain during or after activity, and a tender, sometimes thickened tendon on palpation.
Achilles tendinopathy is extremely common in runners, middle-aged adults, and people who suddenly increase their activity levels. It is also common in people with a tight calf complex, flat feet, or a leg length discrepancy.
How do heel raises help?
The Achilles tendon is placed under the greatest load when the heel is low relative to the forefoot, i.e. when you're barefoot or wearing flat shoes. Heel raises work by elevating the heel, which reduces the distance the calf must stretch and therefore reduces the load placed on the Achilles tendon with every step.
This offloading effect allows inflamed tendon tissue to begin healing without the repeated mechanical stress that prevents recovery. Heel raises are typically used in the acute and subacute phases of Achilles tendinopathy as part of a broader treatment plan that also includes progressive loading exercises (e.g. eccentric calf raises) and footwear modification.
Insoles and orthotics for Achilles tendonitis
Heel raises address one factor — heel height. But Achilles tendon load is also influenced by how the foot behaves through the gait cycle, which is where insoles and orthotics come in.
Excessive pronation causes the lower leg to rotate internally as the foot rolls in. Because the Achilles inserts onto the heel bone, this rotation creates a whipping or bowstring effect through the tendon, concentrating stress along its medial side. For people whose Achilles pain is driven by this pattern, an orthotic that controls rearfoot motion often does more than a heel raise alone.
In practice the two are frequently combined: an orthotic to manage foot mechanics, with a heel raise added on top for additional offloading during the painful phase. Most prefabricated orthotics accept a self-adhesive heel raise bonded directly to the heel of the device.
What to look for in an insole for Achilles tendonitis:
- A deep heel cup — cradles the heel and improves rearfoot positioning
- Firm density — softer devices compress under load and lose their corrective effect, particularly in heavier or more active people
- Adequate arch support — reduces the degree of pronation and therefore tendon torsion
- Room for a heel raise — enough depth in the shoe to add height without crowding the foot
Firm-density prefabricated orthotics such as Formthotics, Powerstep and Interpod are commonly used for this. Which suits you depends on body weight, activity level and footwear — see our guide to the right orthotic for your feet.
Heel lifts vs heel cups — what's the difference?
They sound similar and are often confused, but they do different jobs.
A heel lift (heel raise) is a wedge that adds height under the heel. Its purpose is to reduce Achilles tension by shortening the distance the calf and tendon must stretch. It's the appropriate choice for Achilles tendinopathy and leg length discrepancy.
A heel cup is a cradle that surrounds and cushions the heel. It adds little or no height. Its purpose is shock absorption and fat pad support, which makes it better suited to plantar fasciitis, heel spurs and fat pad atrophy.
If your pain is at the back of the heel or in the tendon itself, you want a heel lift. If it's underneath the heel, a heel cup is more likely to help. Some gel heel cups incorporate a slight lift, which can suit mixed presentations.
Heel raises for leg length discrepancy
A leg length discrepancy (LLD), where one leg is structurally shorter than the other, can cause a range of musculoskeletal problems including low back pain, hip pain, knee pain, and Achilles tendon overload on the longer leg. A heel raise placed in the shoe of the shorter leg corrects the discrepancy and restores level pelvic alignment.
Even a relatively small LLD of 5-10mm can be clinically significant. If you suspect a leg length difference, ask your podiatrist for a full biomechanical assessment.
Sever's disease in children
Sever's disease (calcaneal apophysitis) is the most common cause of heel pain in children aged 8-14. It occurs when the growth plate at the back of the heel becomes inflamed during periods of rapid growth, when the calf muscles are relatively tight. Heel raises are a mainstay of management as they reduce Achilles tension and offload the growth plate during the growth spurt.
Which heel raise should I use?
Heel raises come in different heights. The correct height depends on your condition:
- 4mm - mild Achilles tightness, minor LLD correction, Sever's disease
- 6mm - moderate Achilles tendinopathy, moderate LLD
- 8mm - significant Achilles tendon offloading, larger LLD corrections
- 10mm - substantial heel elevation, typically used for significant structural LLD
For bilateral use (both feet), use the same height in both shoes. For LLD correction, use only in the shorter limb as directed by your podiatrist.
How to use a heel raise
Most self-adhesive heel raises are designed to be placed directly on top of the insole in the shoe, adhesive side down, at the heel. They should sit firmly under the heel without bunching. If placing them directly under the insole (between insole and shoe lining), ensure the raise doesn't affect the fit of the shoe.
Frequently asked questions
Should I use a heel lift in one shoe or both?
For Achilles tendinopathy, both — using a lift on one side only creates an artificial leg length difference and can shift the problem elsewhere. For a genuine leg length discrepancy, the lift goes in the shorter side only, at the height your podiatrist has determined.
How long should I wear heel lifts for Achilles tendonitis?
Heel lifts are generally a temporary measure used during the painful phase, not a permanent solution. As symptoms settle and loading exercises progress, the height is usually reduced gradually rather than removed all at once — dropping straight back to flat can provoke a flare. Your podiatrist should guide the timeline, which commonly spans several weeks to a few months.
Can I use heel lifts in sandals or thongs?
Not easily — self-adhesive lifts need an enclosed shoe with a heel counter to stay in place and function properly. If you spend a lot of time in open footwear, a supportive orthotic sandal or slide with a built-in contoured footbed is a more practical option than trying to add a lift.
Do heel lifts fit in all shoes?
Most enclosed shoes and boots accommodate a 4-8mm lift without issue. Low-volume footwear such as dress shoes, ballet flats and slim trainers can become tight, particularly if you're also using an orthotic. Work boots and running shoes generally have the most room.
Are heel lifts the same as shoe heel elevators?
Yes — heel lift, heel raise, heel wedge and shoe heel elevator all describe the same product. Height-increasing insoles marketed for appearance are a different thing: they're usually much taller and aren't designed for therapeutic offloading.
Can I use a heel lift with an orthotic?
Yes, and it's a common combination. Self-adhesive heel raises bond directly to the heel of most prefabricated orthotics. Check total shoe depth once both are in place, since the combined height can crowd the foot in lower-volume footwear.
Will heel lifts weaken my calf muscles?
Not over the short-to-medium term at the heights used therapeutically. This is precisely why heel lifts are paired with progressive loading exercises rather than used alone — the lift reduces load so the tendon can tolerate the strengthening work that produces lasting recovery.
Browse our full range of heel raises and heel elevators including Trekker, Interpod, Dola and Vasyli, or explore our heel and arch pain collection for a complete range of podiatrist-recommended products.
Disclaimer: This article is for general information only. Heel raises should be used as directed by your podiatrist as part of a comprehensive treatment plan.