- Jeffrey Peng MD
- Mar 4
- 4 min read
By Dr. Jeffrey Peng, MD · Published March 04, 2026 · 5 min read
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Achilles tendonitis is one of the most common conditions I see in my sports medicine clinic. Patients often arrive frustrated after weeks of pain in the back of their ankle, wondering whether they need expensive treatments or lengthy rehabilitation programs. The good news? One of the most effective interventions is surprisingly simple and affordable: a heel lift.
Recent clinical trials suggest that heel lifts can provide immediate pain relief for Achilles tendonitis — and may even outperform the gold standard treatment of eccentric exercises. In this article, I break down the science behind heel lifts, how to choose the right one, and how to integrate them into a comprehensive treatment plan.
Why Do Heel Lifts Work for Achilles Tendonitis?
The mechanism behind heel lifts is straightforward. By slightly elevating the heel, these inserts change the angle of the foot and reduce tension on the Achilles tendon — particularly at the insertion point where it attaches to the heel bone. Even a small amount of offloading can translate into significant and immediate pain relief during walking and daily activities.
Think of it this way: the Achilles tendon is under constant strain every time you take a step. A heel lift reduces the distance the tendon needs to stretch with each stride, effectively giving it a break while you go about your day. This is especially helpful for patients with insertional Achilles tendinopathy, where the pain is concentrated right at the back of the heel.
What Does the Research Say About Heel Lifts?
A 2024 study published in the Orthopaedic Journal of Sports Medicine examined the effects of a 20 mm (approximately ¾ inch) heel lift in patients with insertional Achilles tendinopathy. The researchers found that participants experienced immediate pain reduction during walking after inserting the heel lift into their shoes. After wearing the lifts for two weeks, subjects showed significant improvements in symptom severity scores, walking speed, stride length, and ankle flexibility — all markers of improved Achilles tendon function.
These findings are particularly encouraging because they demonstrate both immediate and sustained benefits. The heel lifts did not just mask pain temporarily; they appeared to facilitate meaningful improvements in how patients walked and moved.
Can Heel Lifts Outperform Eccentric Exercises?
Eccentric calf exercises — such as slowly lowering yourself off the edge of a step — have long been considered the gold standard for treating Achilles tendinopathy. However, a randomized controlled trial published in the British Journal of Sports Medicine challenged this assumption. The HEALTHY trial compared heel lifts directly to eccentric exercises in 100 patients with mid-portion Achilles tendinopathy and found that heel lifts outperformed eccentric exercises in both pain relief and functional improvement at 12 weeks.
In my practice, this finding aligns with a common challenge: most patients struggle to adhere to a demanding eccentric exercise routine, especially after a long day at work. Heel lifts offer a fundamentally different approach — simply insert them into your shoes and go about your day. The researchers also found that patient satisfaction was significantly higher in the heel lift group. When a treatment is effective, easy to use, and well-liked by patients, that is an ideal combination.
It is worth noting that both studies had relatively small sample sizes and focused on short-term outcomes, so more research is needed to understand how heel lifts perform over longer periods. Nevertheless, the evidence so far is promising, and this is arguably the lowest-barrier treatment available for Achilles tendonitis.
How to Choose the Right Heel Lift
Not all heel lifts are created equal, and choosing the wrong one could potentially make things worse. Here is what to look for:
Thickness matters. The first study used a 20 mm (¾ inch) lift, while the second study used a 12 mm (just under ½ inch) lift. I recommend starting with a lower height around half an inch and increasing if needed. An adjustable heel lift gives you the flexibility to fine-tune the elevation to your comfort level.
Material and firmness are important. You want a firm lift that will not compress and lose its elevation under your body weight. Gel and foam inserts may feel comfortable initially, but they need to be sturdy enough to maintain the heel height throughout the day.
Proper fit is essential. Heel lifts should sit snugly inside your shoe without sliding around. Most come in standard small, medium, and large sizes. A well-fitting heel lift will stay in place and provide consistent relief with every step.
A Step-by-Step Treatment Approach for Achilles Tendonitis
In my practice, I recommend a multimodal approach to Achilles tendonitis. Here is the strategy I typically discuss with patients:
Start with a heel lift. This is the simplest and most affordable first step. A quality adjustable heel lift costs around $15 and can provide immediate pain relief. Wear it in your shoes throughout the day for at least two weeks.
Add topical anti-inflammatory medication if needed. Over-the-counter topical diclofenac (Voltaren gel) is an effective and inexpensive option. It delivers anti-inflammatory medication directly to the area without the systemic side effects of oral medications like ibuprofen.
Incorporate a structured exercise program. While heel lifts can provide immediate symptom relief, we also want to promote tendon healing and long-term resilience. A progressive loading program that includes eccentric exercises helps strengthen the tendon over time.
If you continue to experience pain after trying these conservative measures, I encourage you to schedule a consultation so we can discuss additional treatment options tailored to your specific situation.
References
1. Alghamdi NH, Pohlig RT, Seymore KD, Sions JM, Crenshaw JR, Grävare Silbernagel K. Immediate and Short-Term Effects of In-Shoe Heel-Lift Orthoses on Clinical and Biomechanical Outcomes in Patients With Insertional Achilles Tendinopathy. Orthop J Sports Med. 2024;12(2):23259671231221583. doi:10.1177/23259671231221583
2. Rabusin CL, Menz HB, McClelland JA, Evans AM, Malliaras P, Docking SI, Landorf KB, Gerrard JM, Munteanu SE. Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial. Br J Sports Med. 2021;55(9):486-492. doi:10.1136/bjsports-2019-101776
Medical Disclaimer: This content is for educational purposes only and does not substitute for the medical advice of a physician. Always consult your healthcare provider before beginning any new treatment program. The information presented reflects the opinion of Dr. Jeffrey Peng and does not represent the views of his employers or affiliated hospital systems.