Heel Lifts for Achilles Tendonitis: Do They Really Work Better Than Exercise?
Updated: Aug 24
By Dr. Jeffrey Peng, MD · Updated August 2026
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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 the ankle, wondering whether they need expensive treatments or lengthy rehabilitation programs. 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 traditional gold-standard of eccentric exercises. Here’s what the evidence shows and how to use them effectively.
Why Do Heel Lifts Work for Achilles Tendonitis?
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.
The Achilles tendon is under constant strain with every step. A heel lift reduces the distance the tendon needs to stretch with each stride, effectively giving it a break. This is especially helpful for patients with insertional Achilles tendinopathy, where pain is concentrated at the back of the heel.
What Does the Research Say?
A 2024 study published in the Orthopaedic Journal of Sports Medicine examined a 20 mm (≈¾ inch) heel lift in patients with insertional Achilles tendinopathy. Participants experienced immediate pain reduction during walking. After two weeks of use, they showed significant improvements in symptom severity, walking speed, stride length, and ankle flexibility.
These findings demonstrate both immediate and sustained benefits. The lifts did not simply mask pain; they appeared to facilitate meaningful improvements in gait and function.
Can Heel Lifts Outperform Eccentric Exercises?
Eccentric calf exercises have long been considered the gold standard for Achilles tendinopathy. However, a randomized controlled trial published in the British Journal of Sports Medicine (the HEALTHY trial) compared heel lifts directly to eccentric exercises in 100 patients with mid-portion Achilles tendinopathy. Heel lifts outperformed eccentric exercises in both pain relief and functional improvement at 12 weeks.
This aligns with a common clinical challenge: many patients struggle to adhere to a demanding eccentric exercise routine. Heel lifts offer a simpler approach — insert them into your shoes and continue daily activities. Patient satisfaction was also significantly higher in the heel-lift group.
Both studies had relatively small sample sizes and focused on short-term outcomes, so more long-term data is needed. Still, the evidence so far is promising, and heel lifts represent one of the lowest-barrier treatments available for Achilles tendonitis.
How to Choose the Right Heel Lift
Thickness matters. Studies used 12–20 mm lifts. I recommend starting around ½ inch and increasing if needed. Adjustable lifts allow fine-tuning.
Material and firmness are important. Choose a firm lift that will not compress under body weight. Soft gel or foam inserts may feel comfortable initially but often lose elevation during the day.
Proper fit is essential. The lift should sit snugly without sliding. A well-fitting heel lift stays in place and provides consistent relief with every step.
A Practical Treatment Approach
In my practice I typically recommend a multimodal approach:
1. Start with a heel lift — the simplest and most affordable first step. Wear it throughout the day for at least two weeks.
2. Add topical anti-inflammatory medication if needed (e.g., topical diclofenac).
3. Incorporate progressive loading / eccentric exercises to promote long-term tendon resilience once acute pain settles.
If pain persists despite these measures, schedule a consultation so we can discuss additional options tailored to your situation.
References
1. Alghamdi NH, et al. 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, et al. 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.
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