Foot Health

The Ultimate Guide to Custom Orthotics for Heel Pain Relief

Orthotics and custom-made shoe inserts are medical devices based on a patient's foot impression and have proven to be an effective solution for managing and treating heel pain.

Dr. Hassan Portrail
Dr. Mohammed Hassan
15 July 2023

Heel pain is a common condition that can cause significant discomfort and impede mobility.
Various issues such as plantar fasciitis, Achilles tendonitis, heel spurs, or general foot strain can
cause it. Fortunately, orthotics and custom-made shoe inserts are medical devices based on a
patient's foot impression and have proven to be an effective solution for managing and treating
heel pain. This article will explore some characteristics of custom orthotics aiming to improve
heel pain.

1. Proper Support and Stability:

Orthotics are an excellent solution for heel pain, offering foot support and stability. They are
designed to cradle the arches of the feet, helping to promote proper alignment of the foot and
ankle. This helps to distribute pressure evenly across the entire foot, reducing strain. By
supporting a correct posture, orthotics also reduces the risk of further injury or discomfort.

2. Correction of Abnormal Foot Mechanics:

Abnormal foot mechanics can lead to much pain and discomfort for those affected.
Overpronation, which is an excessive inward rolling of the foot, and supination, which is
insufficient inward rolling, are two examples of these abnormal foot mechanics. To correct these
issues, orthotics play a crucial role. Orthotics support the heel and surrounding tissues, reducing
the foot's stress. This helps to alleviate pain and discomfort caused by the abnormal foot

3. Reduction of Pressure and Strain on the Heel:

Orthotics are designed to reduce pressure on the heel, allowing for optimal pain management
and healing of soft tissue inflammation. The cushioning effect of orthotic inserts absorbs shock.
It minimizes the impact on the heel during activities such as walking, running, or standing for
extended periods. Two examples that come to my mind are using a deeper heel cup on custom
orthotics. This will lead to improved cushioning. This is better for patients on their feet for an
extended period. Another example of pressure relieving mechanisms we could use on custom
orthotics is offloading or relieving pressure from a sore spot, i.e., around the heel spur, painful
lesion, callus, or hardened area that causes discomfort. The unloading mechanism helps to
relieve pain and pressure-related thickening of the skin.

4. Enhanced Shock Absorption:

Heel pain can be aggravated by the repetitive impact experienced during daily activities.
Orthotics offer excellent shock absorption properties, reducing the forces transmitted to the
heels with each step. This feature is particularly beneficial for individuals engaged in high-
impact sports or occupations that involve prolonged standing or walking. By attenuating the
shock, orthotics provide a cushioning effect that minimizes discomfort, allowing individuals to
stay active and mobile without exacerbating their heel pain.

5. Improved Biomechanics and Foot Function:

Orthotics alleviate heel pain and improve overall biomechanics and foot function. The proper
alignment and support provided by orthotic inserts optimize the distribution of weight and
pressure throughout the foot, reducing excessive stress on the heels. This promotes a more
natural gait, enhances stability, and prevents the development of compensatory movement
patterns that can lead to further foot problems. By improving foot mechanics, orthotics help
restore proper function and prevent future heel pain.

6. Customization for Individual Needs:

One of the significant advantages of orthotics is the ability of the doctor to customize them
based on the patient. Each person's foot structure and mechanics are unique, and off-the-shelf
inserts may not adequately address these individual factors. For example, recently, I had a 31-
year-old patient, who is active, present to the clinic with heel pain. She weighs 125 pounds.
Upon examining and evaluating her, I noted that she is also flat-footed upon standing. She also
has pain in the heel area. I have decided to look at her feet. I have decided to pick a few items
for her custom device. For example, I have chosen to use the top cover made of poron, known
to withstand high compression and repeated use. I also would like a deep heel cup so she gets
support around the heel area as a schoolteacher. The patient's weight is essential to consider
because it will help me pick the material for the shell. If a patient is heavy, I will pick a shell
made of graphite. This would be semi-rigid, making it ideal for the patient. If the patient is not so
heavy, I will opt for semi-flexible shell material. The patient will not have an issue tolerating such
material. I would also have the lab apply a medial arch for support. She does not have an arch
when weight-bearing.

7. Versatility and Compatibility:

A custom insert could be swapped and used on other shoes when a patient gets a custom
insert. They should fit any closed-toed tennis shoes without any difficulty. Some patients may
opt for more pairs if swapping them for different shoes are cumbersome.


Orthotics have proven to be valuable in managing and relieving heel pain. With their ability to
provide proper support, correct abnormal foot mechanics, and reduce pressure and strain on
the heel, orthotics offer significant benefits for individuals suffering from heel pain. The
customized nature of orthotic inserts ensures a personalized fit, enhancing their effectiveness
and promoting individual comfort. Orthotics are vital in alleviating heel pain and helping the
healing process by improving foot biomechanics, reducing shock impact, and optimizing foot
function. Incorporating orthotics into daily activities can lead to a pain-free and active lifestyle,
promoting overall foot health and well-being.