When we think about treating plantar fasciitis, our minds often go straight to stretching, footwear, and orthotics—and rightly so. But there’s one underrated gem I keep reaching for in my practice: the humble heel cup.
No, it won’t cure plantar fasciitis on its own. But when used as part of a well-rounded care plan, a heel cup can offer immediate symptom relief and support healing over time.
Let’s dig into how and why this little device works—and what to look for when choosing one.
First, What Exactly Does a Heel Cup Do?
A heel cup is a contoured insert that sits under the heel inside the shoe. It may look simple, but the right design can reduce pain through two key mechanisms:
1. It Lifts the Heel—Reducing Tension on the Plantar Fascia
That slight elevation shortens the effective length of the plantar fascia, reducing the amount of strain it experiences with every step.
This means fewer microtears, especially at the insertion point on the calcaneus, where most plantar fasciitis pain lives.
2. It Absorbs Shock—Minimizing Repetitive Impact
During gait, the heel strikes the ground with significant force. For people with plantar fasciitis, that impact travels straight to an already-irritated fascia.
A well-cushioned heel cup helps absorb and diffuse this energy, reducing the daily trauma that contributes to ongoing pain and inflammation.
Bonus Benefits:
- Fat Pad Preservation: In older adults or high-mileage walkers, the natural heel fat pad may thin. A heel cup helps centralize and supplement this cushioning.
- Pressure Redistribution: Rather than letting all the force land on the most tender point, heel cups spread pressure across a broader surface.
Best Materials for Heel Cups in Clinical Use
Not all heel cups are created equal. For medical foot care settings, I recommend:
1. Poron® (Polyurethane Foam)
- Why it’s great: Excellent shock absorption, high rebound (resists flattening), breathable.
- Ideal for: Clients needing long-term cushioning that won’t degrade.
- Pro tip: A 6mm horseshoe-shaped Poron pad is fantastic under the heel. Layer with Hypafix or Cambrelle if needed.
2. Silicone Gel
- Why it’s great: Soft, dense, and very conformable. Mimics natural fat pad feel.
- Ideal for: Diabetic clients or those needing extra softness and pressure redistribution.
- Watch out: Can trap moisture—avoid in macerated or high-sweat clients unless used with wicking socks.
3. Thermoplastic Rubber or EVA Composites
- Why they work: Slightly firmer, offering both cushioning and mild control.
- Ideal for: Athletic populations or clients who need durability and stability.
Tips for Fitting and Use
- Choose the correct size—too small and it won’t cradle the heel; too large and it may crowd the shoe.
- Advise clients to wear heel cups in both shoes, even if only one foot hurts, to avoid creating a leg length discrepancy.
- Heel cups should always be used in conjunction with proper footwear, not flimsy flats or unsupportive slippers.
Final Thoughts for Nurses:
A heel cup might seem basic, but when it comes to relieving plantar fasciitis pain, it can punch well above its weight. It’s affordable, easy to implement, and incredibly helpful when used alongside stretching, strengthening, and footwear education.
In my experience, the right materials—especially Poron—can make a world of difference in comfort and recovery.
Bottom line? The next time you’re treating a client with heel pain, don’t overlook the power of a well-placed heel cup. It might just become your new go-to.
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