What Is The Main Difference?
The main difference is the area supported and the purpose of the device.
A heel lift sits beneath the rear of the foot and raises the heel by a controlled amount.
An orthotic insole normally extends beneath the arch or the entire foot and is designed to provide broader support, stability or pressure redistribution.
Although both products sit inside footwear, they should not be treated as interchangeable.
What Does A Heel Lift Do?
A heel lift raises the heel relative to the front of the foot.
Depending on why it is being used, this may:
- Reduce the amount of ankle dorsiflexion required during walking
- Alter tension through the calf and Achilles tendon
- Reduce compression around the back of the heel
- Provide local cushioning beneath the heel
- Make very flat footwear feel more comfortable
- Compensate for a professionally assessed leg-length difference
For insertional Achilles tendinopathy, NHS guidance notes that heel elevation can reduce compression and tension through the tendon.
A heel lift influences the position of the foot only while it is being worn. It does not permanently alter leg length, posture or foot structure.
What Does An Orthotic Insole Do?
An orthotic insole supports a larger area beneath the foot.
Depending on its design, it may help:
- Support the arch
- Stabilise the rearfoot
- Redistribute pressure
- Reduce loading through painful areas
- Influence excessive foot movement
- Cushion the heel and forefoot
- Improve comfort during prolonged standing or walking
Orthotic insoles are often used as one element of a wider care plan alongside rehabilitation, footwear changes and activity management.
Some are soft and primarily cushioning, while others are more structured and designed to influence foot mechanics.
Heel Lift vs Orthotic Insole At A Glance
A Heel Lift Primarily Provides
- Heel elevation
- A change in ankle position
- Local rearfoot cushioning
- Temporary reduction in Achilles loading
- Adjustment for selected leg-length differences
- A compact fit inside footwear
An Orthotic Insole Primarily Provides
- Arch support
- Rearfoot stability
- Pressure redistribution
- Wider support beneath the foot
- Management of excessive pronation where relevant
- Heel and forefoot cushioning depending on the design
The correct choice depends on the intended purpose rather than simply where pain is felt.
Which Is Better For Plantar Fasciitis?
Neither option is automatically best for every person with plantar fasciitis.
NHS guidance recommends footwear with cushioned heels and good arch support and suggests that insoles or heel pads may help.
A Heel Lift May Be Considered When
- Completely flat footwear aggravates symptoms
- Calf or Achilles tightness accompanies the heel pain
- Local heel cushioning improves comfort
- A modest change in heel height has been recommended
- There is a separate assessed leg-length difference
An Orthotic Insole May Be Considered When
- The arch requires additional support
- Low arches or excessive inward movement contribute to symptoms
- A flat cushioning insert provides insufficient stability
- Pressure needs to be redistributed across the foot
- Symptoms repeatedly return during prolonged standing or walking
A structured orthotic may be the more logical option where broader support is required. A heel lift may be more relevant where the purpose is specifically to elevate the heel.
Which Is Better For Achilles Tendon Pain?
A heel lift may be more directly relevant because it changes heel height and reduces how far the ankle moves upwards during walking.
For insertional Achilles tendinopathy, heel elevation may reduce compression where the tendon attaches to the heel. Equal raises are generally used in both shoes for this purpose.
An orthotic insole may still be considered where Achilles symptoms occur alongside:
- Low or high arches
- Excessive foot movement
- Poor rearfoot stability
- Uneven pressure distribution
- A broader requirement for arch support
The Royal National Orthopaedic Hospital notes that an orthotic may be appropriate where altered foot biomechanics are present alongside Achilles tendinopathy.
Neither device should replace progressive rehabilitation where tendon strengthening and load management are required.
Which Is Better For A Leg-Length Difference?
A heel lift may be used where a genuine leg-length difference has been measured and a healthcare professional has recommended partial or full compensation.
The lift is usually placed beneath the shorter side.
However, perceived unevenness does not always mean that one leg is structurally shorter. Differences can also appear because of:
- Pelvic position
- Foot posture
- Joint stiffness
- Muscle imbalance
- Previous injury
- Spinal or hip conditions
For this reason, a one-sided heel lift should not be selected purely through self-observation.
An orthotic may be used alongside or instead of a lift where the asymmetry also involves foot posture, pressure or stability.
Which Is Better For Overpronation Or Low Arches?
An orthotic insole is generally more suitable because it can provide structured support beneath the arch and rearfoot.
A heel lift raises the foot but does not normally provide meaningful support beneath the midfoot.
The Bio Advanced Full Length Insole, for example, is a flexible EVA orthotic with intrinsic rearfoot support, a metatarsal raise and targeted midfoot features. It can also be heat-moulded, ground or trimmed where professional modification is required.
Structured orthotic option:
Bio Advanced Full Length Insole
Which Is Better For General Heel Cushioning?
Where the main issue is discomfort from hard flooring or repeated impact, neither a high heel lift nor a firm orthotic may be necessary.
A cushioning insole or heel pad may provide:
- Shock absorption
- Softer heel contact
- Pressure relief
- Greater comfort during prolonged standing
- Cushioning without substantially altering heel height
The NHS includes cushioned heels, heel pads and insoles among self-management options for plantar fasciitis.
This is why the correct question is not always “heel lift or orthotic?” Sometimes a simpler cushioning product may be more appropriate.
Can An Orthotic Include A Heel Lift?
Yes.
Some orthotic insoles include built-in heel elevation or can be modified with an additional heel-lift component.
The Bio Advanced Full Length Insole is supplied with customisation components that include heel lifts, heel cushions and wedges.
Combining the functions into one device may provide:
- Arch support
- Rearfoot control
- Heel elevation
- Broader pressure distribution
- A smoother transition beneath the foot
Professional modification is preferable where substantial height or biomechanical adjustment is required.
Can You Wear A Separate Heel Lift With An Orthotic?
Potentially, but the combination must fit securely inside the shoe.
Adding a heel lift beneath or above an orthotic can:
- Raise the heel further
- Change how the arch support contacts the foot
- Reduce available shoe depth
- Push the heel towards the top of the shoe
- Increase forefoot pressure
- Make the footwear feel unstable
Where both are needed, check that:
- The orthotic remains flat
- The heel lift cannot move
- The heel remains securely held
- The toes are not compressed
- The shoe still fastens properly
- The combination does not create excessive pressure
A single orthotic incorporating the required lift may be more stable than stacking several separate inserts.
Full-Length vs Three-Quarter-Length Orthotics
Orthotic insoles are available in different lengths.
Full-Length Orthotics
These extend from the heel to the toes and may provide:
- Cushioning beneath the entire foot
- Arch and rearfoot support
- Forefoot pressure distribution
- A continuous surface inside the shoe
They usually require footwear with adequate depth or a removable liner.
Three-Quarter-Length Orthotics
These finish behind the forefoot and may be easier to fit inside:
- Formal shoes
- Shallower footwear
- Shoes without removable liners
- Footwear with limited toe-box space
A separate heel lift occupies less room than either type, but it also provides less overall foot support.
How Much Space Do They Take Inside Shoes?
A heel lift is compact but raises the rear of the foot. An orthotic takes up more surface area and may also reduce internal shoe depth.
Suitable footwear should ideally provide:
- A secure fastening
- A stable heel counter
- Adequate internal depth
- Sufficient width
- Enough toe room
- A removable liner where possible
- A supportive sole
The shoe and insert must work together. A clinically suitable device can still become uncomfortable when placed inside footwear that is too shallow, narrow or loose.
Should Heel Lifts Be Worn In Both Shoes?
For Achilles symptoms or general bilateral heel elevation, equal lifts are commonly worn in both shoes to avoid unintentionally creating a difference between the two sides.
For a measured leg-length difference, a lift may be used only on one side.
Orthotic insoles are also commonly supplied as a pair, although the support or modifications may differ between feet where professionally prescribed.
Dedicated guide:
Should You Wear Heel Lifts In Both Shoes?
should you wear heel lifts in both shoes
How Long Does It Take To Adjust?
Both heel lifts and orthotic insoles may feel unfamiliar initially.
NHS orthotic guidance recommends introducing insoles gradually, beginning with around one hour and increasing wear over approximately one to two weeks.
A similar gradual approach is sensible with a heel lift:
- Begin during ordinary walking.
- Wear it for a short period.
- Check for rubbing, pressure or instability.
- Increase wear as comfort allows.
- Avoid immediately testing it during a long shift or demanding exercise.
Stop using the device if it causes severe pain or symptoms that continue to worsen.
Why Choose The 5 Layer Heel Elevator?
The 5 Layer Heel Elevator (Mid Density) is designed for situations where adjustable heel elevation is required.
Key features include:
- Five peel-away layers
- Adjustable height from approximately 15 mm to 3 mm
- EVA foam construction
- Non-slip top cover
- Adhesive layers for stability
- Compact design
- Supplied as a pair
- Latex-free construction
The removable layers allow heel height to be adjusted in approximately 3 mm stages.
Product:
When Might The Bio Advanced Insole Be More Appropriate?
The Bio Advanced Full Length Insole may be more appropriate where the main requirement is structured support rather than heel elevation alone.
It provides:
- Full-length support
- Flexible EVA construction
- Multiple density options
- Intrinsic rearfoot support
- A metatarsal raise
- Targeted midfoot support
- Heat-mouldable and grindable construction
- Additional customisation components
Orthotix lists it for concerns including plantar fasciitis, overpronation, flat feet, pressure relief and tired feet.
Product:
Bio Advanced Full Length Insole
The Key Takeaway
A heel lift and an orthotic insole are not competing versions of the same product.
Choose a heel lift when the primary objective is:
- Raising the heel
- Reducing ankle dorsiflexion
- Temporarily reducing Achilles tension
- Adjusting a measured leg-length difference
Choose an orthotic insole when the primary objective is:
- Supporting the arch
- Stabilising the foot
- Redistributing pressure
- Managing excessive movement
- Providing support across a larger area
Some people need cushioning alone, while others may benefit from an orthotic that incorporates heel elevation. The device should match the underlying requirement rather than being chosen solely according to where pain is felt.
