Why Does It Matter Which Shoe The Lift Goes In?
A heel lift raises the rear of the foot inside the shoe.
When equal lifts are placed beneath both heels, the person’s overall heel height changes without deliberately making one leg higher than the other.
When a lift is placed in only one shoe, it creates or alters a difference between the two sides. This may affect:
- Pelvic position
- Step length
- Walking balance
- Pressure beneath each foot
- Knee and hip movement
- Comfort through the lower back
- How securely each heel sits inside its shoe
A one-sided lift can be appropriate when it addresses a measured clinical requirement. It should not normally be used simply because pain occurs on only one side.
Should You Wear Both Heel Lifts For Achilles Tendon Pain?
Usually, yes.
When heel lifts are used to reduce ankle dorsiflexion and temporarily offload an irritated Achilles tendon, equal heights are commonly worn in both shoes.
This remains the case even when only one Achilles tendon is painful.
Using matching lifts may:
- Maintain similar leg height on both sides
- Reduce the risk of creating an artificial imbalance
- Make walking feel more symmetrical
- Provide a similar footwear position for both feet
- Reduce Achilles loading without deliberately altering leg length
NHS Achilles-tendinopathy guidance specifically advises placing a heel lift in both shoes even when symptoms affect only one tendon.
Heel lifts may be used temporarily to reduce ankle dorsiflexion during activity, although progressive tendon-loading rehabilitation remains important for longer-term recovery.
Why Use Both If Only One Side Hurts?
Pain on one side does not necessarily mean that only that leg should be elevated.
The aim of the heel lift in this situation is to alter ankle position and loading rather than correct a difference in leg length.
Placing a lift only beneath the painful side may:
- Make that leg functionally higher
- Change the person’s walking pattern
- Create an uneven feeling
- Transfer pressure towards the opposite side
- Cause new discomfort elsewhere
Equal lifts allow both feet to sit at a similar height while the painful tendon receives the intended reduction in ankle dorsiflexion.
What About Insertional Achilles Tendinopathy?
Insertional Achilles tendinopathy affects the point where the tendon attaches to the heel bone.
Greater ankle dorsiflexion may increase compression around this area. Raising both heels can reduce how far the ankle moves upwards during standing and walking.
The lift should still be treated as a supportive tool rather than a complete treatment. Rehabilitation may also include:
- Progressive calf strengthening
- Temporary modification of aggravating activity
- Avoiding excessive heel-drop positions initially
- Supportive footwear
- Gradual return to higher-load activity
- Clinical assessment where symptoms persist
Matching lifts are generally preferable unless a clinician has identified another reason for using different heights.
Should You Wear Both Heel Lifts For Plantar Fasciitis?
When heel lifts are being trialled for general heel comfort or to alter tension through the calf and sole of the foot, using equal heights in both shoes is often the more balanced starting point.
This avoids deliberately changing the relative length of the legs.
However, heel lifts are not a universal treatment for plantar fasciitis. Depending on the cause of the symptoms, a person may benefit more from:
- Heel cushioning
- Arch support
- A full-length orthotic
- Supportive footwear
- Plantar-fascia stretching
- Calf stretching
- Activity modification
- A night splint for persistent first-step pain
The NHS includes suitable footwear, insoles and heel pads among the options that may help plantar-fasciitis symptoms, but treatment should reflect the individual presentation rather than relying on heel elevation alone.
When Should A Heel Lift Be Worn In Only One Shoe?
A one-sided heel lift may be appropriate where a genuine leg-length difference has been assessed.
In this situation, the lift is normally placed beneath the shorter side to reduce part or all of the measured difference.
A clinician may consider:
- The measured structural difference
- Whether the difference is causing symptoms
- Pelvic and spinal position
- Foot posture
- Joint movement
- Previous surgery or injury
- Existing footwear
- How much correction can fit safely inside the shoe
NHS orthotic guidance confirms that wearing a heel lift in one shoe can help manage symptoms associated with an assessed leg-length discrepancy.
How Do You Know Which Leg Is Shorter?
It is difficult to assess leg length accurately at home.
A person may feel uneven because of:
- Pelvic tilt
- Foot pronation
- Hip or knee position
- Muscle tightness
- Joint stiffness
- Previous injury
- Scoliosis or spinal position
- Differences in footwear
- A true structural leg-length difference
Standing in front of a mirror or noticing that one trouser leg appears longer is not enough to identify the cause.
A clinician may assess leg length using:
- Physical measurements
- Standing observation
- Block testing
- Walking assessment
- Joint examination
- Imaging where clinically necessary
This helps determine whether a heel lift is appropriate and which side requires it.
Can You Correct The Entire Difference?
Not always.
The amount of correction required depends on the size of the difference, symptoms and how the person adapts.
Some people tolerate a partial correction more comfortably than an immediate full correction. A clinician may therefore introduce elevation gradually.
The available space inside the shoe also limits how much height can be added internally. A large lift may:
- Push the heel out of the shoe
- Cause rubbing around the heel counter
- Increase pressure beneath the forefoot
- Make the footwear unstable
- Reduce room for the toes
Larger corrections may require an external footwear raise or another professional adaptation rather than placing an increasingly thick insert inside the shoe. NHS orthotic services provide external raises and other footwear modifications where clinically required.
Can You Wear Different Heights In Each Shoe?
Potentially, but normally only where there is a clear clinical reason.
Different heights may be prescribed where:
- A leg-length discrepancy has been measured
- The required correction differs between the sides
- A rehabilitation programme requires a specific arrangement
- An orthotist or podiatrist has provided an individual prescription
For Achilles symptoms or general heel elevation, matching heights are usually preferable.
Do not independently use different lift heights simply because one side feels more painful. Pain intensity does not reliably indicate how much elevation each leg requires.
What If The Product Is Supplied As A Pair?
A product being supplied as a pair does not mean both lifts must be used for every clinical purpose.
For Achilles discomfort or bilateral heel elevation, the pair is normally used together at matching heights.
For an assessed leg-length difference, a clinician may advise using only one lift. The unused device can be retained as a replacement or used in another pair of shoes where appropriate.
The Orthotix 5 Layer Heel Elevator is supplied as a pair and provides adjustable elevation from approximately 3 mm to 15 mm through removable layers.
Should Both Lifts Have The Same Number Of Layers?
For Achilles symptoms or general bilateral use, yes.
Each lift should normally contain the same number of layers so the elevation remains equal.
Before fitting them:
- Count the layers on each lift.
- Remove layers from the underside.
- Make sure both sides remain the same height.
- Position them securely beneath each heel.
- Check that both shoes still fit properly.
For a professionally assessed leg-length difference, the number of layers may intentionally differ or only one lift may be used.
How Much Height Should You Start With?
More height is not automatically more effective.
An adjustable heel lift allows the elevation to be reduced in stages. A modest starting height may be easier to tolerate when no specific measurement has been prescribed.
The appropriate height depends on:
- Why the lift is being used
- Footwear depth
- Achilles or heel symptoms
- Ankle mobility
- Calf tightness
- Stability
- Body weight
- Activity requirements
- Whether one or both sides are being treated
The dedicated guide explains this further:
How Much Heel Lift Should You Use?
What Happens If You Use Only One Lift Unnecessarily?
Using a heel lift on one side changes the relative height of the two legs.
If there is no genuine reason for that change, possible effects may include:
- Uneven walking
- A feeling of being tilted
- Pelvic discomfort
- New knee or hip symptoms
- Lower-back discomfort
- Increased pressure beneath one foot
- Reduced stability
- Different wear patterns between shoes
Some people may tolerate a small difference without obvious symptoms, but unnecessary unilateral elevation provides no clear advantage and can complicate the original problem.
Can One-Sided Pain Still Require Two Lifts?
Yes.
This is particularly relevant for Achilles symptoms.
A person may have pain only on the left side but still use matching lifts in both shoes because the goal is to reduce ankle dorsiflexion without creating a leg-length difference.
The painful side may receive the intended unloading while the opposite lift maintains balance between the legs.
This is different from correcting a true leg-length discrepancy, where the purpose is specifically to alter the difference between the two sides.
What Footwear Works Best With A Pair Of Heel Lifts?
Both shoes must have enough room to accommodate the added height.
Look for footwear with:
- A closed and secure heel
- Lace, strap or hook-and-loop fastening
- Adequate heel depth
- Sufficient toe room
- A stable sole
- A firm heel counter
- Enough width for the foot
- Removable liners where additional room is required
The heel should remain securely inside the shoe after the lift is added.
If the lifts cause both heels to slip, the footwear may be too shallow or the selected lift may be too high.
Where Should The Heel Lifts Sit?
Each lift should be positioned centrally beneath the heel.
It should:
- Sit flat
- Remain stable
- Avoid curling at the edges
- Support the heel evenly
- Avoid moving from side to side
- Feel consistent during every step
Depending on the shoe and product instructions, the lift may sit on top of or beneath the existing liner.
When using a pair, check both shoes rather than assuming they have identical internal space or construction.
How Should You Introduce Heel Lifts?
Introduce both lifts gradually.
A practical approach is to:
- Wear them during a short period of ordinary walking.
- Check for heel slippage, rubbing or pressure.
- Increase wear time as comfort allows.
- Become comfortable before using them during a full work shift.
- Avoid first testing them during running or demanding exercise.
- Monitor for new discomfort elsewhere.
Heel lifts alter foot position immediately, but the wearer may still need time to adapt to the change.
Can You Transfer The Lifts Between Shoes?
Yes, provided each pair of shoes has suitable depth and support.
Before transferring them, check that:
- They sit securely in the new footwear
- Both shoes accommodate the same height
- The heel remains stable
- The lift does not move
- The shoe can still fasten securely
- Toe space remains adequate
A lift that fits comfortably inside trainers may not work equally well in shallow formal footwear.
Can You Use Heel Lifts With Orthotic Insoles?
Potentially, but combining inserts requires enough space inside the shoes.
Adding a heel lift to an orthotic can:
- Increase overall heel height
- Change where the arch support contacts the foot
- Reduce shoe depth
- Push the heel upwards
- Increase forefoot pressure
- Affect stability
Where both functions are required, an orthotic with an incorporated heel raise may provide a more stable option than stacking several separate products.
Professional assessment is sensible where substantial elevation and biomechanical support are both needed.
How Long Should You Wear Both Lifts?
The duration depends on why they are being used.
For Achilles symptoms, lifts may be used temporarily while pain is managed and tendon rehabilitation progresses. Current clinical guidance permits their use as a temporary tool to reduce dorsiflexion during activity.
For a leg-length difference, ongoing use may be recommended if the lift remains clinically appropriate and beneficial.
Regularly review:
- Whether symptoms are improving
- Whether the heel height remains necessary
- The condition of the material
- Shoe fit
- Wear or compression
- Changes in mobility or activity
Do not assume that the same height must be used indefinitely without review.
Why Choose The 5 Layer Heel Elevator?
The 5 Layer Heel Elevator (Mid Density) provides adjustable elevation through removable EVA layers.
Its features include:
- Five peel-away layers
- Adjustment from approximately 15 mm to 3 mm
- Adhesive layers for stability
- A non-slip top surface
- Compact placement beneath the heel
- Multiple size options
- Supplied as a pair
The paired design makes it suitable where equal bilateral elevation is required, while the adjustable layers allow the selected height to be reduced gradually.
The Key Takeaway
Whether heel lifts should be worn in both shoes depends on their purpose.
Wear matching lifts in both shoes when they are being used for:
- Achilles tendon symptoms
- General bilateral heel elevation
- Reducing ankle dorsiflexion without changing leg length
- Comfort in footwear that feels excessively flat
Use a lift in one shoe only when:
- A genuine leg-length difference has been assessed
- The shorter side has been identified
- A healthcare professional has advised unilateral correction
Do not place a lift beneath only the painful side without considering why the device is being used. Equal lifts generally preserve balance, while one-sided elevation intentionally changes the relationship between the legs.
