The effectiveness of raising the heel height of shoes to reduce heel pain in patients with calcaneal spurs.
Dwi Basuki Wibowo, Rudiansyah Harahap, Achmad Widodo and 2 others
PMID 29643574WHAT IT FOUND
Raising the heel by 2 cm shifted standing load away from the center of the heel.
After 8 weeks wearing custom shoes, pain decreased in 10, 3, and 3 participants, but there was no control group.
Key findings
01In 16 patients (23 feet), central heel load during standing was 14.32% of body weight at 0 cm, 1.36% at 2 cm, 0.91% at 3 cm, and 0.89% at 4 cm.
02After 8 weeks of wearing the custom shoes, pain decreased in 10 participants from 100% to 70%, in 3 participants from 70% to 30%, and in 3 participants by less than 30%, and none reported increased pain.
03The heel height change was delivered inside custom shoes that also had a flat insole and 7 mm EVA foam with 3 mm Poron cushioning, so heel height alone cannot be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 16 patients and 23 feet were studied, and the paper did not describe a control group, randomisation, or blinding. The heel height change was built into custom shoes that also had a flat insole and foam cushioning, so the effect of heel height alone cannot be separated. Force measurements were taken only while standing, so they may not show what happened during walking. The center of the heel sensor did not always sit exactly at the spur base. Pain outcomes were reported after 8 weeks without a comparison group.
The easy way to misread this
Do not conclude that raising heel height alone reduces heel pain. The shoes also had custom flat insoles and foam cushioning, and the study had no control group.