Shoe inserts fall into four groups. Heel cups and heel cushions sit only under the heel and add cushioning where the foot first strikes the ground. Comfort gel insoles add a thin layer of cushioning under the heel and the ball of the foot. Arch supports are firmer and are shaped to hold up the arch. Offloading insoles use removable pegs so a clinician can take pressure off one spot on the bottom of the foot. The right one depends on where your foot is sore, what shoes you wear, and whether a clinician has asked you to offload a specific area. Everything below is in our heel cups and heel cushions and insoles and arch supports collections, and the details come from the manufacturers' listings.
Foot inserts at a glance
| Type | Where it sits | Feel | Good fit for | Examples we carry |
|---|---|---|---|---|
| Silicone heel cup | Heel only | Soft to medium, cupped edges | Long hours standing or walking; heel soreness | PediFix GelStep Heel Cups (Small to XXL) |
| Gel heel cushion | Heel only, flat | Soft, slim | Dress shoes and flats where a cup will not fit | Double-Action Gel Heel Cushion (ladies) |
| Achilles heel sleeve | Back of the heel | Gel pad in a fabric sleeve | Rubbing from shoe backs | PediFix Visco-GEL Achilles Heel Protector |
| Comfort gel insole | Heel to ball of foot (3/4 length) | Soft, thin | Heels, flats and boots | Clear Comfort Gel Insoles for Women |
| Arch support | 3/4 or full length | Firm, shaped arch | People who want more arch structure | Spenco Total Support; Orthotic Arch Supports 3/4 length |
| Peg offloading insole | Full length | Firm base with removable pegs | Use as directed by a clinician, often in a post-op or healing shoe | Darco Peg Assist; PressureOFF System 7 |
Heel cups and heel cushions
The PediFix GelStep heel cups are made of dual-durometer silicone: a medium-density body that absorbs impact and a softer blue zone under the heel. The "soft spur spot" versions place that softer zone where heel-spur and plantar fascia pain is usually felt; the "soft center spot" version centers it under the heel. They are uncovered, washable and reusable, and are sized by shoe size:
- Small: women's 4 to 7
- Medium (soft center spot)
- Large: women's 10.5 to 12, men's 9 to 11.5
- XL: women's 12 and up, men's 12 to 14.5
- XXL: men's 15 and up
If a cup feels too bulky in a slim shoe, a flat cushion is the alternative. The Double-Action Gel Heel Cushion uses a circular wave pattern to spread pressure and has a removable center disc, so you can take pressure off one sore spot. For rubbing at the back of the heel rather than underneath, the PediFix Visco-GEL Achilles Heel Protector is a slim sleeve with a gel pad that fits inside most shoes. See more from this brand on our PediFix page.
Comfort insoles and arch supports
A comfort insole is mainly about cushioning. The Clear Comfort Gel Insoles for Women are thin, 3/4 length and adhesive-backed, so they stay put in heels, flats and boots while leaving room for the toes; trim them to fit women's sizes 6 to 10.
An arch support adds structure. The Spenco Total Support Original has an arch support, a deep heel cup and a 3-pod cushioning system, and can be heat molded for a closer fit. The Orthotic Arch Supports are firm, 3/4 length, heat moldable and use a SpenCore cushioning layer. A 3/4 length insert usually fits more shoe styles than a full-length one because it stops before the toes.
Peg offloading insoles
Offloading insoles are a different category. They are used when a clinician wants to take pressure off one area on the bottom of the foot. The Darco Peg Assist insoles have removable pegs, a Poron cover and a stabilizer board that keeps the surrounding pegs from collapsing; the manufacturer lists them for use with the Darco Square Toe Med-Surg Shoe. Sizes run from women's small (4 to 6) to men's XL (12.5 to 14). The PressureOFF System 7 insoles are full length, come as a left or right foot, and also use removable pegs, for example the medium left (up to women's 10, men's 9). Ask your podiatrist or wound care nurse which pegs to remove.
Fit checklist
- Find the sore spot: under the heel, back of the heel, arch, or ball of the foot. Choose the insert that covers that area.
- Check your shoe: take the shoe's own insole out if it lifts out, and try the insert in the shoe you wear most.
- Pick by shoe size: heel cups and insoles are sized by shoe size, not foot length.
- Use a pair: put inserts in both shoes so both legs stay level, unless a clinician tells you otherwise.
- Break it in: wear firmer arch supports for a few hours at first and build up.
- Talk to a clinician first if you have diabetes, poor circulation, numbness or an open sore on your foot.
Frequently asked questions
What is the difference between a heel cup and an insole?
A heel cup sits only under the heel and is cupped to hold the heel's fat pad. An insole covers the heel and more of the foot, either 3/4 length or full length.
Can I wear heel cups in dress shoes?
Sometimes. Cups are thicker than flat cushions. If the heel slips out of the shoe, try a slim gel heel cushion or a thin 3/4 gel insole instead.
Can I use a peg offloading insole in any shoe?
Peg insoles are made for specific post-op or healing shoes, which the listing names. Use them the way your clinician directs.
For more on heel pain, read our plantar fasciitis night splints guide and shop night splints. If you have diabetes, see our diabetes foot care shopping guide, or browse the full foot care range.
This guide is general information, not medical advice. Talk with your doctor, podiatrist, nurse or therapist about what is right for you.