Three types of heel cups, two rubber and one plastic, were evaluated i
n this study. The vertical forces under the heel were monitored using
the Computer Dyno Graphy system in 16 normal subjects. Peak force redu
ction in walking and running after heel cup use was found for all thre
e types of heel cups. The shock absorbency (peak force reduction as a
ratio) of heel cups was better in walking (3.5 km h(-1)) than in runni
ng (10 km h(-1)). Pressure-sensitive film under the heel revealed that
the pressure concentration at the location of calcaneal tuberosity co
uld be smoothed out by the use of heel cups. When plastic heel cups we
re used, pedobarography showed that the contact area of the heel while
standing decreased to 61% of that when barefoot. Roentgenographic stu
dy in six patients with heel pain syndrome showed that the thickness o
f the heel pad increased from 14.4 mm (SD 1.4 mm) to 17.0 mm (SD 1.2 m
m) when plastic heel cups were used. Relevance Rubber and plastic heel
cups increase the shock absorption of the heel through different mech
anisms. Rubber heel cups act as an external shock absorber, while plas
tic heel cups increase the internal shock absorption by confining the
heel pad. We recommend rubber heel cups for patients with heel pain du
e to inflammation, and plastic heel cups for those with atrophy of the
heel pad.