A posted heel is a wedge-shaped correction built into the underside of a custom orthotic's heel, and it plays a much bigger role than most people realize. Instead of simply cushioning your foot, this feature actively changes the angle at which your heel strikes the ground. As a result, it can relieve chronic pain, correct structural imbalances, and slow down the wear-and-tear pattern that leads to conditions like plantar fasciitis and heel spurs. In this guide, we'll explain exactly what a posted heel does, how it's fitted, and who benefits most from it.
What Is a Posted Heel?
A posted heel is a rigid or semi-rigid wedge attached to the heel section of an orthotic device that tilts the foot inward or outward before it fully contacts the ground. In simple terms, it works like a small shim that redirects the way weight travels through your foot. Specifically, this correction happens at the rearfoot, meaning the heel and ankle area, before the misalignment can travel up into the knees and hips.
Orthotics themselves are custom-made shoe inserts shaped from an individual's foot, unlike generic store-bought insoles. According to Wikipedia's overview of orthotics, these devices are designed to support, align, or correct the function of movable body parts. A posted heel takes that concept further by adding a precise angle rather than just a flat supportive shape. For a deeper technical breakdown, our complete guide to rearfoot posting covers the mechanics in more detail.
A posted heel adds a corrective wedge that changes how the foot contacts the ground.
How a Heel Post Corrects Foot Alignment
A heel post corrects alignment by controlling the direction and speed of the foot's natural rolling motion, known as pronation. Normally, the foot rolls slightly inward when you step, but excessive rolling, called overpronation, puts strain on the arch, ankle, and lower leg. Consequently, a medial posted heel adds material to the inner edge of the orthotic to slow that inward roll.
In contrast, a lateral posted heel addresses the opposite problem, supination, where the foot rolls outward and places excess pressure on the outer edge. Furthermore, because everyone's gait pattern is different, the exact posting angle must be measured individually rather than applied generically. This is precisely why off-the-shelf inserts rarely solve rearfoot alignment problems the way a custom-molded device can.
Who Needs Posted Heel Orthotics?
People who experience uneven shoe wear, chronic heel pain, or a visible inward or outward tilt when they walk are often good candidates for posted heel orthotics. In particular, this feature is frequently recommended for plantar fasciitis, heel spurs, flat feet, and general rearfoot instability. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, plantar fasciitis is one of the most common causes of heel pain, and correcting mechanical strain is a key part of managing it.
The American Podiatric Medical Association estimates that roughly 75% of Americans will experience some type of foot health problem in their lifetime, and structural misalignment is a leading contributor. As a result, many of these cases respond well to targeted correction rather than generic cushioning. If heel spurs are part of your specific concern, our article on custom orthotic solutions for heel spurs explains how posting factors into treatment.
Types of Posted Heel Orthotics
Not every posted heel orthotic looks the same, since length and coverage vary based on the patient's needs and footwear. Below are three common configurations offered through a custom fabrication process.
- Full-length orthotics with heel post — ideal for maximum support across the entire foot, often used for athletic or high-impact activity.
- Three-quarter length orthotics with heel post — a versatile option that fits well in dress shoes while still correcting rearfoot motion.
- Sulcus length orthotics with heel post — extends slightly further forward for added forefoot contact, often recommended for diabetic or sensitive feet.
How Custom Orthotics Are Fitted With a Posted Heel
Fitting a posted heel correctly requires more than guesswork; it follows a specific clinical process. Here is how it typically works from start to finish.
- Initial consultation and gait assessment: A podiatrist reviews your medical history and watches you walk to identify abnormal foot motion that a posted heel could correct.
- Casting a mold of the foot: A precise mold or digital scan of each foot is taken while it is held in a neutral position, capturing the exact shape needed for a custom orthotic.
- Determining the posting angle: Using the gait analysis and mold, the podiatrist calculates the medial or lateral posting angle required for your specific alignment issue.
- Fabricating the orthotic: Skilled technicians build the wedge directly into the heel of the orthotic shell using durable materials that hold the corrective angle.
- Fitting and final adjustments: The finished orthotic is fitted into your shoes, checked for comfort, and refined during a follow-up visit if needed.
A gait assessment helps determine the correct posted heel angle before fabrication begins.
Posted Heel vs. Standard Orthotic Heel Cups
It helps to see the difference side by side, since these two features are often confused. A standard heel cup mainly cushions, while a posted heel actively corrects motion.
| Feature | Standard Heel Cup | Posted Heel |
|---|---|---|
| Primary function | Cushioning and shock absorption | Corrects foot angle and motion |
| Customization level | Generic fit | Individually measured angle |
| Best for | Mild discomfort or general support | Overpronation, supination, structural pain |
Common Mistakes to Avoid With Posted Heel Orthotics
Even a well-made posted heel orthotic can underperform if it's not used correctly. For example, switching straight from regular shoes to posted orthotics without a break-in period often causes soreness that people mistake for a poor fit. Similarly, wearing them in shoes without enough internal depth or heel stability can prevent the posting from working as intended.
Above all, skipping the follow-up fitting appointment is a mistake worth avoiding, since minor posting adjustments are common after the first few weeks of wear. Therefore, it's worth discussing your progress with your podiatrist rather than assuming the initial fit is final. You can learn more or start a consultation directly through customorthotics.com.
Custom orthotics with a posted heel are built individually for each patient's foot mold.
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This podiatrist-owned practice has more than 20 years of experience fabricating fully custom orthotics from individual foot molds, backed by an A+ Better Business Bureau rating. Call for a complimentary consultation or order online through customorthotics.com.
Frequently Asked Questions About Posted Heel Orthotics
What is a posted heel?
A posted heel is a wedge built into the heel of a custom orthotic that tilts the foot inward or outward to correct abnormal motion. It is designed to control the rearfoot before misalignment travels up the leg.
How does a posted heel correct overpronation?
A posted heel adds a wedge on the inner edge of the orthotic, which slows down the inward rolling motion of the foot during walking or running. This reduces stress on the arch, ankle, and knee joints.
Why do podiatrists recommend posted heel orthotics?
Podiatrists recommend posted heel orthotics because they address the root cause of biomechanical pain rather than just cushioning the foot. This targeted correction often prevents secondary issues in the knees and hips.
What is the difference between a posted heel and a standard heel cup?
A standard heel cup only cushions and cradles the heel, while a posted heel actively changes the angle of foot contact with the ground. The posted version is a corrective feature, not just a comfort feature.
How much do posted heel orthotics cost?
Custom posted heel orthotics typically cost more than off-the-shelf inserts because they require a mold of your individual foot and hands-on fabrication. Pricing varies by provider, materials, and posting complexity, so a consultation is the best way to get an accurate quote.
How long does it take to get used to posted heel orthotics?
Most people adjust to posted heel orthotics within one to two weeks of gradual wear. Starting with a few hours per day and slowly increasing use helps the foot adapt comfortably.
What conditions benefit from a posted heel?
Posted heel orthotics commonly help with plantar fasciitis, heel spurs, overpronation, flat feet, and general rearfoot instability. They are especially useful for conditions caused by uneven weight distribution.
Can a posted heel be added to any orthotic?
A posted heel can be added to most custom orthotic designs, including full-length, three-quarter-length, and sulcus-length devices. However, the exact posting angle must be customized to each patient's gait.
What's the difference between medial and lateral heel posting?
Medial posting adds material on the inner side of the heel to control overpronation, while lateral posting adds material on the outer side to control supination. The correct choice depends entirely on a person's individual gait pattern.
What common mistakes do people make with posted heel orthotics?
A common mistake is switching to posted heel orthotics too quickly instead of breaking them in gradually. Another mistake is wearing them in shoes that don't have enough depth or stability to support the posting correctly.
How are posted heel orthotics fitted?
Fitting posted heel orthotics involves a gait assessment, a mold of the foot, and biomechanical analysis to determine the correct posting angle. The orthotic is then fabricated and adjusted during a follow-up fitting.
Are posted heel orthotics covered by insurance?
Some insurance plans cover custom orthotics with a posted heel when prescribed for a diagnosed medical condition. Coverage varies widely, so it's worth checking with your provider before ordering.
How do I know if I need a posted heel?
Signs you may need a posted heel include uneven shoe wear, chronic heel or arch pain, and a visible inward or outward roll of the ankle when walking. A podiatrist can confirm the need through a gait and mold assessment.
Final Thoughts on Posted Heel Orthotics
In summary, a posted heel is far more than a comfort feature; it's a targeted correction that changes how your foot strikes the ground and reduces strain throughout the lower body. Whether you're dealing with plantar fasciitis, heel spurs, or general overpronation, this posting technique addresses the mechanical cause rather than masking the symptom. Consequently, working with an experienced podiatrist to determine the correct posting angle can make the difference between temporary relief and lasting comfort. If you suspect a posted heel could help your specific foot condition, reach out for a complimentary consultation through customorthotics.com to take the first step toward pain-free movement.