Fat-pad atrophy — the natural thinning of the heel’s protective padding that accelerates after age 50 — is the most common cause of heel pain we diagnose in patients over 60. ZenToes Gel Heel Pillow Cushions aren’t for biomechanical heel pain; they’re a literal pillow of medical-grade TPE gel that replaces lost fat pad thickness. At 10mm thick, they take up significant shoe room, so expect to swap to a half-size-up shoe. But for the right patient — thin-heeled, bruised-feeling with every barefoot step — nothing else feels better. They’re also ideal for the first 2 weeks after heel surgery when the wound needs cushioning without pressure. Hand-wash with soap and water. Replace at 4-6 months.

When the issue is actual heel pain — not shoe fit — a silicone gel heel cup is the OTC first line. The Sof Sole uses medical-grade silicone that provides roughly 3x the shock absorption of foam while distributing pressure laterally away from the central calcaneal tubercle (where plantar fasciitis pain originates). The cupped shape matters: it reflects heel-strike force back up into the fat pad instead of letting it shear sideways. I use these in the first 4-6 weeks of plantar fasciitis rehab, paired with a full arch-support insole for daytime and a night splint overnight. The silicone is dishwasher-safe and typically lasts 6+ months of daily wear before flattening. Sizing: women’s 5-10 / men’s 7-12 fit the standard size.

Dr. Scholl’s Heel Liners earn their place as a closet staple for a specific reason: they solve the most common heel complaint in women’s dress shoes, which is shoe slippage causing blisters on the Achilles. The suede-top, adhesive-back design sits in the back of the heel counter and eliminates vertical slip without bulking up the toe box the way a full-length insole would. The open-cell foam absorbs about 40% of heel-strike impact — modest but meaningful if you’re walking concrete on lunch breaks. I recommend these any time a patient has a shoe they love that runs half a size large. Replace every 30 days; they compress with use. Not for true heel pain (plantar fasciitis, heel spurs, bursitis) — those need arch-engagement, not a passive pad.