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Offloading Boot & Alternatives

A soft foam offloading boot that floats a patient’s heel in a zero pressure environment is oftentimes recommended to prevent and treat heel pressure ulcers.

A variety of other offloading options are available and include:

Heel Positioning Device (IV bags or rolled towels or sheets)

  • Provides some heel elevation but has no mechanism to ensure heel stays in proper position

  • Unlike an offloading boot, does not properly redistribute pressure which is required to protect the Achilles tendon

  • Can increase risk of heel pressure ulcers developing or worsening

Heel Protection Device (sheepskin, “bunny” boot, rigid splint)

  • Removes friction and shear

  • Provides no heel offloading

  • Can directly contribute to development and/or progression of heel pressure ulcers.

Pressure Reduction Mattress (higher-specification foam, active support or alternating-pressure active support mattress)

  • Can provide adequate pressure relief for patients who cannot be repositioned

  • May be an over-engineered solution for cooperative patients

  • Does not float the heel in a zero pressure environment


  • May slip out of place or compress, allowing heel to contact bed surface

  • May be suitable for short-term use with co-operative patients, per NPUAP recommendations

  • May not offload pressure from heel

  • Unlike an offloading boot, does not prevent plantar flexion contracture or lateral foot and leg rotation

Offloading Boot (foam-based, pillow-based, air-based)

  • Completely offloads pressure from heel

  • Floats heel in a pressure-free environment

  • Unlike foam boots, some materials may deflate or irritate the leg or injure the unaffected leg

Heelift® Suspension Boot is an example of a foam-based offloading boot that floats the heel while also providing useful patient comfort features such as:

  • Friction-free tricot backing to allow the cushioned leg to glide over sheets

  • Ventilation holes and open forefoot/ankle to promote air circulation and increase patient comfort

  • Soft breathable open celled foam to provide coolness and prevent irritation of the cushioned leg and to decrease the risk of injuring the patient’s unaffected leg

An offloading boot like Heelift also can provide other important advantages, including:

  • Forefoot support to prevent heel cord contracture

  • Proper positioning to avoid hip rotation

  • Custom padding to prevent foot drop and Achilles tendoniti

  • Provide a cooler environment

  • Inexpensive

Contact us now for details on how a Heelift offloading boot can help improve your patient’s care.