The terms get used interchangeably in clinical practice. Pressure reduction. Offloading. Heel protection. Redistribution. But they are not the same thing. And the distinction matters to clinical outcomes —particularly at the heel, where anatomy conspires against us.

The 2025 International Pressure Injury Guideline makes this explicit. For heels, the recommendation is unambiguous: heels should be "fully free from contact with the support surface." Not reduced pressure. Not redistributed pressure. Zero contact.

This article explains the biomechanical difference between pressure reduction and complete offloading, why it matters specifically at the heel, and what the evidence shows. Let's be clear about definitions first.

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