Total contact casting is the gold standard for plantar foot ulcers but has been questioned in heel pressure ulcers. Current offloading of heel ulcers is typically removable offloading boots. We describe using a modified posterior splint to offload heel ulcers in nonweightbearing patients. The posterior splint is readily available and familiar to practitioners, with less of a learning curve than a total contact cast. As part of the dressing, the posterior splint is less likely to be removed and leads to increased compliance. We hypothesize that this can translate to improved healing of pressure ulcers at the heel.