Windlass Test: How to Detect Plantar Fasciitis

Pain on the bottom of the foot, especially when taking the first steps in the morning, is one of the most common complaints among runners and people who spend many hours on their feet. The Windlass test is the most direct way to check whether the plantar fascia is involved in that pain.

What Does This Test Measure?

The "windlass" mechanism describes how the plantar fascia tightens when the toes extend, especially the big toe, while the ankle is in a specific position. The test reproduces that tension in a controlled way: if the fascia is irritated (plantar fasciitis), extending the big toe reproduces the characteristic pain in the heel or arch.

Equipment Needed

• Nothing essential for the passive version
• For the weight-bearing version, just a step or stable surface for the subject to stand on

How to Perform the Test

1. Passive version (seated)

1. The subject sits with the leg extended and the foot relaxed off the edge of the table
2. With one hand, stabilize the ankle in a neutral or slight dorsiflexion position
3. With the other hand, passively extend (lift) the big toe while keeping the ankle in dorsiflexion
4. Watch and ask whether pain is reproduced in the heel area, at the plantar fascia insertion, or along the arch

2. Weight-bearing version (standing)

1. The subject stands with their weight on the leg being assessed
2. Ask them to extend the big toe by resting it on a step or wedge, keeping the rest of the foot on the ground
3. This version tends to be more sensitive because it adds the tension from body weight

Common Mistakes

• Confusing pain in the metatarsophalangeal joint (from a possible joint restriction) with fascial pain
• Not testing both versions (passive and weight-bearing) when the first is negative but clinical suspicion is high
• Not comparing with the opposite foot, especially in people with mild bilateral pain at baseline

How to Interpret the Results

Result	Interpretation
Negative	Extending the big toe doesn't reproduce pain — plantar fascia probably not involved
Positive	Pain reproduced in the heel or arch when extending the big toe — suggests plantar fasciitis

The Windlass test is a screening tool; it doesn't differentiate between the various degrees of fascia involvement (from mild irritation to chronic degeneration). If pain is persistent, limits activity, or doesn't respond to the usual load modifications, referral for ultrasound assessment is advisable.

Related Tests

Plantar fasciitis shares its location and sometimes its causes with other forefoot problems:

• Mulder's sign (Morton's neuroma) — useful for differentiating fascial pain from a possible interdigital neuroma, both common in the same population
• Weight-bearing lunge test — limited ankle dorsiflexion is a common risk factor associated with plantar fasciitis

Track and Monitor

Plantar fasciitis tends to progress slowly and with ups and downs depending on training load, footwear, and surface. With Movalytics you can record the Windlass test result alongside a pain level (e.g., on a 0-10 scale) at each assessment, and see at a glance whether the trend is improving or worsening as you adjust running volume or foot strengthening exercises.

Frequently Asked Questions

Is the Windlass test painful in people without plantar fasciitis? It shouldn't cause significant pain in a healthy fascia — at most, a normal sensation of tension. What's the relationship between plantar fasciitis and footwear? Footwear with poor arch support, or abrupt changes (for example, switching from highly cushioned shoes to minimalist footwear too quickly), is a common risk factor. Does plantar fasciitis heal on its own? Many cases improve with load modification, stretching/strengthening of the fascia and intrinsic foot muscles, and footwear adjustments, but persistent cases (more than a few weeks without improvement) should be assessed by a professional.