Ankle Flexibility Testing: Weight-Bearing Plantarflexion Test

Ankle plantarflexion is important for walking, running, jumping, calf raises, push-off, change-of-direction tasks and many sport or daily movement patterns. When weight-bearing plantarflexion is reduced, a client may show altered push-off, reduced heel-rise height, asymmetrical calf raise performance, stiffness through the front of the ankle or reduced confidence loading through the forefoot.

The Weight-Bearing Plantarflexion Test is useful because it assesses plantarflexion in a functional position. Instead of measuring the ankle only in non-weight-bearing, it captures how the foot, ankle, calf and balance system behave when the client has to raise the heel against body weight.

Quick Summary

Test name: Weight-Bearing Plantarflexion Test – cm
Alternative names: WBPT, Weight-Bearing Plantar Flexion Test, Heel-Rise Height Test
Category: Ankle range of motion / mobility assessment
Primary score: Heel-rise height in centimetres
Best use: Functional ankle plantarflexion baseline, side-to-side comparison and retesting
Key limitation: Results depend on foot position, toe position, balance, calf strength, pain, measurement method and whether the test is single-leg or double-leg.

What Is the Assessment?

The Weight-Bearing Plantarflexion Test assesses how high the heel can rise from the ground while the client is in a loaded position.

It can be measured as:

• heel-rise height in centimetres
• side-to-side difference
• plantarflexion angle if using an inclinometer or video method
• pain or symptom response
• movement quality and compensation

The test is often more functional than a non-weight-bearing plantarflexion ROM measure because it requires the client to control the ankle, foot and calf while loaded.

Why It Is Used

The test may be used to assess:

• functional ankle plantarflexion range
• heel-rise height
• push-off capacity context
• side-to-side ankle mobility difference
• calf raise setup and control
• baseline and retest change
• symptoms during forefoot loading
• movement restrictions that may influence walking, running, jumping or calf raise tasks

It is especially useful when the goal is to monitor change over time using a simple, repeatable field measure.

What It Measures

The test measures weight-bearing ankle plantarflexion performance using heel-rise height.

It may reflect:

• ankle plantarflexion range
• calf and Achilles complex capacity
• forefoot loading tolerance
• toe and metatarsophalangeal extension tolerance
• balance and postural control
• foot stiffness or mobility
• pain or symptom response
• side-to-side mobility difference
• movement confidence under load

It does not directly measure maximal calf strength, Achilles tendon structure, calf endurance or isolated ankle joint motion unless additional tests are used.

Who It Is Used For

The test may be useful for:

• runners
• jump-sport athletes
• field and court sport athletes
• gym clients
• dancers
• older adults
• clients with ankle mobility goals
• clients completing calf raise progressions
• professionals monitoring lower-limb ROM and movement capacity

It may need modification if the client cannot safely balance, cannot tolerate forefoot loading, has high pain during heel rise or cannot perform the chosen loaded variation.

Equipment Required

• Flat non-slip surface
• Wall, rail or light fingertip support if needed
• Ruler, tape measure or digital distance measurement option
• Optional Measurz AR measurement to document heel-rise height
• Optional Measurz inclinometer if recording plantarflexion angle
• Measurz/MAT platform to record side, distance, symptoms and retest comparison
• Optional MAT tools such as Anker, Gripper or Muscle Meter for related lower-limb strength testing
• Optional video recording for heel-rise quality and compensation

Measurz can store this test alongside ankle ROM, calf raise endurance, lower-limb strength, balance, orthopaedic tests, outcome measures and endurance assessments within the broader Measurz/MAT test library.

Step-by-Step Protocol

1. Prepare the surface

Use a flat, non-slip surface. Record whether the test is performed barefoot, in socks or in shoes.

2. Choose the test version

Decide whether the test will be performed double-leg or single-leg. Do not compare single-leg and double-leg results directly.

3. Position the client

The client stands upright with the test foot flat on the floor. If testing single-leg, the opposite foot is lifted or supported according to the chosen protocol.

4. Standardise support

Allow light fingertip support if needed, but record it clearly. Avoid pulling up through the hands.

5. Set the measurement point

Choose a consistent heel landmark, such as the lowest point of the calcaneus or a marked point on the heel. Use the same landmark each time.

6. Perform the heel rise

Ask the client to rise up onto the forefoot as high as comfortably possible while keeping the knee position and foot alignment controlled.

7. Hold the top position briefly

Ask the client to pause long enough for measurement. Avoid bouncing or using momentum.

8. Measure heel-rise height

Measure the vertical distance from the floor to the selected heel landmark at the highest controlled position.

9. Repeat on both sides

Repeat using the same method, support and instructions.

10. Record symptoms and compensation

Record pain, stiffness, heel lift quality, balance, knee bend, foot rotation, toe discomfort and any other compensation.

Scoring and Interpretation

Common scoring options:

• heel-rise height in centimetres
• left-right difference
• single-leg versus double-leg version
• pain or symptom response
• balance or support required
• movement-quality notes
• compensation notes

Greater heel-rise height generally indicates greater weight-bearing plantarflexion performance under the tested setup.

Interpretation is stronger when combined with:

• pain score
• symptom location
• side-to-side comparison
• calf raise endurance
• single-leg calf raise height
• ankle dorsiflexion
• ankle plantarflexion ROM
• balance testing
• gait, running, hopping or jumping findings
• lower-limb strength testing

The result does not explain the cause of reduced plantarflexion by itself. It helps guide exercise selection, monitoring and further assessment decisions.

Normative Data, Benchmarks or Reference Values

Exact universal norms for the Weight-Bearing Plantarflexion Test measured in centimetres are limited.

Heel-rise height depends on:

• body size
• foot length
• toe extension
• calf strength
• ankle mobility
• balance
• footwear
• single-leg or double-leg version
• measurement landmark
• support used
• pain or symptoms

Practical field guidance:

• compare left and right sides
• compare baseline to retest
• track heel-rise height in centimetres
• track pain and symptom response
• track balance and support use
• record whether the knee bends or the foot rotates
• combine with calf raise endurance and ankle dorsiflexion testing

A meaningful side-to-side difference should be noted, especially if it aligns with symptoms, reduced push-off, lower calf raise height or functional movement changes.

Use published reference values only when the protocol, population and measurement method are comparable.

Reliability and Validity

Weight-bearing plantarflexion measurement can be useful when the protocol is standardised.

Reliability improves when the same:

• surface
• footwear
• test version
• support level
• heel landmark
• measurement tool
• instructions
• number of trials
• endpoint definition
• symptom scale

are used each time.

Research on functional heel-rise and weight-bearing plantarflexion methods supports the value of standardised clinical measurement, but the exact protocol matters. Heel-rise height, plantarflexion angle and calf raise repetitions should not be treated as interchangeable measures.

Small changes should be interpreted cautiously unless they are repeated, exceed expected measurement variation and align with symptoms, function or related testing.

Common Errors and Limitations

Common errors include:

• changing from double-leg to single-leg testing
• changing footwear between sessions
• allowing strong hand support
• not recording support use
• measuring from different heel landmarks
• allowing excessive knee bend
• allowing foot rotation
• not recording pain or symptoms
• comparing heel-rise height with plantarflexion angle without context
• interpreting the result as isolated calf strength

Limitations include:

• heel-rise height is influenced by strength and balance
• toe extension can affect performance
• pain can reduce height
• footwear changes results
• support use changes difficulty
• side-to-side comparison may be more useful than universal norms
• the test does not diagnose the cause of restriction
• the test does not measure calf endurance unless repetitions are added

Practical Applications

The Weight-Bearing Plantarflexion Test can help professionals:

• monitor functional plantarflexion progress
• compare sides
• track heel-rise height after training or mobility work
• support calf raise programming
• add context to walking, running and jumping assessment
• monitor symptoms during forefoot loading
• combine ankle ROM findings with calf raise endurance, balance and strength tests

It is most useful when paired with:

• Weight-Bearing Lunge Test
• Ankle Plantarflexion Test
• Single-Leg Calf Raise Test
• Calf Raise Endurance Test
• Balance Tests
• Hop Tests
• Running Gait Checklist
• Lower-limb strength testing

How to Record This in Measurz/MAT

Record:

• test name: Weight-Bearing Plantarflexion Test – cm
• side tested
• single-leg or double-leg version
• heel-rise height in centimetres
• footwear
• support used
• heel landmark
• knee position
• foot position
• pain or symptoms
• balance notes
• compensation notes
• retest date

Use Measurz AR measurement for heel-rise height, the Measurz inclinometer if recording plantarflexion angle, and notes for symptoms and compensations.

A useful Measurz note may read:

“WBPT single-leg, barefoot, light fingertip support. Right heel-rise height 8.4 cm, left 10.1 cm. Mild right anterior ankle stiffness, no pain. Slight knee flexion on right at top range. Retest same setup.”

FAQs

What does the Weight-Bearing Plantarflexion Test measure?

It measures how high the heel can rise in a loaded position, giving information about functional ankle plantarflexion and heel-rise capacity.

Is this the same as a calf raise test?

Not exactly. The WBPT focuses on heel-rise height or plantarflexion range. A calf raise test usually measures repetitions, endurance or strength capacity.

Should it be tested single-leg or double-leg?

Both can be useful, but they should be recorded separately. Single-leg testing is usually more demanding and provides clearer side-to-side information.

What is a good score?

There are limited universal norms for heel-rise height in centimetres. Baseline, side-to-side comparison and retest change are usually most useful.

Should both sides be tested?

Yes. Side-to-side comparison is highly useful.

Can it diagnose Achilles or ankle pathology?

No. It measures functional plantarflexion performance but does not diagnose the cause of restriction or symptoms.

Key Takeaways

• The Weight-Bearing Plantarflexion Test measures loaded heel-rise height.
• It can be recorded in centimetres, angle or both depending on the protocol.
• Side-to-side and baseline comparison are often more useful than universal norms.
• Standardisation is essential.
• Footwear, support, heel landmark, pain and compensation should be recorded.
• Measurz can record height, angle, symptoms, setup and progress.

References

Bohannon, R. W. (2022). The heel-raise test for ankle plantarflexor strength: A scoping review and meta-analysis of studies providing norms. Journal of Physical Therapy Science, 34(7), 528–531.

Movement Assessment Technologies. (n.d.). Weight-bearing plantar flexion test. https://www.matassessment.com/blog/weight-bearing-plantar-flexion-test

Movement Assessment Technologies Help Centre. (n.d.). Weight-bearing plantar flexion test. https://help.matassessment.com/en/articles/128-weight-bearing-plantar-flexion-test

Walder, S., Ness, B., & Zimney, K. (2018). The reliability of a novel heel-rise test versus goniometry to assess ankle plantarflexion active range of motion. International Journal of Sports Physical Therapy, 13(1), 19–27.