Windlass Test | Plantar Fasciitis Assessment | Heel Pain Exam

The Windlass Test is a common orthopedic test to assess for plantar fasciitis, which is one of the leading causes of heel pain next to Achilles tendinopathy.
De Garceau et al. (2003) found a sensitivity of 32 % and a Specificity of 100% for this test in the diagnosis of plantar fasciitis.
This means that this test is not useful to exclude the presence of plantar fasciitis, but very useful to confirm the suspected pathology.

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To perform the test have your patient standing on a stool or chair with the foot position so that the head of the metatarsal rests on the edge of the stool while the patient puts weight on the leg and then passively dorsiflex the big toe.

This test is positive if the patient feels pain or increased pain at the insertion of the plantar fascia at the head of the first metatarsal.
If the extension is not possible at the MTP joint this may indicate a Hallux Rigidus.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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It can be interesting to perform the Navicular Drop Test which assesses overpronation of the subtalar joint, which can be a contributing factor to plantar fasciitis.

De Garceau D, Dean D, Requejo SM, Thordarson DB. The association between diagnosis of plantar fasciitis and Windlass test results. Foot & ankle international. 2003 Mar;24(3):251-5.