A positive windlass test indicates which condition?

• A. Plantar fasciitis
• B. Morton's neuroma
• C. Achilles tendinopathy
• D. Calcaneal spur

Answer: (A)

The windlass test checks the plantar fascia by dorsiflexing the big toe to tighten the arch. When the toe is bent upward, the plantar fascia is pulled taut, lifting the arch like a windlass. If plantar fascia inflammation is present, this stretch reproduces heel pain, especially under the medial heel where the fascia attaches. So a positive windlass test points to plantar fasciitis. Other conditions—Morton's neuroma, which causes forefoot symptoms; Achilles tendinopathy, with posterior heel pain and tendon-specific tests; and calcaneal spur-related pain—do not produce the same plantar fascia–tension pain with toe dorsiflexion, making the windlass test most specific for plantar fasciitis.