Standard protocols using the Measurz inclinometer or the MAT
The Weight-Bearing Plantar Flexion Test assesses how far a person can raise the heel during a controlled single-leg heel rise. It provides a practical measure of plantar-flexion performance under body weight—the position used during walking push-off, running, jumping and calf-raise tasks.
Two measurement options are provided:
1. Measurz inclinometer method: records angular excursion of the foot in degrees.
2. MAT heel-rise-height method: uses the MAT to standardise foot placement and records vertical heel rise in centimetres with a rigid ruler or Measurz AR measurement.
Choose one primary method at baseline and use it at every retest. Degrees and centimetres are different outcomes and must not be combined or treated as interchangeable.
Important: This is a functional movement test, not a pure measure of talocrural-joint range. The result is influenced by ankle plantar flexion, movement through the foot and toes, calf capacity, balance, forefoot tolerance and motor control.
Non-weight-bearing goniometry measures ankle motion while the person lies or sits. This test asks a different, more functional question: how much plantar-flexion movement can the person express while supporting body weight?
It can help clinicians compare sides, establish a baseline, monitor rehabilitation and observe heel-rise strategy. It does not independently measure maximal calf strength or endurance. Use dynamometry for force and a separate heel-rise endurance test for endurance.
For both methods
- flat, non-slip floor;
- wall or stable rail for light fingertip support;
- Measurz app; and
- optional skin-safe marker and camera for setup records.
- smartphone in a rigid case; and
- broad elastic strap or secure phone holder.
- the MAT;
- rigid centimetre ruler or set square, or Measurz AR measurement; and
- skin-safe marker or narrow tape for the heel landmark.
Ask about current pain, recent ankle or Achilles injury, surgery, swelling, dizziness and forefoot symptoms. Record resting symptoms.
Explain:
“This test measures how far you can rise during a controlled single-leg heel raise. Rise as high as you comfortably can without bending the knee, rolling the ankle or pushing through your hands.”
Use caution—or postpone the test—after acute injury, with suspected fracture or Achilles rupture, after recent surgery without clearance, or when single-leg loading is unsafe.
- Test barefoot on a flat, non-slip surface.
- Face the wall.
- Position the tip of the great toe 15 cm from the wall.
- Point the second toe forward and keep the centre of the heel aligned behind it.
- Allow the fingertips to touch the wall for balance, with elbows at approximately 90°.
- Keep the tested hip and knee extended without locking into hyperextension.
- Flex the non-tested knee so that foot remains clear of the floor.
- Keep the pelvis level and trunk upright.
Record or photograph the foot position so it can be reproduced.
Identify:
1. Centre of the ankle mortise: midpoint between the medial and lateral malleoli.
2. Second metatarsal: the long bone running toward the second toe.
3. Second metatarsal head: the prominence at the base of the second toe.
Place the phone flat on the dorsum of the foot, centred over the second-metatarsal line. Align its long axis from the centre of the ankle mortise toward the second metatarsal head. Secure it firmly without restricting circulation or toe movement.
The phone must not slide. Do not ask the client to hold it and do not rely on the examiner holding it against the moving foot.
- Open the Inclinometer in Measurz.
- Confirm the phone is aligned and secure.
- With the entire tested foot flat and body weight controlled over that limb, select zero/calibrate.
- Confirm the starting display is 0° before the movement.
The final value represents angular excursion from the standing start, not an absolute anatomical ankle angle.
Instruct:
“Shift your weight fully onto this leg. Keep your knee straight and your body tall. Rise as high as you can through the ball of your foot, pause briefly while I capture the angle, then lower with control.”
At the top, check that the knee remains extended, trunk stays upright, pelvis remains level, hands are used only for balance, the heel does not markedly invert or evert and the phone has not moved.
Capture the highest stable value in Measurz. A pause of approximately one second is enough; avoid a prolonged hold that adds an endurance demand.
This method measures the maximum vertical rise of a marked heel landmark. The MAT standardises foot position and orientation; a rigid ruler, set square or Measurz AR measurement records the height.
Palpate the posterior calcaneus and identify the lowest central point of the heel while the entire foot is flat. Place a small horizontal skin-safe mark or narrow tape marker at that point.
Use the same point throughout the assessment. Do not alternate between the bottom of the heel, Achilles insertion, shoe edge or lateral malleolus; each produces a different measurement.
- Lay the MAT flat on a dry, non-slip floor with no folds or raised edges.
- Position it beside a wall or stable rail.
- Select a forward line on the MAT that runs perpendicular to the wall.
- Record the line, grid position and direction used.
- Place the tip of the great toe 15 cm from the wall.
- Align the centre of the heel and second toe with the selected forward line.
- Keep the whole foot flat before starting.
- Record the heel and toe coordinates or photograph the setup.
- Adopt the shared single-leg position described above.
The MAT makes foot position repeatable; it does not directly measure vertical heel height.
Place the rigid ruler or set square immediately beside the heel and perpendicular to the MAT. Align 0 cm with the top surface of the MAT, not the floor beneath it, so the MAT's thickness is not added to the result.
If using Measurz AR:
- calibrate the reference plane at the top surface of the MAT;
- position the camera perpendicular to the sagittal plane of the foot;
- include the MAT surface and marked heel point in view; and
- keep camera height, distance and position consistent across sides and retests.
Instruct:
> “Shift your weight fully onto this leg. Keep your knee straight and your body tall. Rise as high as you can through the ball of your foot, hold briefly while I measure the heel, then lower with control.”
At the highest controlled position:
- keep the ruler vertical and read it at eye level;
- measure from the top surface of the MAT to the marked calcaneal point;
- record to the nearest marked increment without claiming greater precision than the tool allows; and
- use a pause of approximately one second.
The examiner must not lift, guide or touch the heel while measuring.
A larger angle or heel-rise height indicates more excursion under the tested setup, but does not automatically mean “better.” A high result can include movement through the midfoot and toes rather than isolated ankle motion.
A lower result may reflect reduced plantar-flexion range, reduced calf force capacity, pain or apprehension, limited great-toe extension, forefoot intolerance, impaired balance or a different foot strategy.
There is no established universal normative value or diagnostic cut-off for either exact protocol. Interpret results using:
1. side-to-side comparison;
2. change from the person's baseline;
3. symptoms and movement quality; and
4. related ankle, calf and foot tests.
Do not apply the commonly quoted 40–50° non-weight-bearing plantar-flexion range directly to either test. The position, loading and measurement method are different.
Keep the following identical:
- measurement method and equipment;
- barefoot status;
- foot position, MAT coordinates and great-toe distance from the wall;
- anatomical landmark and device position;
- knee position and fingertip support;
- instructions; and
- ruler or camera position.
Until measurement error is established for these exact methods, avoid claiming that a very small change is clinically meaningful.
The closest published test is the Functional Heel-Rise Test described by Ness and colleagues. Participants stood barefoot with the great toe 15 cm from a wall, used fingertip support, kept the stance limb extended and performed a maximal unilateral heel rise. The investigators measured vertical head excursion, not heel height or ankle angle. The measure demonstrated excellent intrarater and good-to-excellent interrater reliability in healthy adults aged 18–35.
The protocols above are practical clinical modifications:
- the MAT method measures a marked calcaneal landmark rather than head excursion; and
- the Measurz method measures foot-segment angular excursion.
Their exact reliability, minimal detectable change and validity have not been established. The published heel-rise measurement also correlated only weakly with non-weight-bearing goniometric plantar-flexion ROM, reinforcing that these methods measure different aspects of performance.
- Select either degrees or centimetres as the primary outcome and keep it consistent.
- Use reproducible anatomical landmarks and foot position.
- When using the MAT, align the heel and second toe to a recorded line and measure from the MAT surface to the same marked calcaneal point.
- Treat the result as functional heel-rise excursion, not isolated ankle ROM or calf strength.
Ness, B. M., Sudhagoni, R. G., Tao, H., Full, O. R., Seehafer, L. O., Walder, C. M., & Zimney, K. (2018). The reliability of a novel heel-rise test versus goniometry to assess plantarflexion range of motion. International Journal of Sports Physical Therapy, 13(1), 19–27. https://pmc.ncbi.nlm.nih.gov/articles/PMC5808010/
Movement Assessment Technologies. (2026). Ankle Flexibility Testing: Weight-Bearing Plantarflexion Test. https://www.matassessment.com/blog/weight-bearing-plantarflexion-test-cm-wbpt
