Single Limb Heel Rise Test: A Simple PTTD Self-Check

One of the simplest ways to check your posterior tibial tendon function involves standing on one foot and rising up on your toes. Called the single limb heel rise test, this quick check can reveal problems with the tendon that supports your arch. You can do it at home in under a minute.

What is the single limb heel rise test?

The single limb heel rise test is a physical examination technique doctors and podiatrists use to assess how well your posterior tibial tendon is working. The tendon plays a key role in maintaining your arch and enabling the pushing-off motion when you walk or run.

During this test, you stand on one leg and try to rise up onto your toes. How well you can do this, and whether it causes pain, provides valuable information about your tendon function.

How to perform the test at home

Here’s how to check yourself:

  1. Stand near a wall or chair for balance if needed
  2. Lift your unaffected leg so you’re standing on the affected side only
  3. Rise up onto your toes as high as you comfortably can
  4. Hold for a moment (aim for at least 3-5 seconds)
  5. Note any pain or difficulty along the inner ankle or arch

What to look for

Positive signs of PTTD include:

  • Inability to rise onto your toes at all
  • Significant pain along the inside of your ankle or arch
  • Needing to grab something for balance when you shouldn’t need to
  • Only able to rise slightly or with wobbling
  • One foot significantly weaker than the other

A healthy posterior tibial tendon should let you perform 10+ controlled single limb heel rises without significant pain or instability.

What your results mean

If you pass the test

Being able to perform repeated single limb heel rises without pain suggests your posterior tibial tendon is functioning adequately. However, this doesn’t rule out PTTD entirely—early-stage cases might still pass with minor symptoms.

If you struggle or have pain

Difficulty with this test, especially if it’s worse on one side, suggests possible posterior tibial tendon dysfunction. The tendon may be inflamed, degenerated, or weakened enough to affect your foot mechanics.

This finding warrants professional evaluation, particularly if you also have:

  • Inner ankle pain that worsens with activity
  • Progressive flatfoot (arch collapsing over time)
  • Swelling along the tendon path
  • Difficulty with activities that require push-off

Limitations of the Self-Check

While useful, the single limb heel rise test has limits:

  • Early PTTD may not show obvious weakness yet
  • Other conditions can also cause difficulty (calf weakness, ankle arthritis, nerve issues)
  • Pain thresholds vary, some people push through discomfort
  • Form matters, proper technique gives accurate results

A positive self-test doesn’t mean you have PTTD for certain, but it does mean you should get checked out.

Next steps if your test is positive

If you noticed difficulty or pain with the single limb heel rise, here’s what to do:

  1. Schedule a podiatrist appointment, explain what you found
  2. Note when the pain occurs (during the rise, after, etc.)
  3. Track other symptoms, inner ankle pain, arch changes, swelling
  4. Avoid activities that aggravate it until you’ve been evaluated
  5. Consider temporary support, over-the-counter arch supports may help

Your doctor can perform a more thorough examination, order imaging if needed, and recommend appropriate treatment based on your specific situation.

Sources

  • AAOS (American Academy of Orthopaedic Surgeons) - PTTD Overview
  • American College of Foot and Ankle Surgeons - Posterior Tibial Tendon Dysfunction Clinical Guidelines

This test provides helpful information but cannot replace a professional diagnosis. If you’re experiencing foot or ankle pain, consult a healthcare provider for proper evaluation.