Loading · intermediate · 3 sets of 15 reps

Eccentric Heel Drop (Step)

Rathleff and colleagues (2014) randomised 48 patients with ultrasound-confirmed plantar fasciitis to shoe inserts plus daily plantar-specific stretching, or shoe inserts plus high-load progressive strength training every second day: single-leg heel raises with a towel under the toes. At 3 months the strength group scored 29 points better on the Foot Function Index; at 1, 6 and 12 months the groups did not differ. So it may bring faster relief rather than a better end result. The reps on this page are a simpler version, not the trial's exact dose. The eccentric idea follows Alfredson's work on Achilles tendinosis; the mechanism in the plantar fascia is not established.

Plantar fascia (loaded)Achilles tendonGastrocnemiusSoleus

By Oliver Wakefield-Smith·Last reviewed 2026-05-12·1 primary source cited

This is a loaded exercise, not a held stretch

Adapted from the Rathleff trial

3 sets of 15 slow reps, every other day. 3 seconds down on each rep. Holds are not relevant. This is a simpler version of the trial's exercise, which used heel raises with a towel under the toes and added load over time.

How to do it

1
Stand on a step with the balls of your feet on the edge and your heels hanging off
Heels off the edge
2
Hold a banister or rail lightly for balance, do not pull on it
Balance hand only
3
Rise up onto your toes using both feet, this is the lift, not the load
Both feet up
4
Shift your weight onto the affected leg and slowly lower that heel below the step over 3 seconds
Slow lower, 3 seconds
5
Step back up with both feet. Repeat for 15 reps. Do 3 sets, building over weeks
Concentric up, eccentric down

What you should feel

A controlled, loaded sensation across the underside of the foot and Achilles during the slow lower. Some discomfort during the exercise (up to 5/10) is acceptable. Sharp sudden pain, no.

Important note

This is NOT a stretch you hold, it is 3 sets of 15 slow reps, 3 seconds down on each. Holds are not relevant. Mis-coaching it as an isometric hold defeats the eccentric loading principle.

Easier

Both-foot eccentric (lower with both heels), or perform on a flat floor without the step. Start without bodyweight load and build over 2 to 3 weeks.

Harder

Add a backpack with light load (3 to 5 kg), or perform with the big toe extended up against the step (Alfredson-style with windlass engagement). The 2014 Rathleff trial used single-leg heel raises with a towel under the toes, with the load progressed over time.

Don't do this if

Acute plantar fascia rupture or significant tear
Acute Achilles tendon rupture
Recent foot or ankle fracture
Balance impairment without a sturdy rail to hold

The evidence

Citation: Rathleff MS, Mølgaard CM, et al. (2014). High-load strength training improves outcome in patients with plantar fasciitis: a randomized controlled trial with 12-month follow-up. Scandinavian Journal of Medicine & Science in Sports

Routines that use this

8-Minute Runner Routine

Written by Oliver Wakefield-Smith, Founder of Digital Signet

Researches and writes evidence-based consumer health content. Not a clinician. The studies this site relies on are named and linked on the references page. Email corrections.