Are Calf Raises Good for Plantar Fasciitis?

Calf raises are one of the best-supported exercises for plantar fasciitis, with randomized trial evidence showing they outperform stretching alone when performed with heavy load. The specific version studied most is a single-leg heel raise done with a rolled towel under the toes, which shifts the load directly onto the plantar fascia while strengthening the calf muscles above it. The catch is that the technique, the loading, and the timeline all matter, and the exercise works best as part of a broader approach rather than a standalone fix.

What the Trials Actually Found

The landmark study on this topic randomized 48 people with ultrasound-confirmed plantar fasciitis into two groups. One group did plantar-specific stretching every day plus shoe inserts. The other did high-load calf raises every other day plus the same inserts. At three months, the calf-raise group scored 29 points better on a standard foot-function index than the stretching group, a meaningful gap that reached statistical significance.¹ The researchers described the protocol as “simple and progressive,” and the advantage held through the 12-month follow-up, though the gap between groups narrowed over time as both improved.

A larger trial of 120 participants reinforced these findings. The group doing progressive calf raises achieved significantly greater reductions in that stabbing first-step-in-the-morning pain compared to a group receiving a combination of stretching, manual therapy, laser therapy, and custom orthotics. By 24 weeks, the calf-raise group also showed greater functional recovery and a measurable reduction in plantar fascia thickness on ultrasound.² That last detail is worth pausing on: the fascia itself got thinner, which suggests the exercise was driving structural change rather than just masking symptoms.

Why a Calf Exercise Helps a Foot Problem

The connection between your calf muscles and the bottom of your foot is more direct than most people realize. Cadaveric dissection studies have shown that the Achilles tendon does not simply end at the heel bone. Instead, the tissue surrounding the Achilles continues over the back of the calcaneus as a thin layer of periosteum, which then merges with the plantar fascia on the underside of the foot.³ In practical terms, your calf muscle, Achilles tendon, and plantar fascia are all part of a continuous chain of connective tissue. When you do a heavy calf raise, the force does not stop at the heel. It travels through that chain and loads the plantar fascia itself.

This mechanical loading appears to trigger a biological healing response. When plantar fascia cells are subjected to moderate-to-intensive stretching in laboratory settings, they ramp up production of type I collagen, the structural protein that gives the fascia its strength.⁴ The thinking in current tendinopathy and fasciopathy research is that controlled, heavy loading stimulates the tissue to remodel in a healthier, more organized pattern rather than remaining in the disorganized, degenerated state that characterizes chronic plantar fasciitis.⁵ This is the same principle used in heavy-load protocols for Achilles tendon problems and patellar tendon issues, and the plantar fascia responds to it in a similar way.

The Calf Tightness Connection

There is another reason calf raises make sense for plantar fasciitis that goes beyond the loading-and-remodeling story. An overwhelming proportion of people who develop plantar fasciitis also have tight calves. In one study of 254 patients, roughly four in five had limited ankle dorsiflexion, meaning they could not bend their ankle far enough to bring the shin toward the foot. More than half had tightness specifically isolated to the gastrocnemius, the larger of the two main calf muscles.⁶

When the calf is tight, the Achilles tendon effectively shortens, and because the Achilles and plantar fascia are connected through that continuous soft-tissue chain, the fascia on the bottom of the foot gets yanked harder with every step. Heavy calf raises performed through a full range of motion gradually improve calf flexibility and strength at the same time, which means they address the upstream tightness that feeds the downstream problem. This dual benefit is part of why they tend to outperform protocols that only target the foot itself.

How the Exercise Is Actually Performed

The protocol that produced the strongest results in clinical trials is not a standard gym calf raise. It involves a specific modification: you place a rolled-up towel under your toes before performing the raise. This dorsiflexes the toes (bends them upward), which engages the windlass mechanism and puts the plantar fascia under increased tension throughout the movement. The result is that the fascia gets loaded more heavily than it would during a plain heel raise.

In the original trial, participants stood on a step with the towel under the toes of the affected foot, rose up onto their toes, held at the top for a few seconds, and then lowered slowly back down. The protocol started with bodyweight and progressed to wearing a loaded backpack as the exercise became easier. Sessions were performed every other day rather than daily, giving the tissue time to recover and adapt between bouts. This every-other-day schedule is a departure from typical stretching programs, which usually call for multiple daily sessions, and it reflects the different goal: you are trying to stimulate tissue remodeling, not just improve flexibility.

The movement should be slow and controlled. A common recommendation is about three seconds up, a two-to-three-second hold at the top, and three seconds lowering back down. The slow eccentric (lowering) phase is considered important for driving collagen adaptation. Most protocols use three to four sets of 10 to 12 repetitions per session, though the exact numbers vary somewhat across studies.

Straight-Leg vs Bent-Knee Raises

If you have ever been told to do both straight-leg and bent-knee calf raises, there is a good reason. The two variations target different muscles. A straight-leg calf raise primarily loads the gastrocnemius, the larger, more superficial calf muscle that crosses both the knee and the ankle. A bent-knee raise shifts the work to the soleus, the deeper muscle that lies underneath the gastrocnemius and only crosses the ankle joint. Research on muscle thickness changes after each variation found that bent-knee raises produced about twice the soleus response compared to straight-leg raises, while straight-leg raises dominated for the gastrocnemius.⁷

For plantar fasciitis specifically, the trial protocols have used straight-leg raises, which makes sense given that isolated gastrocnemius tightness was the most common finding in plantar fasciitis patients.⁶ That said, the soleus also contributes to the Achilles-plantar-fascia chain, so some clinicians add bent-knee raises as a secondary exercise. If you can only pick one, straight-leg with the towel under the toes is the version with direct trial support.

Do Not Expect Instant Pain Relief

One of the most common misconceptions about exercise for plantar fasciitis is that you should feel better immediately after a set. A crossover trial that compared isometric calf contractions, isotonic (moving) calf contractions, and plain walking in people with plantar fasciitis found no significant difference in pain levels between the three activities. None of them produced a systematic analgesic effect in the short term.⁸ This was a surprise, because isometric holds had been shown to provide acute pain relief in other tendon problems like patellar tendinopathy.

The practical takeaway is that the benefits of calf raises for plantar fasciitis are cumulative, not immediate. You are not doing them to feel better during the session; you are doing them to progressively strengthen and remodel the tissue over weeks and months. The original trial saw the biggest separation between the exercise group and the stretching group at the three-month mark.¹ Expecting results in days rather than weeks is a recipe for frustration and abandonment.

Combining Calf Raises with Other Treatments

Calf raises do not have to stand alone. In fact, several research groups are exploring whether pairing them with other interventions works better than the exercise by itself. One trial protocol is investigating three arms: insoles plus advice only, insoles plus heavy-slow calf raises, and insoles plus calf raises plus a corticosteroid injection, with the hypothesis that the combination may outperform exercise alone.⁹ The logic is that an injection might reduce acute inflammation enough for someone to tolerate the heavy loading sooner, getting a head start on the remodeling process.

A feasibility study testing that combination found it was well-accepted: 18 out of 20 participants rated the combined treatment as acceptable, and all of them began exercising within a week of receiving the injection.¹⁰ That said, corticosteroid injections carry their own risks, including potential weakening of the fascia with repeated use, so the combination approach is not for everyone and should be a conversation with your provider.

Shoe inserts were used in nearly all of the calf-raise trials, so it is worth noting that the evidence for calf raises was built on top of baseline insole use. Adding insoles or heel cups to reduce impact loading while you build tissue capacity through the exercises is a reasonable and well-supported combination.

When Heel Pain Is Not Actually Plantar Fasciitis

Calf raises are a good treatment for plantar fasciitis specifically. But not all heel pain is plantar fasciitis, and this is where people sometimes go wrong. Fat pad atrophy, in which the cushioning layer under the heel bone thins out, is the second most common cause of plantar heel pain.¹¹ Entrapment of the Baxter nerve, a branch of the lateral plantar nerve that runs along the inside of the heel, is another mimic. Both conditions produce pain in a similar location but respond to different treatments.

A few rough clues can help distinguish them. Classic plantar fasciitis produces a sharp, stabbing pain at the inside of the heel that is worst with the very first steps in the morning and tends to ease up after a few minutes of walking. Fat pad pain is typically more diffuse, centered directly under the heel bone, and may worsen rather than improve with walking. Baxter nerve entrapment can produce burning or tingling along the inner heel. If your pain does not fit the classic plantar fasciitis pattern, or if calf raises consistently make it worse rather than producing a gradual improvement over weeks, getting a proper diagnosis through imaging or clinical examination is important before pushing harder on an exercise program.

Sticking with the Program Long Enough

The biggest practical barrier to calf raises working is compliance. The exercise itself is simple: a step, a towel, and eventually a backpack with some weight in it. But doing it consistently every other day for three months requires a level of discipline that many people underestimate, especially when the early weeks may not bring noticeable relief. In the feasibility study that tracked adherence through training diaries, 10 out of 15 participants who returned their diaries completed at least 20 training sessions, and the average was about 21 sessions over the study period.¹⁰ Five participants did not even return their diaries, which is a common finding in exercise research and hints at the real-world dropout rate.

One helpful frame is to think of the exercise the same way you would think about physical therapy for a torn ligament: it is a rehab program with a timeline, not a quick fix. You should expect some discomfort during the exercise, particularly as you progress the load, but that discomfort should not be sharp or significantly worse the morning after. A general guideline many clinicians use is that pain during the exercise should stay below a 5 out of 10, and morning pain the next day should not be worse than your baseline. If it is, drop the load and build back up more slowly.

Adding Balance and Foot Intrinsic Work

Calf raises build strength in the posterior chain, but they do not directly train the small intrinsic muscles of the foot that help support the arch. Research comparing calf raises with short-foot exercises, in which you actively shorten the arch by pulling the ball of the foot toward the heel without curling the toes, found that both improve dynamic balance and postural stability. However, the short-foot exercise produced greater long-term improvements in measures of feedforward control, meaning the body’s ability to preemptively stabilize before a perturbation rather than just reacting after one.¹²

For someone dealing with plantar fasciitis, this suggests that calf raises and foot intrinsic exercises are complementary rather than interchangeable. The calf raise handles the heavy loading, calf flexibility, and fascial remodeling. Foot intrinsic work handles arch support and neuromuscular control. Many rehab programs include both, alongside calf stretching and sometimes manual therapy, though the calf raise with heavy load is the component with the strongest direct evidence for reducing plantar fasciitis symptoms specifically.

If you are looking for a minimal effective approach, start with the towel-under-toes heel raise every other day, use insoles for daily activities, and give it a genuine three months before deciding whether it is working. The evidence says this combination alone outperforms a more complex program of stretching, hands-on therapy, and electrotherapy for most people with chronic plantar fasciitis.²