You are here

Plantaris injury

Anatomy

The plantaris muscle is a fine rope like tendon running next to the larger Achilles Tendon. It’s function is to work with the Achilles to flex the ankle and knee joint by extending from the outside (lateral) back of the femur (allowing you to stand on your toes or point your foot). The plantaris starts just above lateral head of the gastrocnemius muscle and runs beneath the gastrocnemius and soleus muscles located near the inner (medial border) of the Achilles tendon and attaches to medial side of the Calcaneus (heel bone).

Mechanism of Injury

Commonly called Tennis leg, a tear or rupture of the plantaris involves the plantaris muscle and possibly the medial head or inside of the gastrocnemius muscle which is the larger of the two calf muscle. Injuries are usually the result of a sudden muscular action such as reaching out for a tennis shot.

Symptoms

  • Patients often report hearing a pop in the back of their calf.
  • Pain and swelling most commonly at the junction of calf muscle and the Achilles tendon, the location of the rupture.
  • Palpation of a defect at the site of pain and swelling is usually possible.
  • The flexion compression test of the gastrocnemius muscle for Achilles rupture is negative, meaning that the Achilles still flexes the foot when the Plantaris is ruptured.

Examination and diagnosis

Plantaris muscle rupture can be diagnosed via history and physical examination. Ultrasound imaging and MRI can confirm the injury.. Unless associated with bony injury, x-rays of the area will not be useful. Injury to the plantaris muscle can present with similar clinical features to conditions like deep vein thrombosis, rupture of Baker's cyst, and tumors. An MRI is accurate in differentiating and characterizing plantaris muscle injury.  

Treatment and rehabilitation

Once diagnosis is confirmed and Achilles tendon rupture ruled out, the following treatments are effective for reducing pain and swelling, and speeding recovery:

  • Ice and compression.  
  • Soft tissue manipulation and massage to directly stimulate repair.
  • Elastic support (e.g., ACE, TEDs stocking, Tubigrip) from foot to knee
  • Patient can use crutches in early phase if weight bearing is painful.
  • Physical therapy with range of motion exercises and soft tissue manipulation followed by a gradual strengthening program is an important aspect of management.

 

New ways to heal joints can keep us fitter as we age
If we live longer, will our joints still work? While many diseases can kill you, arthritis has the potential to ruin your long life.
Metal has been used in patients since the time of Hippocrates (400 BCE) to repair broken bones and replace missing parts. The earliest metals included copper, tin or lead and often did not have the strength to last forever. Over the years, the metals we use have improved. They have become stronger and leach fewer ions into the body.
 Segmental Meniscal Defects
The meniscus can be compared to a gasket in a hose: If it is cut, water leaks out.
July 14th, 2015
In light of Wes Matthews and other NBA athletes suffering Achilles ruptures, Dr. Stone speaks to Mavs Moneyball, a...
April 27th, 2016
Dr Stone talking about Steph Curry's injury and the Warrior's season.
December 11th, 2014
"A few select orthopedic surgeons and researchers around the country are pioneering alternate cartilage...

Kevin R. Stone · Jonathan R. Pelsis · Scott T. Surrette · Ann W. Walgenbach · Thomas J. Turek 

Kevin R. Stone · Jonathan R. Pelsis · Scott T. Surrette · Ann W. Walgenbach · Thomas J. Turek 

Stone, K.R., A.W. Walgenbach, A. Freyer, T.J. Turek, and D.P. Speer. 2006.