Muscle Article - Plantaris

The Plantaris is a muscle that attaches on the posterior aspect of your femur (upper leg bone) just above the back of your knee on the lateral side (outside).  This muscle has a very small muscle belly in comparison to its incredibly long tendon.  The muscle belly runs from approximately just above the posterior knee crease for about 4-6 cm inferiorly before becoming a tendon.  The tendon then runs medially (on the inside) of your calf, sitting on top of your soleus (deep calf muscle) and underneath your gastrocnemius (superficial calf muscle).  The tendon continues to run down the inside of your calf.  It eventually becomes more superficial (the gastrocnemius doesn’t hide it anymore) and can be palpated on the inside of your calf.  At the level of your calf where you Achilles becomes evident, the Plantaris tendon runs along side, just medially to your Achilles.  The tendon can be easily palpated on some people but not all.  The tendon then continues down along side your Achilles, often feeling like the same tendon, before inserting into the Calcaneous (heal bone) next to the Achilles or with the Achilles.

This muscle has lost its importance as humans have evolved.  In Apes in continues to the toes and is important in tree climbing and mobility.  Its function is so insignificant that it can be harvested for surgical replacement of damaged tendon elsewhere, with little to no loss of complete function of the knee and ankle.  In a recently published study, it was found that 3% of those people viewed didn’t even have a Plantaris tendon.

So why discuss it?  Because it has the ability to cause pain in runners.

The Plantaris muscle, although relatively useless, can be torn or ruptured.  You may feel a whip-like sting in the calf while pushing off with that leg, or when accelerating.  There may be a ‘snap’ heard at the time of injury.  There will be consistent calf pain associated with swelling.  The function of the foot and ankle will remain in tact however.  This type of injury can be very difficult to assess.  It is often misdiagnosed for Achilles tears and an MRI of the area is still not 100% accurate.  Hence, keep it in mind when the standard symptoms of treatment for an Achilles tear/rupture doesn’t seem to be working.

Secondly, the tendon as it runs along side your Achilles can inflame.  This will give vague aching pain along side the medial side of your Achilles and sometimes into the insertion onto the Calcaneous.  Again, this is unusual and difficult to assess.  Hence, when standard assessment and treatment is not working for you, think Plantaris.  Go and visit your local Sports Physician or Sports Doctor and see what they think.

How to treat it yourself?  If the area seems inflamed to you then treat it as such.  Icing after exercise.  Anti-inflammatories that can be obtained from your local chemist – please consult your medical practitioner if you are at all apprehensive about side affects.  Functional rest – get into the pool (yes, that ugly word,…the pool) and cross train for a small period to allow some rest and recovery.  Don’t push off anything too quickly or accelerate to quickly.  Be careful of stairs.

Soft Tissue work to the muscle belly itself will help.  The difficulty is having enough anatomical knowledge to find he little critter.  Treatment to the calf and about the Achilles tendon may also help.  The two tendons (Plantaris and Achilles) may become adhered (stuck together) via inflammatory processes and therefore lose their ability to slide over each other as they should.  Get this treated and ask for some self massage clues to self treat at home.  For starters, try gently frictioning the site with your fingers (gentle, rhythmical backward and forward movements) for 2-3 minutes a couple of times a day.  This may be enough to mobilise the adhered area and improve your symptoms,

Happy running.

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