The plantaris muscle produces a very long thin tendon (up to 40 cm) that descends medially between the gastrocnemius and soleus in the posterior leg, running along the medial border of the Achilles tendon to insert on the medial calcaneus separately from (and medial to) the Achilles tendon. The plantaris tendon is absent in 7-10% of individuals. It serves as a common donor nerve for autologous tendon grafting in hand surgery.
Plantaris tendon rupture causes sudden posterior calf pain that is often confused with Achilles tendon rupture or deep vein thrombosis ('tennis leg'). The clinical distinction is that plantaris rupture preserves Achilles continuity — the patient can still perform a single-leg heel raise (unlike complete Achilles rupture). Thompson test is negative. Ultrasound demonstrates the intact Achilles with haematoma medially at the plantaris rupture site. Management is conservative. The plantaris tendon is harvested through a small transverse medial ankle incision for hand flexor and extensor tendon graft reconstruction, providing 30-40 cm of thin tendon.
Sudden eccentric calf loading during acceleration sports tears the plantaris musculotendinous junction, producing acute posterior medial calf pain with bruising that descends to the ankle over 24-48 hours; the intact Achilles on Thompson test and ability to perform a heel raise distinguish this from Achilles rupture; conservative management with compression and graduated loading produces full recovery.
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