The plantaris has a very short belly (approximately 5 to 10 cm) and an extremely long, thin tendon (up to 40 cm) running between the gastrocnemius and soleus to insert medial to the Achilles. Absent in 7 to 10 percent of people, its tendon provides no significant plantarflexion force contribution. Its clinical importance lies in its use as a graft donor for Achilles tendon reconstruction and in causing the sudden medial calf pain of tennis leg when it ruptures.
Minimal plantarflexion assistance; predominantly used as a surgical graft donor
Plantaris tendon rupture during sprinting or racket sport produces the sudden sharp medial calf pain and pop of tennis leg — clinically identical to Achilles rupture but with a negative Thompson test and preserved plantarflexion. Ultrasound shows fluid between the gastrocnemius and soleus muscles without Achilles continuity disruption. Conservative management with compression and graduated loading resolves most cases within 6 to 8 weeks.
Medial calf tear producing sudden pain during push-off activities, distinguished from Achilles rupture by negative Thompson test, managed conservatively.
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