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 and then along the medial border of the Achilles tendon to insert on the calcaneus medial to it. 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 free tendon graft and as one cause of sudden calf pain when it ruptures.
| Muscle | |
|---|---|
| Attachment | Inserts on the posterior calcaneus medial to the Achilles tendon |
Minimal plantarflexion assistance; predominantly used as a surgical graft donor
Plantaris rupture during sprinting or racket sport produces sudden sharp medial calf pain and a pop, one cause of tennis leg (more often due to a medial gastrocnemius tear). Unlike Achilles rupture, the Thompson test is negative and a single-leg heel raise is preserved, and bruising may track down to the ankle over a day or two. Ultrasound shows fluid between the gastrocnemius and soleus with an intact Achilles tendon. Conservative management with compression and graduated loading resolves most cases within 6 to 8 weeks. When present, the tendon can be harvested through a small medial ankle incision as a long, thin graft for hand tendon or Achilles reconstruction.
Medial calf tear producing sudden pain during push-off activities, distinguished from Achilles rupture by negative Thompson test, managed conservatively.
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