The plantaris tendon

Spang, Christoph; Alfredson, Håkan; Docking, Sean; Masci, Lorenzo; Andersson, Gustav

doi:10.1302/0301-620x.98b10.37939

Cited by 42 publications

(24 citation statements)

References 66 publications

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“…The plantaris tendon has long been considered to be a vestigial tendon, present in around 80% of the population, and more commonly absent bilaterally than unilaterally [1] . The plantaris originates from the posterolateral knee and its tendon runs between the gastrocnemius and soleus muscles, and ultimately inserting on the medial calcaneus or Achilles tendon [2] , providing very little strength to plantarflexion (around 0.7%) [3] . Ruptures tend to be relatively mild and resumption of activity can usually be undertaken rapidly [2] .…”

Section: Discussionmentioning

confidence: 99%

“…The plantaris originates from the posterolateral knee and its tendon runs between the gastrocnemius and soleus muscles, and ultimately inserting on the medial calcaneus or Achilles tendon [2] , providing very little strength to plantarflexion (around 0.7%) [3] . Ruptures tend to be relatively mild and resumption of activity can usually be undertaken rapidly [2] . The tendon is increasingly being examined at its distal end as a potential contributor to mid-portion Achilles tendinopathy.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided corticosteroid injection for proximal plantaris tendinopathy: A case report

Cushman

Shihab

2020

Radiology Case Reports

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Minimal literature is available on the diagnosis and treatment of proximal plantaris tendinopathy. Calf pain is a common complaint in runners, ranging from myofascial pain to acute strains. Rarely, the plantaris tendon can be involved in mid-calf pain. This case highlights a 23-year-old female elite runner with a case of symptomatic proximal plantaris tendinopathy. Insidious mid-calf pain and/or tightness with tenderness to palpation was noted, and ultrasonographic examination provided an accurate diagnosis. An ultrasound-guided corticosteroid injection was performed, providing complete pain relief without recurrence, even 1 year after the initial injection. The patient was able to return to full activity. Successful treatment of this rare condition with ultrasound-guided corticosteroid injection should be considered once a proper diagnosis is made.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided corticosteroid injection for proximal plantaris tendinopathy: A case report

Cushman

Shihab

2020

Radiology Case Reports

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“…Pain tolerance is subjective, and it is possible that patients using the Alfredson protocol do not appropriately load their tendon, secondary to pain. Additionally, there has been some evidence to suggest that plantaris may play a role in the development and persistence of Achilles tendinopathy [47][48][49]. Coupled with other possible local impairments [50,51], in some cases eccentric exercise may not sufficiently improve outcomes for patients with Achilles tendinopathy because it may not address the predisposing problem.…”

Section: Discussionmentioning

confidence: 99%

Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Jayaseelan

Mischke

Strazzulla

2019

JFMK

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Background: Achilles tendinopathy is a common health condition encountered in the orthopedic and sports medicine settings. Eccentric exercise is a common intervention in the management of pain and limited function for this patient population, although contemporary evidence suggests additional exercise methods may be effective as well. Study design: Narrative review: Methods: A literature review was performed using the electronic databases Pubmed and PEDRO for articles through February 2019. Randomized clinical trials integrating eccentric exercise, with or without co-interventions, were evaluated. Outcomes related to pain and/or function were considered. A patient case is provided to highlight decision making processes related to clinical prescription of eccentrics for Achilles tendinopathy. Results: After screening titles and abstracts, seven studies were included for full review. Two articles compared eccentric exercise to a control group, four compared eccentrics to the use of modalities, while one used eccentric exercise as part of a multimodal intervention. In each case, eccentric exercise was effective in reducing pain and improving function. In comparison to other forms of exercise or additional interventions, eccentric exercise was frequently not more effective than other options. Discussion: Eccentric exercise has been associated with clinical benefit in improving pain and function for patients with Achilles tendinopathy. Despite the available evidence reporting effectiveness of eccentrics, other options may be equally useful. Appropriate load modification and exercise prescription for patients with Achilles tendinopathy requires systematic clinical reasoning and incorporation of patient values to optimize outcomes.

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“…The plantaris tendon is well known to be difficult to localise/identify, and earlier anatomical studies have claimed that up to 20% individuals lack this tendon 10. However, recent research on cadavers (following the plantaris from proximal to distal) has shown that most likely all individuals have a plantaris tendon, but the course and insertion of the plantaris tendon varies, and up to nine different positions in relation to the Achilles mid-portion have been reported 9.…”

Section: Discussionmentioning

confidence: 99%

Surgical plantaris tendon removal for patients with plantaris tendon-related pain only and a normal Achilles tendon: a case series

Alfredson

Masci²,

Spang

2018

BMJ Open Sport Exerc Med

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ObjectivesSurgical removal of the plantaris tendon can cure plantaris-associated Achilles tendinopathy, a condition in which Achilles and plantaris tendinopathy coexist. However, rare cases with plantaris tendinopathy alone are often misdiagnosed due to a normal Achilles tendon.Design and settingProspective case series study at one centre.ParticipantsTen consecutive patients (9 men and one woman, mean age 35 years, range 19–67) with plantaris tendon-related pain alone in altogether 13 tendons were included. All had had a long duration (median 10 months, range 3 months to 10 years) of pain symptoms on the medial side of the Achilles tendon mid-portion. Preoperative ultrasound showed thickened plantaris tendon but a normal Achilles tendon.InterventionsOperative treatment consisting of ultrasound-guided excision of the plantaris tendon.Primary and secondary outcome measuresScores from Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A)were taken preoperatively and postoperatively (median duration 10 months). Patient satisfaction and time until full return to sports activity level was asked by a questionnaire.ResultsThe VISA-A scores increased from 61 (range 45–81) preoperatively to 97 (range 94–100) postoperatively (p<0.01). Follow-up results at 10 months (range 7–72 months) on 9/10 patients showed full satisfaction and return to their preinjury sports or recreational activityConclusionThe plantaris tendon should be kept in mind when evaluating painful conditions in the Achilles tendon region, especially when no Achilles tendinopathy is present. Excision of the plantaris tendon via a minor surgical procedure in local anaesthesia results in a good outcome.

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The plantaris tendon

Cited by 42 publications

References 66 publications

Ultrasound-guided corticosteroid injection for proximal plantaris tendinopathy: A case report

Ultrasound-guided corticosteroid injection for proximal plantaris tendinopathy: A case report

Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Surgical plantaris tendon removal for patients with plantaris tendon-related pain only and a normal Achilles tendon: a case series

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