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Have a retired lady coming for assesment.

This is my first session with her as she has just moved into my area and all the info has been gleaned over the phone. From elsewhere she has had orthoses to control knee pain (successul). For the last nine months she has been having intensive physio to address a heel pain that she has been told (by orthopod , physio and podiatrist) arises from plantaris. I know that plantaris pain can extend down as far as the midleg but have not heard of it causing heel pain. The pain is described as shooting and travels from the medial heel/ankle up as far as the knee.

There is some arthitis in a joint in one foot that she had an mua for. Apparently her knees have some marked arthritis as well. The physio has suggested she has an orthotic review. However, before that I am more concerned to see if there is soft tissue stuff to deal with. Trigger points for plantaris tend to be for pain in the knee or mid leg. I can do a general acupuncture to the calf to see if that benefits. These have not been done before by anyone.

Any thoughts much appreciated.

Ian

Sounds odd to me --- I never heard of it, except for trigger points in upper belly of gastroc (which are near plantaris muscle) refering pain to heel.

It sounds possibly more a neural tension prob - have you done a slump test?

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Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

The only time I have ever seen the plantaris cause problems, pain-wise, is when it ruptures. When a plantaris ruptures, it is often described as a rubber band like feel/sound or that someone hit them with a stick on the back of the leg. These generally resolve into being asymptomatic by 2-4 weeks post rupture.

Never heard, however, of the plantaris causing heel pain, but I suppose it is possible. Honestly, I don't think it is strong enough of a muscle to cause any significant pathology at the heel. However, I have seen it used for nice little tendon grafts for reinforcing Achilles tendon rupture repairs.

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Sincerely,

Kevin

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Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College

e-mail: kevinakirby@comcast.net

Private Practice:
107 Scripps Drive, Suite 200
Sacramento, CA 95825 USA
My location

Voice: (916) 925-8111 Fax: (916) 925-8136
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