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Dr. Brian Abelson DC.

Interwoven Threads: The Plantar Fascia-Achilles Tendon Connection

Updated: Mar 10


Spiky Ball Below a Foot

The plantar fascia and Achilles tendon are more connected than you might think, each playing a pivotal role in your body's biomechanics and power. Tightness in your calf muscles can quickly transfer to these areas, altering your gait and affecting your energy during motion. It's a fascinating chain reaction where tension in the calf muscles immediately impacts the Achilles tendon and, in turn, the plantar fascia.


Article Index:

 

Image of the Plantar Fascia

The Splendor of Our Plantar Fascia


Your plantar fascia is a remarkable structure that plays several vital roles. This brilliant element heightens shock absorption as a mobile adapter, stabilizes the metatarsal joints, and bolsters propulsion during walking and running by transforming into a rigid lever.


In addition to these, the plantar fascia safeguards the arch of the foot, preventing it from collapsing (by lifting the arch during the preparatory phase of gait for take-off). This action embodies what is known as the Windlass Mechanism of the plantar fascia. Indeed, the plantar fascia stands out as a superbly designed structure.


When the plantar fascia is robust and flexible, its functions are executed impeccably. However, localized tension resulting from repetitive movements, injuries, or muscle imbalances can decrease the plantar fascia's elasticity. This decline in elasticity often results in diminished shock absorption and propulsion capabilities. Similarly, transferred tension from the Achilles tendon can also trigger these issues.


 

Yoda!

The Connections are Strong! (Young Padawan)


I'm sorry, but I simply couldn't resist some Star Wars humour. (May the Force Be With You!)


Steering back to our main topic, the heart of the plantar fascia is known as the plantar aponeurosis. This part is considerably thicker compared to the slender edges of the plantar fascia (the medial and lateral sections). This robust plantar aponeurosis plays a key role in channelling forces through the Achilles tendon (at the conclusion of the Stance Phase of gait) to the forefoot. (2,3,4,5)

Dancer in Deep Plié

The interconnection of the Achilles tendon and the plantar fascia is effective for generating force. However, complications often surface when imbalances or restrictions exist further up the kinetic chain, eventually leading to issues in the foot. As previously stated, the Achilles tendon is a product of the two calf muscles, which have a direct connection with the hamstrings. These hamstrings, in turn, are influenced by imbalances or restrictions in the hip muscles.


This is why it's critical to look beyond the Achilles tendon and plantar fascia when addressing tension. We must also consider the broader kinetic chain, ensuring tension is properly managed throughout.


 

Manual Therapy


Manual therapy often becomes necessary when issues arise in the Achilles tendon or plantar fascia. To ensure comprehensive management, it's crucial to address both soft-tissue and joint issues across the entire kinetic chain, from the foot to the hip. In the videos provided, Dr. Abelson, who developed Motion Specific Release, demonstrates a selection of techniques that can help relieve these restrictions. Remember, these are just some of the many methods that may be employed.


Calf Pain No More - Release Tom, Dick, and Harry

In this video, Dr. Brian Abelson, the creator of Motion Specific Release, demonstrates potent MSR techniques aimed at re-establishing the relative movement between tissue layers. This can mitigate calf pain and serve as a vital component in the comprehensive approach to treating Achilles injuries. (Abelson, 2018)


7-Point Ankle & Foot Mobilization: A Key to Achilles Tendon Recovery

Enhancing joint mobility is paramount, especially when focusing on comprehensive treatment for Achilles tendon injuries. Ignoring joint mobility constraints would significantly diminish the efficacy of any myofascial treatment, given that these issues are intrinsic components of the body's kinetic chain. (Abelson, 2018)


 

Exercise


Consider the rationale behind the exercises we've chosen below. Our goal extends beyond easing tension in the plantar fascia and Achilles tendon; we aim to also target tightness in the calf muscles, hamstrings, and glutes. Additionally, it's important to consider any limitations in the opposing muscles as well.


Mobility Exercises


Sam's Daily Five Hip and Leg Stretches

Engaging in routine stretching exercises is vital for preserving optimal musculoskeletal health, particularly for those who spend considerable time seated. Sam's Daily Five Hip and Leg Stretches provide a practical and beneficial routine to incorporate as an active break during long sitting sessions.


Foot Pain Relief - Self Myofascial Release

Foot mobility is of paramount importance in the prevention of injuries, the enhancement of sports performance, and the management of various foot conditions such as plantar fasciitis and bunions. Appreciating the far-reaching impact of foot mobility on the entire kinetic chain, including the ankles, knees, hips, and lower back, is essential.


Strengthening Exercises


Strengthening the calf and foot muscles is vital for supporting the Achilles tendon and plantar fascia. These exercises build strength and endurance in the muscles, which in turn helps to protect and stabilize these connective tissues, allowing for better absorption and distribution of forces during movement. This minimizes the risk of injuries and enhances balance and stability, crucial for everyday activities. Therefore, regular targeted exercises for the calf and foot muscles are essential for optimal lower leg function and health.


Effective Foot and Toe Strengthening

Strong ankles, feet, and toes are essential for injury prevention and optimal sports performance. The anatomy and biomechanics of the foot and ankle complex play a vital role in maintaining the body's stability, balance, and movement.


Improve Your Balance - Advanced Exercise Video

Improve Your Balance - Advanced

Exercise—Balance exercises can benefit people of any age. They improve one's ability to control and stabilize one's body's position. Balance exercises can also reduce injury risk, rehabilitate current injuries, or increase sports performance.


 


Conclusion - The Plantar Fascia-Achilles Tendon Connection


In conclusion, the delicate interplay between the plantar fascia and Achilles tendon is a testament to the intricate design of our body's kinetic chain. From enhancing shock absorption to propelling us forward, these structures work in harmony with the calf muscles, hamstrings, and glutes to facilitate our mobility. This article has explored their interconnectedness, the importance of addressing tension throughout the kinetic chain, and the role of manual therapy in treatment.


We've also underscored the significance of mobility and strengthening exercises, which are essential for maintaining the health and functionality of our lower extremities. By incorporating the suggested routines, from Sam's Daily Five to foot and toe strengthening, we can support our body's complex biomechanics and embrace a proactive approach to our musculoskeletal health. Remember, nurturing these connections is key to a balanced and dynamic life.


 

DR. BRIAN ABELSON, DC. - The Author


Photo of Dr. Brian Abelson

With over 30 years of clinical experience and a track record of treating more than 25,000 patients, Dr. Abelson developed the Motion Specific Release (MSR) Treatment Systems to provide powerful and effective solutions for musculoskeletal issues.


As an internationally best-selling author, he is passionate about sharing knowledge and techniques that can benefit the broader healthcare community. A perpetual student, Dr. Abelson continually integrates cutting-edge methods into the MSR programs, with a strong emphasis on multidisciplinary and patient-centered care.


Beyond his professional life, Dr. Abelson is a dedicated husband and father of two. He and his wife share a deep love for international travel, immersing themselves in different cultures, music, and the joy of connecting with people around the world. An Ironman triathlete and marathon runner for over 30 years, he is also a committed environmentalist with a passion for human rights. His practice, Kinetic Health, is based in Calgary, Alberta, Canada.



 

References

  1. Dynamic loading of the plantar aponeurosis in walking., Erdemir, A., Hamel, A.J., Fauth, A.R., Piazza, S.J., Sharkey, N.A., 2004. J. Bone Joint Surg. Am. 86-A (3), 546–552.

  2. The windlass mechanism of the foot: a mechanical model to explain pathology., Fuller EA. J Am Podiatr Med Assoc. 2000;90:35–46.

  3. The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle., Carlson, R.E., Fleming, L.L., Hutton, W.C., 2000. Foot Ankle Int. 21 (1), 18–25.

  4. Three-dimensional reconstructions of the Achilles tendon insertion in man., Milz, S., Rufai, A., Buettner, A., Putz, R., Ralphs, J.R., Benjamin, M., 2002. J. Anat. 200 (Pt 2), 145–152.

  5. Anatomy of the Achilles tendon and plantar fascia in relation to the calcaneus in various age groups., Snow, S.W., Bohne, W.H., DiCarlo, E., Chang, V.K., 1995. Foot Ankle Int. 16 (7), 418–421.

  6. Neumann, D. A. (2010). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. Elsevier Health Sciences.

  7. Stecco, C., Corradin, M., Macchi, V., Morra, A., Porzionato, A., Biz, C., De Caro, R. (2013). Plantar fascia anatomy and its relationship with Achilles tendon and paratenon. Journal of Anatomy, 223(6), 665–676. doi:10.1111/joa.12111.

  8. Huang, Y. C., Wang, L. Y., Wang, H. C., Chang, K. L., Leong, C. P. (2017). The Relationship Between the Flexible Flatfoot and Plantar Fasciitis: Ultrasonographic Evaluation. Chang Gung Medical Journal, 30(6), 449-456.

  9. Kim, J. H., Chung, J., Song, M., Park, K., Akram, J., Kim, J., Kim, S. J. (2019). The Role of the Plantar Fascia and Achilles Tendon Loading in Patients with Plantar Fasciitis. Physical Therapy Korea, 26(6), 373–380. doi:10.12674/ptk.2019.26.6.373.

  10. Alfredson, H., Cook, J. (2007). A treatment algorithm for managing Achilles tendinopathy: new treatment options. British Journal of Sports Medicine, 41(4), 211–216. doi:10.1136/bjsm.2007.035543.


 

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1 Comment


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Jun 29, 2020

Great blog on plantar fasciitis. Heel pain can be a chronic painful condition. Ever try rolling the arch on a frozen water bottle?


Teri

Atlas Biomechanics

https://www.atlasbiomechanics.com

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