Interwoven Threads: The Plantar Fascia-Achilles Tendon Link
Updated: Nov 23
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.
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The Splendor of Our Plantar Fascia
Your plantar fascia is a remarkable structure, playing 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 lead to a decrease in 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.
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The Connections are Strong! (Young Padawan)
Apologies, but I simply couldn't resist a bit of Star Wars humor there. (And may the Force accompany 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 channeling forces through the Achilles tendon (at the conclusion of the Stance Phase of gait) to the forefoot. (2,3,4,5)
The interconnection of the Achilles tendon and the plantar fascia is an effective system 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.
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Manual Therapy
When issues arise in the Achilles tendon or plantar fascia, manual therapy often becomes necessary. It's crucial to address both soft-tissue and joint issues across the entire kinetic chain, from the foot to the hip, to ensure comprehensive management. 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 not only mitigate calf pain but also serves 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)
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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 not only minimizes the risk of injuries but also enhances balance and stability, crucial for everyday activities. Regular targeted exercises for the calf and foot muscles are therefore essential for optimal lower leg function and health.
Effective Foot and Toe Strengthening
Having strong ankles, feet, and toes is 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 - Balance exercises can be of great benefit to people of any age. Balance exercises improve your ability to control and stabilize your body's position. Balance exercises are great at reducing injury risk, rehabilitating current injuries, or increasing your sports performance.
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Conclusion
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.
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Dr. Brian Abelson - The Author
Dr. Abelson is committed to running an evidence-based practice (EBP) incorporating the most up-to-date research evidence. He combines his clinical expertise with each patient's specific values and needs to deliver effective, patient-centred, personalized care.
As the Motion Specific Release (MSR) Treatment Systems developer, Dr. Abelson operates a clinical practice in Calgary, Alberta, under Kinetic Health. He has authored ten publications and continues offering online courses and his live programs to healthcare professionals seeking to expand their knowledge and skills in treating musculoskeletal conditions. By staying current with the latest research and offering innovative treatment options, Dr. Abelson is dedicated to helping his patients achieve optimal health and wellness.
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References
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.
The windlass mechanism of the foot: a mechanical model to explain pathology., Fuller EA. J Am Podiatr Med Assoc. 2000;90:35–46.
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.
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.
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.
Neumann, D. A. (2010). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. Elsevier Health Sciences.
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.
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.
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.
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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