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  • Dr. Brian Abelson DC.

THE PLANTAR FASCIA - ACHILLES TENDON CONNECTION

Updated: Jun 30


You may be wondering what the plantar Fascia on the bottom of your foot has to do with the Achilles Tendon. This important anatomical connection impacts both biomechanics and force generation. As you will discover, any tension within the Achilles Tendon (and associated calf muscles) soon has an effect upon the plantar fascia. The Achilles Tendon is formed by the merging of two calf muscles - the gastrocnemius and soleus. Any tension or restrictions in these muscles soon exhibits itself in the Achilles Tendon, and then into the plantar fascia. This tension can easily alter gait patterns and will greatly affect your ability to store and release energy when walking, running, or jumping.



Your Plantar Fascia


Your plantar fascia is actually quite an amazing structure, and is responsible for performing multiple functions.

  • The plantar fascia enhances shock absorption by acting as a mobile adaptor, it stabilizes the metatarsal joints, and aids in propulsion when walking and running by becoming a rigid lever.

  • The plantar fascia also stabilizes the arch of the foot and prevents the arch from collapsing (by lifting the arch in preparation for the take-off phase of gait). This is what we refer to as the Plantar Fascia’s Windlass Mechanism. Overall the plantar fascia is a very impressive well designed structure. (2)

When the plantar fascia is strong and supple, it functions incredibly well. Unfortunately, localized tension from repetitive motion, injury, or muscle imbalances can results in a loss of elasticity in the plantar fascia. This lack of elasticity often leads to decreased capacity for shock absorption, accompanied by decrease in propulsion. (1) Just as localized tension can lead to these problems so can tension being transferred from the Achilles tendon.



The Connections are Strong! (Young Padawan)


Sorry, I couldn't help myself with this Star Wars reference. (May Force be with you!)


To get back on track, the central area of the plantar fascia is called the plantar aponeurosis. This is a very thick structure when compared to the thinner outer portions of the plantar fascia (medial and lateral sections). The thick plantar aponeurosis plays an important role in transmitting forces through the Achilles tendon (during the end of the Stance Phase of gait) to the forefoot. (2,3,4,5)

The Achilles tendon, plantar fascia linkage is a great system for force generation.However, problems often arise when there are imbalances or restrictions further up the kinetic chain, which can then manifest as problems in the foot. As I mentioned the Achilles tendon is formed by the two calf muscles, but those calf muscles connect directly into the hamstrings, which are also affected by restrictions or imbalances in the muscles of the hip.


This is why, in order to effectively address tension in the linkages between the Achilles tendon and the plantar fascia, we must also address tension throughout the larger kinetic chain.

HIT THE ENTIRE KINETIC CHAIN - EXERCISE RECOMMENDATIONS


As you review the following exercises, think about why we have made these specific recommendations. Remember, the goal is to address restrictions in the plantar fascia and also those in the calf muscles, the hamstrings, and even up into the gluteal muscles. In addition, we must also consider restrictions that may be present in the antagonists muscles.


MOBILITY EXERCISES


Plantar Fasciitis Exercises - Foot Stretching Routine (Follow Along): This foot stretching routine focuses on the long and short flexors and extensors of the foot. Great routine for anyone suffering from Plantar Fasciitis. Take your time with routine. It should be performed 6 days per week and combined with our other myofascial release exercises.


Foundational Self Myofascial Foot Release: Great Exercise for Plantar Fasciitis, Bunions, and most foot conditions. This video goes over the logic of doing a myofascial release of the foot. Then it shows you how to release the structures under your foot using a lacrosse ball in combination with some pin and stretch techniques.




Stretching Your Calf Muscles: Calf stretches for both your calf muscles the gastrocnemius and soleus. Only minor changes in technique can make a huge difference in increasing your calf flexibility. This exercise improves the flexibility of both your calf muscles and your Achilles tendon. This stretch is demonstrated in a static fashion but it can also be performed in dynamic manner, moving back and forth from this position.


Hamstrings - Myofascial Release & Pin and Stretch: Tight hamstrings can result in limited extension of the knee, as well as increased flexion of the knee (in other words, tight hamstrings work to pull the lower part of the leg backwards). This over-flexion has a ripple effect all the way down the kinetic chain, since these restrictions directly cause increased dorsiflexion of the ankle, and increased stress on both the Achilles tendon and plantar fascia of the foot. Since the Achilles tendon is attached to the heel bone (calcaneus) and to the plantar fascia, tight hamstring muscles directly impact the amount of force being transferred to these structures.



STRENGTHENING EXERCISES



Foot & Ankle Strengthening Routine - Using a Theraband (Follow Along Video): This foot and ankle strengthening routine works the flexors, extensors, internal and external foot rotators using a Theraband.






Pen and Penny (Loonie) Exercise - Foot Doming: The Pen and Loonie exercise is a great way to increase intrinsic muscle foot strength. These muscles can become lazy from excessive use of shoes, especially those that support the arch of the foot. Performing this exercise on a regular basis improves the foot's spring like nature. Your ability to store and release energy. This exercise will give your foot and ankle stability especially for those who have suffered from repeated ankle sprains.


Calf Strengthening - Eccentric Calf Raises & Pulsations: The Eccentric Calf Raise is a great way to increase calf strength, without causing further injuries. These dynamic calf-pulsations are ideal exercises for improving sports performance and power. This is an advanced exercise, so before attempting this exercise, make sure you can easily perform the standard Eccentric Calf Raises & Pulsations.


Deadlifts (Barbell and Dumbbells): Deadlifts are great exercises for strengthening your gluteal and hamstring muscles. They are also excellent for strengthening your core and low back.








DR. BRIAN ABELSON DC.

Dr. Abelson believes in running an Evidence Based Practice (EBP). EBP's strive to adhere to the best research evidence available, while combining their clinical expertise with the specific values of each patient.

Dr. Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 10th publications which will be available later this year.


Want to learn more about Plantar Fasciitis? Check out Dr. Abelson's book - "RESOLVING PLANTAR FASCIITIS" where you can find practical advice about how to resolve this painful condition.


This book gives you specific tests that can help determine the root cause of your problem. Then, Dr, Abelson helps you to build an individualized exercise program specific to YOUR needs. If you suffer from Plantar Fasciitis, then you really do need to check out this book .






REFERENCES

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

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

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

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

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

  6. Stecco, Carla; Stecco, Carla. Functional Atlas of the Human Fascial System E-Book (Page 364). Elsevier Health Sciences. Kindle Edition.

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