Is The Achilles Tendon Attached To The Plantar Fascia?

The Achilles Tendon And The Plantar Fascia Is the Achilles tendon attached to the plantar fascia? Well.. yes, yes it is! Hopefully, we are all analytical about our treatment modalities and ponder the reasons behind why we do what we do! Take the management of plantar heel pain.. aka “plantar fasciitis”. One of the mainstays…

Simon Bartold
Director of Bartold Clinical

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2 responses to “Is The Achilles Tendon Attached To The Plantar Fascia?”

  1. Hi Simon
    Hopefully I can get a copy of the paper and have a read.

    Not sure I can draw a direct link between the increasingly obvious contiguity (alone) between the paratenon and the PF as being a reason to do such (static) calf stretches in relation to PHP but I do think the paper adds to others that suggest we might be having to move away from a soft tissue intervention model (hands on or whichever exercise paradigm we might follow) that seems to keep fascial tissue (deep aponeurotic, epimysial, perimysial and endomysial) outwith clinical reasoning in relation to injury or other pt presentations. The reason is not simply contiguity (I don’t think contiguity alone is sufficient an argument) but increasingly, researchers, at microscopic level, are adding to our understanding of the varied innervation of fascia and potential role within the human pain experience (can of worms opened up) and a level of force transmission between limb segments (and other insights). Quite how all this latter one plays out dynamically is still an unknown quantity but I’m sure finite element work and one day, perhaps, some measurement tools that can be placed in humans will more fully answer these. Together these insights, plus the contiguity, can now bring a lot to our thinking and perhaps calls for a reshaping of our thinking. Personally, allowing for the model of fascial thinking I’ve tended to be in, the clinical reasoning impact is that I think less of origin and insertions when people present and look to blend that knowledge into map of possible fascial influence beyond any one given segment or even beyond the presenting limb. So, in the context of the OP, if I am thinking PHP that seems, in fact, PF then yes I will consider the TA but actually the proposed fascial contributors from the fascia of the calf, thigh etc. (And yes I am into the BPS model).

    In terms of static stretch however, there is an interesting little review article (2021) that is open access: “Fascial or Muscle Stretching? A Narrative Review”.
    https://www.mdpi.com/2076-3417/11/1/307
    Much of this stuff is over my simple bmx etc head, so will leave it to the better able in the group to argue, but it may bring some interesting discussion here.
    Cheers
    Ian

    • Excellent thank you Ian. I agree with you in relation to stretching and feel there must be an alternative mechanism for any pain reduction seen in the PF as a result of stretching the PF. What is it? Well the next discussion popping up soon might provide food for thought in terms of loading versus lengthening. We shall see but it definitely is a work in progress!

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