{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:39:50Z","timestamp":1778866790166,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,10,24]],"date-time":"2016-10-24T00:00:00Z","timestamp":1477267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Institutional Funds"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Differential motion between the plantaris and Achilles tendons has been hypothesized to contribute to pain in some patients presenting with Achilles tendinopathy. However, objective evidence of differential Achilles\u2010plantaris motion is currently lacking from the literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether differential, multidirectional motion exists between the plantaris tendon (PT) and Achilles tendon (AT) as documented by dynamic ultrasound (US) and postdissection examination in an unembalmed cadaveric model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, cadaveric laboratory investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Procedural skills laboratory in a tertiary medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Twenty unembalmed knee\u2010ankle\u2010foot specimens (9 right, 11 left) obtained from 6 male and 10 female donors ages 55\u201096 years (mean 80 years) with body mass indices of 14.1\u201033.2 kg\/m<jats:sup>2<\/jats:sup> (mean 22.5 kg\/m<jats:sup>2<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single, experienced operator used high\u2010resolution dynamic US to qualitatively document differential PT\u2010AT motion during passive ankle dorsiflexion\u2010plantarflexion. Specimens were then dissected and passive dorsiflexion\u2010plantarflexion was repeated while differential PT\u2010AT motion was visualized directly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>Presence or absence of multidirectional differential PT\u2010AT motion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 20 specimens exhibited smooth but variable amplitude multidirectional differential PT\u2010AT motion. Whereas US readily demonstrated medial\u2010lateral and anterior\u2010posterior PT motion relative to the AT, differential longitudinal motion was only appreciated on dissection and direct inspection. Many specimens exhibited partial or complete encasement of the PT between the gastrocnemius portion of the AT and the soleus aponeurosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Some degree of multidirectional differential PT\u2010AT motion appears to be a normal phenomenon, and PT motion can be evaluated sonographically in both the medial\u2010lateral and anterior\u2010posterior directions. The existence of normal differential PT\u2010AT motion suggests that alterations in PT motion or repetitive stress within the PT\u2010AT interval may produce symptoms in some patients presenting with Achilles region pain syndromes. The PT should be evaluated in all patients presenting with Achilles, plantaris, or calf pain syndromes. Future research would benefit from the development of a sonographic classification system for PT anatomy and motion with the goal of differentiating normal versus pathologic states and identifying risk factors for symptom development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2016.10.013","type":"journal-article","created":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T01:47:10Z","timestamp":1477360030000},"page":"691-698","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Differential Plantaris\u2010Achilles Tendon Motion: A Sonographic and Cadaveric 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