The Evidence is Everywhere

Just in case your curiosity requires more information, the evidence abounds that supports the isolated gastrocnemius contracture as a major contributor, if not the singular cause of many foot and ankle disorders.

  1. Abbassian A, Kohls-Gatzoulis J, Solan MC. Proximal Medial Gastrocnemius Release in the Treatment of Recalcitrant Plantar Fasciitis. Foot & Ankle International. 2012;1:14-19.
  2. Aronow MS. Triceps Surae Contractures Associated With Posterior Tibial Tendon Dysfunction. Tech. Orthop. 2000;15:164-173.
  3. Aronow MS, Diaz-Doran V, Sullivan RJ, Adams DJ. The Effect of Triceps Surae Contracture Force on Plantar Foot Pressure Distribution. Foot & Ankle International. 2006;1:43-52.
  4. Atkins D, Crawford F, Edwards J, Lambert M. A systematic review of treatments for the painful heel. Rheumatology(Oxford)1999;38:968-973.
  5. Barouk LB, P Toulec E. Resulltats de la liberation proximale des gastrocnemius. Med Chir Pied. 2006;22:151-156.
  6. Barrett SL.  Understanding And Managing Equinus Deformities. Podiatry Today. 2011;24:1-7.
  7. Barske HL, DiGiovanni BF, Douglass M, Nawoczenski DA. Current Concepts Review: Isolated Gastrocnemius Contracture and Gastrocnemius Recession. Foot & Ankle International.2012;33:915-921.
  8. Bolívar YA, Munuera PV, Padillo JP. Relationship Between Tightness of the Posterior Muscles of the Lower Limb and Plantar Fasciitis. Foot & Ankle International. 2013;1:42-48.
  9. Crawford F, Thomson C. Interventions for treating plantar heel pain. Cochrane Database Syst Rev. 2003;3:CD000416.
  10. Davis PF, Severud E, Baxter DE. Painful Heel Syndrome: Results of Nonoperative Treatment. Foot & Ankle International. 1994;10:531-535.
  11. DeHeer, PA: Understanding Equinus. Podiatry Management. September 2012, 157-168.
  12. DiGiovanni BF, Moore AM, Zlotnicki JP, Pinney SJ. Preferred Management of Recalcitrant Plantar Fasciitis Among Orthopaedic Foot and Ankle Surgeons. Foot & Ankle International. 2012;6:507-512.
  13. DiGiovanni CW, Kuo R, Tejwani N, Price R, HansenJr. ST, Cziernecki J, Sangeorzan BJ. Isolated Gastrocnemius Tightness. The Journal of Bone & Joint Surgery. 2002;6:962-970.
  14. DiGiovanni CW, Langer P. The Role of Isolated Gastrocnemius and Combined Achilles Contractures in the Flatfoot. Foot & Ankle Clinics. 2007;2:363-379.
  15. Drake M, Bittenbender C, Boyles RE. The short-term effects of treating plantar fasciitis with a temporary custom foot orthosis and stretching. J Orthop Sports Phys Ther. 2011;41:221-231.
  16. Duthon VB, Lubbeke A, Duc SR, Stern R, Assal M. Non-insertional Achilles tendinopathy treated with gastrocnemius lengthening. Foot Ankle Int. April 2011;32(4):375-379.
  17. Gajdosik RL, Vander Linden DW, McNair PJ, Williams AK, Riggin TJ: Effects of an eight-week stretching program on the passive-elastic properties and function of the calf muscles of older women. Clin Biomech (Bristol, Avon) 2005;20:973–983.
  18. Garrett T, Neibert PJ. The Effectiveness of a Gastrocnemius/Soleus Stretching Program as a Therapeutic Treatment of Plantar Fasciitis. J Sport Rehabil. 2013.
  19. Gentchos CE, Bohay DR, Anderson JG. Gastrocnemius Recession as Treatment for Refractory Achilles Tendinopathy: A Case Report. Foot & Ankle International. 2008;6:620-623.
  20. Greenhagen RM, Johnson AR, Bevilacqua NJ. Gastrocnemius recession or tendo-achilles lengthening for equinus deformity in the diabetic foot? Clin Podiatr Med Surg. 2012;3:413-424.
  21. Gurdezi S, and Kohls-Gatzoulis J, Solan, MC. Results of proximal medial gastrocnemius release for Achilles tendinopathy. Foot & Ankle International. 2013;10:1364-1369.
  22. Guyton GP, M ann RA, Kreiger LE, Mendel T, Kahan J. Cumulative Industrial Trauma as an Etiology of Seven Common Disorders in the Foot and Ankle. What Is the Evidence? Foot & Ankle International. 2000;21:1047-1056.
  23. Harty J, Soffe K, O’Toole G, Stephens MM. The Role of Hamstring Tightness in Plantar Fasciitis. Foot & Ankle International. 2005;12:1089-1092.
  24. Hill RS. Ankle equinus. Prevalence and linkage to common foot pathology. J Am Podiatr Med Assoc. 1995;85:295-300.
  25. Holmes GB, Lin J. Etiologic Factors Associated with Symptomatic Achilles Tendinopathy. Foot & Ankle International. 2006;27:952-959.
  26. Karagounis P, Tsironi M, Prionas G, Tsiganos G, Baltopoulos P. Treatment of Plantar Fasciitis in Recreational Athletes: Two Different Therapeutic Protocols. Foot & Ankle Specialist. 2011;4:226-234.
  27. Kiewiet NJ, Holthusen SM, Bohay DR, Anderson JG. Gastrocnemius Recession for Chronic Noninsertional Achilles Tendinopathy. Foot & Ankle International. 2013;4:481-485.
  28. Laborde JM. Bilateral Proximal Fifth Metatarsal Nonunion Treated with Gastrocnemius-Soleus Recession. JBJS Case Connector. 2013;3:e68.
  29. League AC. Current Concepts Review: Plantar Fasciitis. Foot & Ankle International. 2008;3:358-366.
  30. Macklin K, Healy A, Chockalingam, N. The effect of calf muscle stretching exercises on ankle joint dorsiflexion and dynamic foot pressures, force and related temporal parameters. Foot (Edinb). 2012;22:10-17.
  31. Magnussen RA, Dunn WR, Thomson AB. Nonoperative treatment of midportion Achilles tendinopathy: a systematic review. Clin J Sport Med. 2009;1:54-64.
  32. Mahieu NN, Witvrouw E, Stevens V, Van Tiggelen D, Roget P. Intrinsic risk factors for the development of achilles tendon overuse injury: a prospective study. Am J Sports Med. 2006;2:226-235.
  33. Martin RL, Irrgang JJ, Conti SF. Outcome Study of Subjects with Insertional Plantar Fasciitis. Foot & Ankle International. 1998;12:803-811.
  34. Maskill JD, Bohay DR, Anderson JG. Gastrocnemius Recession to Treat Isolated Foot Pain. Foot & Ankle International. 2010;1:19-23.
  35. McGlamry ED, Kitting RW. Aquinus foot: an analysis of the etiology, pathology and treatment techniques. J Am Podiatry Assoc. 1973;63:165-184.
  36. Morton DJ. Evolution of the Longitudinal Arch of the Human Foot. The Journal of Bone & Joint Surgery. 1924;6:56-90.
  37. Nutt, J. Diseases and Deformities of the foot, E.B.Treat & Co. 1913. Google Digital Copy,
  38. Owens BD, Wolf JM, Seelig AD, Jacobson IG, Boyko EJ, Smith B, Ryan MAK, Gackstetter GD, Smith TC. Risk factors for the Millennium Cohort Study Team. Risk Factors for Lower Extremity Tendinopathies in Military Personnel. Orthopaedic Journal of Sports Medicine. 2013;1.
  39. Patel A, DiGiovanni B. Association between plantar fasciitis and isolated contracture of the gastrocnemius. Foot Ankle Int. 2011;1:5-8.
  40. Perry, J. Gait Analysis: Normal and Abnormal Function. SLACK International, 1992.
  41. Pfeffer, G; Bacchetti, P; Deland, J, et al.: Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int. 1999;20:214 – 221.
  42. Pinney ST, Hansen ST, Sangeorzan BJ. The Effect on Ankle Dorsiflexion of Gastrocnemius Recession. Foot & Ankle International. 2002;23:26-29.
  43. Porter D, Barrill E, Oneacre K, May BD. The Effects of Duration and Frequency of Achilles Tendon Stretching on Dorsiflexion and Outcome in Painful Heel Syndrome: A Randomized, Blinded, Control Study. Foot & Ankle International. 2002;7:619-624.
  44. Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk Factors for Plantar Fasciitis: A Matched Case-Control Study. The Journal of Bone & Joint Surgery. 2003;5:872-877.
  45. Riddle DL, Schappert SM. Volume of Ambulatory Care Visits and Patterns of Care for Patients Diagnosed with Plantar Fasciitis: A National Study of Medical Doctors. Foot & Ankle International. 2004;5:303-310.
  46. Scher CDL, Belmont Jr. LCPJ, Bear MR, Mountcastle SB, Orr JD, Owens MBD. The Incidence of Plantar Fasciitis in the United States Military. The Journal of Bone & Joint Surgery. 2009;12:2867-2872.
  47. Schmidt D. Insights into the evolution of human bipedalism from experimental studies of humans and other primates. J Exp Biol. 2003 May;206(Pt 9):1437-48.
  48. Silfverskiöld N. Reduction of the uncrossed two-joints muscles of the leg to one-joint muscles in spastic conditions. Acta Chir Scand. 1924;56:315-330.
  49. Subotnick SI. Equinus deformity as it affects the forefoot. J Am Podiatry Assoc. 1971;61:423-7.
  50. Tahririan MA, Motififard M, Tahmasebi MN, Siavashi B. Plantar fasciitis. J Res Med Sci. 2012;8:799-804.
  51. Tong KB, Furia J. Economic Burden of Plantar Fasciitis Treatment in the United States. Am J Orthop. 2010;39(5):227-231.
  52. Verrall, G., Schofield, S., Brustad, T.: Chronic Achilles Tendinopathy Treated With Ecentric Stretching Program. Foot & Ankle International. 2011;32:843-849.
  53. Wapner KL, Sharkey PF. The Use of Night Splints for Treatment of Recalcitrant Plantar Fasciitis. Foot & Ankle International. 1991;3:135-137.
  54. Werner RA, Gell N, Hartigan A, Wiggerman N, Keyserling WM. Risk factors for plantar fasciitis among assembly plant workers. PM R. 2010;2:110-116.
  55. Wolgin M, Cook C, Graham C, Mauldin D. Conservative Treatment of Plantar Heel Pain: Long-Term Follow-Up. Foot & Ankle International. 1994;3:97-102.
  56. Young R, Nix S, Wholohan A, Bradhurst R, Reed L. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of Foot and Ankle Research. 2013;6: 1-10.