Rare anatomical variants of the plantaris muscle reported in the case-based anatomical literature include unusual configurations of the muscle belly and accessory heads, atypical proximal attachments and topographical relationships, as well as uncommon patterns of tendon course and distal attachment / insertion [1-21].
This section presents these variants descriptively and organizes them according to their dominant anatomical feature: muscle belly and accessory-head morphology, proximal and topographical variation, or tendon course and distal attachment variation. Associated features involving other anatomical domains are documented within the same case rather than treated as separate variant categories. These groups are organizational categories and do not constitute a formal anatomical classification.
Anatomical Domains of Rare Variation
Rare Muscle Belly and Accessory-Head Variants
This group includes rare case-based configurations in which the dominant anatomical variation involves duplication, bifurcation, accessory muscular components, or an increased number of plantaris muscle heads. Additional proximal, distal or topographical features are described within the corresponding individual cases.
Bilateral Double Plantaris Muscle
Rana et al. [1] described a bilateral double plantaris muscle in a 45-year-old male cadaver. Two muscular bellies, termed outer and inner bellies by the authors, were present on each side, with clear side-to-side differences in proximal attachment and distal continuation.
| Side | Component | Proximal attachment / origin | Distal continuation / attachment |
|---|---|---|---|
| Right | Outer belly | Lower part of the lateral extension of the linea aspera, above the origin of the lateral head of gastrocnemius | Fused with the lateral side of the common tendon of gastrocnemius and soleus below the middle of the leg |
| Right | Inner belly | Fascia covering the popliteus, medial to the origin of the lateral head of gastrocnemius | Attached to a small tuberosity on the superior surface of the calcaneus |
| Left | Outer belly | Lower end of the lateral lip of the linea aspera / lateral supracondylar ridge, above the origin of the lateral head of gastrocnemius | Fused with soft tissue between gastrocnemius and soleus laterally below the middle of the leg |
| Left | Inner belly | Posterior ligament of the knee at the intercondylar region, with additional fibres from the lower part of the lateral supracondylar ridge | Passed between gastrocnemius and soleus and fused with the crural fascia immediately above the calcaneus |
Topographical Relationships
On the right, the inner belly crossed the tibial nerve and the popliteal artery lay medial to both bellies. On the left, the nerve to the lateral head of gastrocnemius crossed the inner belly, while the tibial nerve and popliteal artery lay medial to it [1].
Unilateral Double Plantaris Muscle
Kwinter et al. [2] described a unilateral double plantaris muscle in the right lower limb of a 47-year-old female cadaver. An anomalous medial plantaris was present in addition to the typical lateral plantaris, while a single typical plantaris was present on the left side.
| Side | Muscle configuration | Proximal attachment | Tendon organisation / distal attachment |
|---|---|---|---|
| Right | Anomalous medial plantaris + typical lateral plantaris | The proximal attachment of the anomalous medial plantaris was located superior to that of the lateral plantaris | The two tendons fused into a common tendon, which passed between gastrocnemius and soleus and divided distally into three distinct attachments on the posteromedial calcaneus |
| Left | Single typical plantaris | Lateral femoral condyle | The independent tendon followed an anteromedial course and attached to the calcaneus anterior to the medial side of the calcaneal tendon |
Unilateral Double Plantaris Muscle
Mehta et al. [3] described a unilateral double plantaris muscle in the right lower limb of an adult Indian cadaver. A lateral and a medial belly arose from different proximal attachments and subsequently joined to form a common muscle mass.
| Component | Proximal attachment / origin | Relative morphology |
|---|---|---|
| Lateral belly | Common origin with the lateral head of gastrocnemius | Slightly shorter and deeper than the medial belly |
| Medial belly | Proximal attachment above the lateral femoral condyle | More superficial than the lateral belly |
The two bellies joined to form a common muscle mass, which continued into a single long, tapering tendon attaching to the superior aspect of the calcaneus [3].
Associated Topographical Feature
A 2.4-cm fibrous extension connected the medial belly with the oblique popliteal ligament. The surrounding muscles and neurovascular structures showed normal topographical relationships [3].
Bifurcated Plantaris Muscle
Smędra et al. [4] described a right plantaris muscle with two heads in a 68-year-old female. The lateral and medial heads had distinct proximal attachments and passed into a long plantaris tendon.
| Head | Proximal attachment / origin |
|---|---|
| Lateral head | Lateral femoral condyle and lateral head of gastrocnemius |
| Medial head | Popliteal surface of the femur immediately above the intercondylar fossa |
The two bellies passed into a long tendon oriented toward the medial side of the calf [4].
Histological Examination
Histological examination showed normal histological structure of both plantaris heads [4].
Bicipital Origin and the Course of the Plantaris Muscle
Heo et al. [5] described two distinct plantaris muscles in the right lower limb of a 75-year-old Korean female. The superior and inferior plantaris muscles each possessed their own muscle belly and tendon and showed different proximal attachments and tendon courses.
| Component | Proximal attachment / origin | Tendon course / distal attachment |
|---|---|---|
| Superior plantaris muscle (sPM) | Lower lateral supracondylar ridge and knee joint capsule | The medial component of the iPM merged with the sPM tendon. The sPM tendon then continued to the proximal one-third of the medial head of gastrocnemius and inserted into the fascia at its inner surface. |
| Inferior plantaris muscle (iPM) | Knee joint capsule and lateral head of gastrocnemius, with indirect attachment to the lateral femoral condyle and sPM tendon | At the distal belly, the iPM split into medial and lateral tendinous components. The lateral component travelled inferomedially between gastrocnemius and soleus and inserted at the calcaneal tuberosity along with the calcaneal tendon; the medial component merged with the sPM tendon. |
Bifurcated Plantaris Muscle
Kurtys et al. [6] described a bifurcated right plantaris muscle in a 71-year-old male cadaver. The muscle consisted of superior and inferior parts whose fibres were firmly connected and inseparable proximally, while the two parts developed different tendinous continuations.
| Component | Proximal attachment / origin | Tendinous continuation / attachment |
|---|---|---|
| Superior part | Lateral femoral condyle and iliotibial tract through tendinous band A | The smaller superior part ran more horizontally and continued into a short, thin tendon (band B), which attached to the semimembranosus tendon through a broad fan-shaped attachment |
| Inferior part | Lateral femoral condyle and iliotibial tract through tendinous band A | The inferior part ran downward and continued into the classical long, slender plantaris tendon |
Band A formed a relatively broad tendinous connection with the iliotibial tract and had a fan-shaped attachment [6].
Variant Plantaris Muscle with Degenerated Accessory Head
Futa et al. [7] described a right-sided duplicated plantaris muscle in a 79-year-old female cadaver. A normally positioned anterior head and a posterior accessory head were present and arose from distinct proximal attachment sites.
| Component | Proximal attachment / origin | Morphology / continuation |
|---|---|---|
| Normally positioned anterior head | Lateral distal femur (lateral supracondylar line) | Roughly triangular in shape; united with the posterior accessory head and continued into the common distal plantaris tendon |
| Posterior accessory head | Iliotibial band at the level of the distal femur, approximately 3 cm proximal to the lateral epicondyle | Roughly rectangular and paler than the normally positioned head; united with the anterior head and continued into the common distal plantaris tendon |
Both heads were located deep to the lateral head of gastrocnemius. They united and continued as a single typical plantaris tendon, which travelled between the overlying gastrocnemius and underlying soleus and inserted into the calcaneal tendon [7].
Histological Examination
Histological examination demonstrated typical skeletal muscle fibres in the normally positioned head, whereas the accessory head showed severe muscle fibre degeneration with adipose tissue infiltration [7].
Three-Headed Plantaris Muscle
Olewnik et al. [8] described a three-headed plantaris muscle in the right lower limb of a 73-year-old female cadaver. The three heads showed distinct proximal attachment patterns, and their tendons ultimately contributed to the formation of a common plantaris tendon.
| Component | Proximal attachment / origin | Tendinous organisation |
|---|---|---|
| First head | Posterior femoral surface and medial side of the lateral femoral condyle | Its tendon was connected to the tendon of the second head |
| Second head | Lateral femoral condyle and lateral head of gastrocnemius | Its tendon was connected to the tendon of the first head |
| Third head | Lateral head of gastrocnemius | Its tendon contributed to the formation of the common plantaris tendon |
The tendons associated with the three heads ultimately formed a common plantaris tendon [8].
Tendon Course
The common plantaris tendon was located on the medial side of the soleus and passed medial to both the gastrocnemius and soleus, rather than through the usual space between them, before reaching the medial crural region [8].
Three-Headed Plantaris Muscle Fused with Distal Kaplan Fibres
Maślanka et al. [9] described a three-headed plantaris muscle in the right lower limb of an 82-year-old body donor. The first belly was fused at its origin with the distal Kaplan fibres, with some of its fibres additionally attaching to the lateral femoral condyle. The other two bellies were attached to the lateral femoral condyle and knee joint capsule by numerous thin muscle fibres.
| Component | Proximal attachment / origin | Morphology / continuation |
|---|---|---|
| First belly | Distal Kaplan fibres; additional fibres attached to the lateral femoral condyle | Fused at its origin with the distal Kaplan fibres |
| Other two bellies | Lateral femoral condyle and knee joint capsule | Attached by numerous thin muscle fibres |
Three-Headed Plantaris Muscle with Bipartite Insertion of Two Accessory Heads
Triantafyllou et al. [10] described a left-sided three-headed plantaris muscle with two accessory heads in an 84-year-old male cadaver. The contralateral plantaris muscle was typical.
| Component | Proximal attachment / origin | Morphology / insertion |
|---|---|---|
| First (typical) head | Popliteal surface of the femur; originated independently from the accessory heads | Contributed to the long and thin plantaris tendon; inserted into the calcaneal tuberosity |
| Two accessory heads | Popliteal surface of the femur; each originated independently | Each had a short and thin tendon with bipartite insertion: laterally into the first plantaris head and medially into the medial femoral condyle via their musculoaponeurotic complex expansion |
Four-Headed Plantaris Muscle
Zielinska et al. [11] described a four-headed plantaris muscle in the left lower limb of a 76-year-old male cadaver. All four heads connected to form a single muscle belly that continued as the plantaris tendon to the calcaneal tuberosity.
| Component | Proximal attachment / origin |
|---|---|
| First head | Popliteal surface of the femur |
| Second head | Distal Kaplan fibres |
| Third head | Lateral femoral epicondyle |
| Fourth head | Lateral femoral epicondyle |
Bilateral Accessory Plantaris Muscles with Asymmetric Origins and Insertions
Furno et al. [12] described bilateral accessory plantaris muscles with asymmetric origins and insertions in an 88-year-old Japanese female cadaver. Primary plantaris muscles were present bilaterally.
| Side | Accessory proximal morphology / origin | Accessory distal insertion |
|---|---|---|
| Left | Located superior and deep to the gastrocnemius heads in the popliteal fossa, relative to the primary plantaris muscle | Tendinous portion of the medial head of gastrocnemius |
| Right | Origin just lateral to the lateral supracondylar line of the femur | Tendinous portion of the lateral head of gastrocnemius |
Rare Proximal and Topographical Variants
This group includes rare case-based configurations in which the dominant anatomical variation involves an unusual proximal attachment / origin or an atypical topographical relationship of the plantaris muscle or tendon with adjacent neural, vascular or musculoskeletal structures. Associated muscle-belly, tendon-course or distal attachment features are described within the corresponding individual cases.
Plantaris Tendon Passing Between the Tibial Nerve and Its Branch to the Soleus Muscle
Das and Vasudeva [13] described an anomalous course of the plantaris tendon in the right lower limb of a 54-year-old male cadaver. In the lower part of the popliteal fossa, the tendon passed between the tibial nerve and its branch to the soleus muscle. No such variation was detected in the left lower limb.
| Anatomical feature | Observation |
|---|---|
| Proximal attachment / origin | Lateral supracondylar line of the femur and oblique popliteal ligament |
| Tendon course | Long slender tendon passed between the heads of the gastrocnemius and the soleus muscle |
| Neurotopographical relationship | In the lower part of the popliteal fossa, the tendon passed between the tibial nerve and its branch to the soleus muscle |
| Distal insertion | Medial border of the calcaneal tendon |
Plantaris Muscle with an Additional Tendinous Origin and Tibial Nerve–Soleus Branch Relationship
Nayak et al. [14] described a plantaris variation in the right lower limb of a 51-year-old male cadaver. An additional tendon arose from the fascia covering the popliteus muscle and joined the plantaris tendon. The plantaris muscle also had an unusual relationship with the tibial nerve and its branch to the soleus muscle.
| Anatomical feature | Observation |
|---|---|
| Plantaris muscle origin | Capsule of the knee joint and lateral head of the gastrocnemius |
| Additional tendon | Arose from the fascia covering the popliteus muscle and joined the plantaris tendon |
| Tendinous continuation | The two tendons merged to form a single tendon |
| Distal attachment / insertion | Common tendon attached to the tendocalcaneus |
| Neurotopographical relationship | Plantaris muscle positioned between the tibial nerve and its branch to the soleus muscle |
Bifurcated Plantaris Muscle with Complex Neurovascular Relationships in the Popliteal Fossa
Kotian et al. [15] described a bifurcated plantaris muscle in a 65-year-old male cadaver. The muscle originated from the lateral condyle of the femur as a single fleshy bundle deep to the origin of the lateral head of gastrocnemius and divided into two separate bellies approximately 1 cm distal to its origin. The two bellies followed different courses in relation to the popliteal neurovascular structures.
| Component | Morphology / course | Topographical and tendinous relationships |
|---|---|---|
| Common proximal portion | Single fleshy bundle arising from the lateral condyle of the femur; divided into two separate bellies approximately 1 cm distal to its origin | Located deep to the origin of the lateral head of gastrocnemius |
| Inferior, smaller belly | Spindle-shaped; passed obliquely downward and continued as a thin, later thread-like tendon | Passed posterior to the popliteal vessels and nerve to popliteus; its tendon ran posterior to the main trunk of the tibial nerve and its branch to soleus, but anterior to the nerves to the lateral head of gastrocnemius with additional branches to soleus. Distally, the tendon became very fine and passed deep to the medial head of gastrocnemius to the medial side of the origin of the soleus muscle |
| Superior, larger belly | Flat; coursed immediately posterior to the knee joint and became tendinous distally | Passed anterior to the popliteal vessels, tibial nerve and a common trunk from the tibial nerve to the medial head of gastrocnemius and soleus; most tendinous fibres blended with the knee joint capsule over the medial tibial condyle, deep to the medial head of gastrocnemius |
| Interconnection of the two divisions | A thin thread-like continuation from the superior division continued from the capsular insertion deep to the medial head of gastrocnemius and joined the thin tendon from the inferior division on the medial side of the origin of the soleus muscle | Formed a common tendinous band |
| Common tendinous band | Continued deep to the medial part of gastrocnemius and along the medial side of soleus | Emerged medial to the calcaneal tendon in the lower one-third of the leg and inserted onto the calcaneum |
Plantaris Muscle with Origin from the Knee Joint Capsule and Unusual Neurovascular Relationships
Olewnik et al. [16] described a plantaris muscle with an anomalous origin and course in a 71-year-old male cadaver. The muscle belly was attached to the knee joint capsule, medial to the lateral head of the gastrocnemius muscle, and passed posterior to the tibial nerve and popliteal vessels.
| Anatomical feature | Observation |
|---|---|
| Proximal attachment / origin | Knee joint capsule, medial to the lateral head of gastrocnemius |
| Muscle belly course | Passed posterior to the tibial nerve and popliteal vessels |
| Tendon course | Continued posterior to the tibial nerve; after entering the space between gastrocnemius and soleus, the tendon coursed medially |
| Distal attachment / insertion | Very wide insertion encircling the posterior and medial surfaces of the calcaneal tendon |
Double-Headed Plantaris Muscle with the Popliteal Neurovascular Bundle Passing Between Its Heads
Rao et al. [17] described a unilateral double-headed plantaris muscle in the right lower limb of an approximately 60-year-old female cadaver. The lateral head was fleshy and the medial head was aponeurotic. The two heads joined posterior to the main neurovascular bundle, while the narrow gap between them was traversed by the tibial nerve, popliteal vein and popliteal artery.
| Component | Proximal attachment / morphology | Course / continuation |
|---|---|---|
| Lateral head | Fleshy; originated from the lateral supracondylar line | Joined the medial head posterior to the main neurovascular bundle |
| Medial head | Aponeurotic; originated from the knee joint capsule, oblique popliteal ligament and fascia covering the popliteus muscle | Joined the lateral head posterior to the main neurovascular bundle |
| Neurovascular relationship | Narrow gap between the two heads | Traversed by the tibial nerve, popliteal vein and popliteal artery |
| Plantaris tendon | — | Passed first between gastrocnemius and soleus, then along the medial side of the tendocalcaneus to the ankle joint |
| Medial distal slip | — | At the ankle joint, merged with the anterior surface of the tendocalcaneus |
| Lateral distal slip | — | At the ankle joint, merged with the deep fascia lateral to the insertion of the tendocalcaneus |
Rare Tendon Course and Distal Attachment Variants
This group includes rare case-based configurations in which the dominant anatomical variation involves an unusual tendon course, distal continuation, branching pattern or terminal attachment / insertion. Cases in which the plantaris tendon is absent and the muscle instead continues through an atypical fascial structure are also included. Associated proximal, muscle-belly or topographical features are described within the corresponding individual cases.
Absent Plantaris Tendon with Fascial Continuation to the Soleus Muscle
Sugavasi et al. [18] described a unilateral plantaris variation in the right lower limb of a 60-year-old male cadaver. The muscle originated from the lateral supracondylar line of the femur, but the plantaris tendon was absent. Instead, the muscle belly ended as a thin fascia through which it fused with the soleus muscle near its origin.
| Anatomical feature | Observation |
|---|---|
| Proximal attachment / origin | Lateral supracondylar line of the femur |
| Muscle belly course | Coursed inferomedially, superficial to the popliteal vessels and tibial nerve, and deep to the lateral head of gastrocnemius |
| Distal fascial continuation | Muscle belly ended as a thin fascia through which it fused with the soleus muscle near its origin |
| Plantaris tendon | Absent |
Plantaris Tendon Insertion into the Deep Crural Fascia with Contralateral Absence of the Plantaris Muscle
Olewnik et al. [19] described two different plantaris configurations in a 58-year-old female cadaver. On the right side, the plantaris tendon inserted into the deep crural fascia. On the left side, the plantaris muscle was absent.
| Side | Anatomical feature | Observation |
|---|---|---|
| Right | Proximal attachment / origin | Knee joint capsule; origin located under the lateral head of gastrocnemius |
| Right | Muscle belly course | Ran between the medial head of gastrocnemius and soleus, then coursed toward the medial side of the leg, anterior to the Achilles tendon |
| Right | Distal attachment / insertion | Plantaris tendon inserted into the deep crural fascia |
| Left | Plantaris muscle | Absent |
Plantaris Tendon with Three Distal Bands and Four Insertion Points
Gonera et al. [20] described a complex distal configuration of the plantaris tendon in the right lower limb of a 68-year-old male cadaver. The tendon was completely separate from the Achilles tendon proximally and, distally, formed three bands with four insertion points.
| Component | Morphology / continuation | Distal attachment / insertion |
|---|---|---|
| Main plantaris tendon | Completely separate from the Achilles tendon proximally; ran between gastrocnemius and soleus without a fascial connection to the Achilles tendon | Distally formed three bands with four insertion points |
| Band A | Emerged from the main plantaris tendon | Middle rough area on the posterior surface of the calcaneus, near the flexor retinaculum of the tarsal canal |
| Band B | Continuation of the main plantaris tendon; bifurcated into branches B1 and B2 | B1 inserted on the medial side and B2 on the lateral side of the calcaneal tuberosity |
| Band C | Emerged from the main plantaris tendon | Superior nonarticular surface of the calcaneus, anterior to the Achilles tendon |
Plantaris Tendon with Four Distal Attachments and a Tendinous Bridge Between Band A and the Achilles Tendon
Kurtys et al. [21] described a complex distal configuration of the plantaris tendon in a 68-year-old male cadaver. No abnormalities of the plantaris muscle belly were detected, and the tendon initially followed a typical course. Distally, the main tendon divided into bands A and B, each of which subsequently divided into two terminal branches. An additional tendinous bridge, band C, was present between band A and the Achilles tendon.
| Component | Morphology / course | Distal attachment / relationship |
|---|---|---|
| Plantaris muscle | Muscle belly without detected abnormalities; origin located on the knee joint capsule under the lateral head of gastrocnemius | Continued as a long, thin plantaris tendon |
| Main plantaris tendon | Ran downward between soleus and the medial head of gastrocnemius, then appeared medial to the Achilles tendon; the course was initially typical until the tendon approached the Achilles tendon | Divided into two thinner bands, A and B, which descended parallel to each other before dividing again |
| Band A | One of two thinner bands arising from the main plantaris tendon; subsequently divided into A1 and A2 | Gave rise to the two distal branches A1 and A2 |
| Band A1 | Fan-shaped distal branch | Superomedial surface of the calcaneal tuberosity, separately from the Achilles tendon |
| Band A2 | Straight, plain distal branch | Medial surface of the calcaneal body |
| Band B | One of two thinner bands arising from the main plantaris tendon; subsequently divided into B1 and B2 | Gave rise to the two distal branches B1 and B2 |
| Band B1 | Distal branch of band B | Superior surface of the calcaneus, anterior to the calcaneal tendon |
| Band B2 | Distal branch of band B | Medial surface of the calcaneal body, medial and inferior to B1 and anterior to A2 |
| Band C | Tendinous bridge arising from the first centimetre of band A | Present between band A and the Achilles tendon; coursed toward the anteromedial surface of the Achilles tendon |
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VARIANTIS. Plantaris muscle: rare and case-based variants. In: VARIANTIS Encyclopedia of Human Anatomical Variation [Internet]. 2026 [cited 2026 Aug 27]. Available from: View entry URL
VARIANTIS (2026) ‘Plantaris muscle: rare and case-based variants’. VARIANTIS Encyclopedia of Human Anatomical Variation. Available at: View entry URL (Accessed: 27 August 2026).
VARIANTIS, ‘Plantaris muscle: rare and case-based variants’, VARIANTIS Encyclopedia of Human Anatomical Variation (2026), View entry URL [accessed 27 August 2026].