Association of Isolated Gastrocnemius Tightness in Patients with Heel Pain

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Zaina Tariq
Hamna Zahoor
Rahat Ayub
Anam Abbas
Rahat Afzal
Wadha Ijaz Kamran


Background: Heel pain is a common musculoskeletal complaint among adults, significantly impacting quality of life. Recent studies suggest a strong association between isolated gastrocnemius tightness and heel pain, although comprehensive research in diverse populations remains scarce. Understanding the relationship between gastrocnemius tightness and heel pain is crucial for developing effective treatment strategies.

Objective: This study aimed to investigate the association of isolated gastrocnemius tightness with heel pain in a Pakistani adult population, focusing on the prevalence of gastrocnemius tightness among individuals presenting with heel pain and the effectiveness of specific diagnostic tests in identifying this condition.

Methods: A prospective cross-sectional study was conducted involving 223 participants from various hospitals in Lahore, Pakistan. The study population comprised adults aged 30 to 60 years experiencing heel pain. Diagnostic assessments included the Windlass and Silfverskiöld tests to evaluate plantar fasciitis and gastrocnemius tightness, respectively. Data on age, gender, and test outcomes were collected and analyzed using SPSS version 25.0, employing descriptive statistics, Pearson's correlation, and significance testing to explore the association between heel pain and gastrocnemius tightness.

Results: The average age of participants was 42.24 ± 4.973 years, with a gender distribution of 59.6% females and 40.4% males. The Windlass test was positive in 89.2% (199) of participants, while the Silfverskiöld test showed a positive outcome for gastrocnemius tightness in 79.8% (178) of cases. A significant correlation was found between the results of the Windlass and Silfverskiöld tests (Pearson correlation = .691, p < .000), indicating a strong association between isolated gastrocnemius tightness and heel pain.

Conclusion: This study confirms a significant association between isolated gastrocnemius tightness and heel pain among adults in Lahore, Pakistan. The findings underscore the importance of assessing gastrocnemius tightness in patients presenting with heel pain and suggest that targeted interventions addressing this condition could enhance treatment outcomes.

Article Details

How to Cite
Tariq, Z., Zahoor, H., Ayub, R., Abbas, A., Afzal, R., & Kamran, W. I. (2024). Association of Isolated Gastrocnemius Tightness in Patients with Heel Pain. Journal of Health and Rehabilitation Research, 4(1), 734–738.
Author Biographies

Rahat Ayub, University of Manangement & Technology Lahore Pakistan.

Assistant Professor.

Anam Abbas, University of Management & Technology Lahore Pakistan.


Rahat Afzal, Govt Teaching Hospital Shahdara Lahore Pakistan.

Clinical Physiotherapist.


Anselmo DS, Thatcher L, Erfle D. Gastrocnemius recession as an alternative to midfoot arthrodesis for painful midfoot arthritis. The Journal of Foot and Ankle Surgery. 2020;59(5):1106-8.

Bandyopadhyay A, Kumar S, Mandal P. Isolated Gastrocnemius Contraction and Gastroc Recession Surgery in Case of Planter Fasciitis: A Systemic Review and Meta-Analysis. Indian Journal of Orthopaedics. 2023;57(9):1359-75.

Boonchum H, Bovonsunthonchai S, Sinsurin K, Kunanusornchai W. Effect of a home-based stretching exercise on multi-segmental foot motion and clinical outcomes in patients with plantar fasciitis. Journal of Musculoskeletal & Neuronal Interactions. 2020;20(3):411.

Busquets R, Sanchez-Raya J, Sallent A, Maled I, Duarri G. Proximal medial gastrocnemius release: muscle strength evaluation. Foot and Ankle Surgery. 2020;26(7):828-32.

Cobacho MT, Barcia JM, Freijó-Gutiérrez V, Caballero-Gómez F, Ferrer-Torregrosa J. A Predictive Model for Gastrocnemius Tightness in Forefoot Pain and Intractable Plantar Keratosis of the Second Rocker. Journal of the American Podiatric Medical Association. 2021;111(3).

DeHeer PA, Standish SN, Kirchner KJ, Fleischer AE. Prevalence and Distribution of Ankle Joint Equinus in 249 Consecutive Patients Attending a Foot and Ankle Specialty Clinic. Journal of the American Podiatric Medical Association. 2021;111(2).

Hoefnagels EM, Weerheijm L, Witteveen AG, Louwerens J-WK, Keijsers N. The effect of lengthening the gastrocnemius muscle in chronic therapy resistant plantar fasciitis. Foot and Ankle Surgery. 2021;27(5):543-9.

Jameel W, Ali M, Awais D, Asif T, Fasih M, Ilyas A, et al. Association between the plantar fasciitis and isolated contracture of gastrocnemius in Lahore. Pioneer Journal of Biostatistics and Medical Research. 2023;1(2).

Koh DTS, Yeo W, Koo KOT, Singh IR, Yeo NEM. Radiofrequency plantar fascia coblation with and without gastrocnemius recession in the management of recalcitrant plantar fasciitis. Foot & Ankle International. 2022;43(9):1167-73.

Laborde JM. Tendon Balancing for Diabetic Foot Ulcers, Foot Pain and Charcot Foot. Diabetic Foot-Recent Advances: IntechOpen; 2022.

Lalevée M, Menez C, Roussignol X, Hue AG, Dujardin F, Dodelin D, et al. A comparative study between isolated gastrocnemius tightness patients and controls by quantitative Gait analysis and baropodometry. Foot and Ankle Surgery. 2021;27(7):772-6.

Landorf KB, Kaminski MR, Munteanu SE, Zammit GV, Menz HB. Clinical measures of foot posture and ankle joint dorsiflexion do not differ in adults with and without plantar heel pain. Scientific reports. 2021;11(1):6451.

Latt LD, Jaffe DE, Tang Y, Taljanovic MS. Evaluation and treatment of chronic plantar fasciitis. Foot & ankle orthopaedics. 2020;5(1):2473011419896763.

Lee SH, Suh DH, Kim HJ, Jang WY, Park YH, Sung HJ, et al. Association of ankle dorsiflexion with plantar fasciitis. The Journal of Foot and Ankle Surgery. 2021;60(4):733-7.

Lee W, Giro ME, Crymes C. Association of Haglund Deformity Size and Insertional Achilles Tendinopathy. Foot & Ankle International. 2023:10711007231168625.

Mansur H, Ferreira GF, Ferreira-Junior JB, de Araújo BAS, Maranho DA. Leg length discrepancy is not a risk factor for plantar fasciitis. Archives of orthopaedic and trauma surgery. 2024:1-6.

Mohamed SHK, ALanni EF, Faggal MS, Ibrahim MM. Prevalence of Calf muscle tightness in asymptomatic flat foot subjects. Egyptian Journal of Physical Therapy. 2022;10(1):26-31.

Molund M. Isolated gastrocnemius tightness in foot pathology: diagnostics, treatment and outcomes. 2020.

Pearce CJ, Seow D, Lau BP. Correlation between gastrocnemius tightness and heel pain severity in plantar fasciitis. Foot & Ankle International. 2021;42(1):76-82.

Pickin CC, Elmajee M, Aljawadi A, Fathalla I, Pillai A. Gastrocnemius recession in recalcitrant plantar fasciitis: a systematic review. The Journal of Foot and Ankle Surgery. 2022;61(2):396-400.

Primadhi RA, Tohari NES, Kestriani ND. Effects of Running Intensity on Forefoot Plantar Pressure Elevation. Sport Mont. 2023;21(1).

Purnell J, Johnson AH, Cody EA. Outcomes of Isolated Open Gastrocnemius Recession for the Treatment of Chronic Insertional Achilles Tendinopathy: A Retrospective Cohort Study. Foot & Ankle International. 2023;44(11):1105-11.

Ramalingam K, Perumal D, Balan H, Leong JF, Thiruselvam T, BALAN H. The Incidence of Gastrocnemius Tightness Among Clinic Staff in a District Hospital’s Clinic in the State of Kedah, Malaysia. Cureus. 2023;15(6).

Riiser MO, Husebye EE, Hellesnes J, Molund M. Outcomes After Proximal Medial Gastrocnemius Recession and Stretching vs Stretching as Treatment of Chronic Plantar Fasciitis at 6-Year Follow-up. Foot & Ankle International. 2024;45(1):1-9.

Rose B, Singh D. Inferior heel pain. Orthopaedics and Trauma. 2020;34(1):10-6.

Ryskalin L, Morucci G, Soldani P, Gesi M. Do the fasciae of the soleus have a role in plantar fasciitis? Clinical Anatomy. 2023.

Sullivan J, Pappas E, Burns J. Role of mechanical factors in the clinical presentation of plantar heel pain: Implications for management. The Foot. 2020;42:101636.

Waqas N, Amjad F, Ilyas S, Zulfiqar F. The Impact of Habitual Heel Wearing on Calf Muscle Tightness. Annals of Punjab Medical College (APMC). 2021;15(2):152-6.