Ankle Plantar Flexion

Electrode Placement
Application Instruction by Dr. Lucinda Baker

Electrode placement for plantar flexion stimulation. The popliteal fossa is marked, and the lateral malleolus is visible. Two large electrodes are used, along with a symmetric biphasic waveform, to allow activation of the whole gastroc soleus complex. The proximal electrode is placed over the origins of both the medial and the lateral gastroc. The distal electrode is placed over the soleus, where it is exposed.

Ankle Plantar Flexion

Video Instruction
Audio Transcript:

Electrode placement for plantar flexion stimulation. The popliteal fossa is marked, and the lateral malleolus is visible. Two large electrodes are used, along with a symmetric biphasic waveform, to allow activation of the whole gastroc soleus complex. The proximal electrode is placed over the origins of both the medial and the lateral gastroc. The distal electrode is placed over the soleus, where it is exposed.

During stimulation active plantar flexion occurs, but because this subject is not weight bearing it would have to be graded two out of five.

Strong activation of the gastric-soleus complex can cause severe cramping. Powerful contractions should always be done with the subject standing on the limb being stimulated.

Ankle Plantar Flexion

Muscle Anatomy

Muscles involved in ankle plantar flexion

Gastrocnemius
Origin: Superior to articular surfaces of lateral condyle of femur and medial condyle of femur
Insertion: Tendo calcaneus (Achilles tendon) into mid-posterior calcaneus
Other actions: Flexes knee

Soleus
Origin: Fibula, medial border of tibia (Soleal line)
Insertion: Tendo calcaneus (Achilles tendon)

Plantaris
Origin: Lateral supracondylar ridge of femur above lateral head of gastrocnemius
Insertion: Endo calcaneus (Medial side, deep to Gastrocnemius tendon)
Other actions: Flexes knee

Ankle Plantar Flexion

Nerve Anatomy

Nerves involved in ankle plantar flexion:

Gastrocnemius
Nerve innervation: Tibial nerve from the sciatic nerve
Nerve root: S1-S2

Soleus
Nerve innervation: Tibial nerve
Nerve root: L5-S1

Plantaris
Nerve innervation: Tibial nerve
Nerve root: Anterior rami of S1-S2