The medial and lateral bellies of gastrocnemius: A cadaveric and ultrasound investigation

Abstract

It is commonly reported that the medial belly (MG) of the gastrocnemius muscle extends further distally than the lateral belly (LG). This observation is made in several standard anatomy texts with no explanation or quantitative data. In this study, the medial and lateral bellies of gastrocnemius in 45 embalmed cadavers were measured. The observed difference in length of the two bellies was found to be highly significant (mean difference in length = 1.74 cm, P < 0.001). In 8 out of 84 legs examined (9.5%), however, the MG was found to be shorter than the LG (three right legs, five left legs, bilateral in two individuals). Surprisingly, there was no correlation between the difference in muscle belly length in any individual and ipsilateral leg length or total body length, suggesting that the difference in belly length may be unrelated to biomechanical function. An ultrasound investigation into the activity pattern of the two bellies was carried out on five volunteers. Muscle activity was monitored during passive and active movements of the ankle and knee joints at different leg positions. During knee flexion and ankle plantarflexion, the LG contracted first in four of the five subjects, followed by the MG, then a period of either LG predomination or equal contraction. The fifth subject, who showed a reversed pattern of activity, had previously suffered an inversion injury of the ankle. We suggest that the initial activation of the LG may help to stabilize the ankle during plantarflexion. We found no evidence that gastrocnemius acts as a shunt muscle during distraction of the knee.