Achilles tendon

Achilles tendon

Infobox Anatomy
Name = Achilles tendon
Latin = tendo calcaneus, tendo Achillis
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Caption = Posterior view of the foot and leg, showing the Achilles tendon ("tendo calcaneus"). The gastrocnemius muscle is cut to expose the soleus.


Caption2 = Lateral view of the human ankle, including the Achilles tendon
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MeshName = Achilles+tendon
MeshNumber = A02.880.176
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DorlandsSuf = 12793915
The Achilles tendon (or occasionally Achilles’ tendon), also known as the calcaneal tendon or the tendocalcaneous, is a tendon of the posterior leg. It serves to attach the gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone.

Anatomy

The Achilles tendon is the tendonous extension of three muscles in the lower leg: gastrocnemius, soleus, and plantaris. In humans, the tendon passes behind the ankle. It is the thickest and strongest tendon in the body. It is about 15 cm long, and begins near the middle of the calf, but receives fleshy fibers on its anterior surface, almost to its lower end. Gradually becoming contracted below, it is inserted into the middle part of the posterior surface of the calcaneus, a bursa being interposed between the tendon and the upper part of this surface. The tendon spreads out somewhat at its lower end, so that its narrowest part is about 4 cm above its insertion. It is covered by the fascia and the integument, and stands out prominently behind the bone; the gap is filled up with areolar and adipose tissue. Along its lateral side, but superficial to it, is the small saphenous vein. The Achilles' muscle reflex tests the integrity of the S1 spinal root.

Nomenclature

The oldest-known written record of the tendon being named for Achilles is in 1693 by the Flemish/Dutch anatomist Philip Verheyen. In his widely used text "Corporis Humani Anatomia", Chapter XV, page 328, he described the tendon's location and said that it was commonly called "the cord of Achilles" ("quae vulgo dicitur "chorda Achillis").

The name Achilles' heel comes from Greek mythology. Achilles' mother, the goddess Thetis, received a prophecy of her son's death. In order to protect him, she dipped him into the River Styx, which protected his entire body from harm. However, in order to dip him into the river, she needed to grab onto his heel. During the Trojan War, Achilles was struck on his unprotected heel by a poisoned arrow, which killed him.

Because eponyms have no relationship to the subject matter anatomical eponyms are being replaced by descriptive terms. The current terminology for Achilles tendon is calcaneal tendon. However, recently the medical community has decided to revert to the old eponyms and this tendon is, once again, known as the Achilles.

Role in disease

Achilles tendinitis is inflammation of the tendon, generally due to overuse of the affected limb or as part of a strain injury. More common is Achilles tendinosis, a degenerative condition with inflammation of the tendon, often accompanied by pain and swelling of the surrounding tissue and paratendon. Maffulli et al. suggested that the clinical label of tendinopathy should be given to the combination of tendon pain, swelling and impaired performance. Achilles tendon rupture is a partial or complete break in the tendon; it requires immobilisation or surgery. Xanthoma can develop in the Achilles tendon in patients with familial hypercholesterolemia.


=Treatment of da

Initial treatment of damage to the tendon is generally nonoperative. Orthotics can produce early relief to the tendon by the correction of malalignments, non-steroidal anti-inflammatory drugs (NSAIDs) are generally to be avoided as they make the more-common tendinopathy (degenerative) injuries worseFact|date=February 2007; though they may very occasionally be indicated for the rarer tendinitis (inflammatory) injuries. Physiotherapy by eccentric calf stretching under resistance is commonly recommended, usually in conjunction with podiatric insoles or heel cushioning. According to reports by Hakan Alfredson, M.D., and associates of clinical trials in Sweden, the pain in Achilles tendinopathy arises from the nerves associated with neovascularization and can be effectively treated with 1-4 small injections of a sclerosant. In a cross-over trial, 19 of 20 of his patients were successfully treated with this sclerotherapy.Fact|date=December 2007

In case of Achilles tendon rupture is concerned, there are three main types of treatment: the open and the percutaneous operative methods, and nonoperative approaches.

An achilles injury can take up to 12-16 months to recover from.

Role in postural orientation

Bilateral Achilles tendon vibration in the absence of vision has a major impact on postural orientation. [http://linkinghub.elsevier.com/retrieve/pii/S1388245707004221] Vibration applied to the Achilles tendon is well known to induce in freely standing subjects a backward body displacement and in restrained subjects an illusory forward body tilt. [http://linkinghub.elsevier.com/retrieve/pii/S0304394007000948] The vibrations stimulate muscle spindles in the calf muscles. The muscles spindles alert the brain that the body is moving forward, so the central nervous system compensates by moving the body backwards.


=Additional


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Look at other dictionaries:

  • Achilles tendon — n. the tendon connecting the back of the heel to the muscles of the calf: also written Achilles tendon …   English World dictionary

  • Achilles' tendon — A*chil les ten don, n. [L. Achillis tendo.] (Anat.) The strong tendon formed of the united tendons of the large muscles in the calf of the leg, an inserted into the bone of the heel; so called from the mythological account of Achilles being held… …   The Collaborative International Dictionary of English

  • Achilles tendon — from Mod.L. tendo Achillis, first used by German surgeon Heister and so called in reference to the one vulnerable spot of the great Greek hero ACHILLES (Cf. Achilles), whose mother held him by the heel when she dipped him in the River Styx to… …   Etymology dictionary

  • Achilles' tendon — Achilles heel, Achilles tendon Use an apostrophe in both expressions for consistency, even though the connection with Achilles is remote in the second …   Modern English usage

  • Achilles tendon — ► NOUN ▪ the tendon connecting calf muscles to the heel …   English terms dictionary

  • Achilles tendon — A tough sinew that attaches the calf muscle to the back of the heel bone. The Achilles tendon is one of the longest tendons in the body. It is also formally called the tendo Achilles or the tendo calcaneus, the calcaneus being the heel bone.… …   Medical dictionary

  • Achilles tendon — Anat. the tendon joining the calf muscles to the heel bone. Also, Achilles tendon. [1900 05] * * * ▪ anatomy also called  calcaneal tendon        strong tendon at the back of the heel that connects the calf muscles to the heel. The tendon is… …   Universalium

  • Achilles' tendon — n. the tendon connecting the heel with the calf muscles. * * * Achilles tendon noun The attachment of the soleus and gastrocnemius muscles of the calf of the leg to the heel bone • • • Main Entry: ↑Achillean * * * Achilles tendon, the strong… …   Useful english dictionary

  • Achilles tendon — UK [əˌkɪliːz ˈtendən] / US [əˌkɪlɪz ˈtendən] noun [countable] Word forms Achilles tendon : singular Achilles tendon plural Achilles tendons medical the tendon that joins the muscles in the back of your lower leg to the muscles in your heel …   English dictionary

  • Achilles tendon — [[t]əkɪ̱liːz te̱ndən[/t]] Achilles tendons N COUNT Your Achilles tendon or your Achilles is the tendon inside the back of your leg just above your heel …   English dictionary

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