Achilles tendon
American Heritage Dictionary:
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Achilles tendon
Oxford Food & Fitness Dictionary:
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Achilles tendon
A large tendon at the back of the ankle which connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). The tendon is very susceptible to injuries. An Achilles tendon weakened by lack of exercise may rupture if the calf muscle contracts suddenly (for example, when a badminton player suddenly changes from a backward to a forward motion or when a jogger misjudges a curb and lands too far forward on his or her foot). A rupture is often accompanied by a loud crack and victims think they have been struck violently behind the heel. In extreme cases, the tendon may be completely ruptured, leaving the victim incapacitated and requiring surgery. Less severe than a complete rupture, but more common, is Achilles tendinitis. This stress injury is characterized by inflammation, pain, and tenderness in and around the tendon. It is common among runners who train over long distances on hard surfaces, and those who increase their training intensity too quickly. Women distance runners who usually wear high-heeled shoes are at particular risk because these shoes effectively shorten the Achilles tendon over a period of years. When they adopt the more flat footed position during running, their tendons are subjected to more stress than they are used to. Training shoes with high backs or hard heeltabs also increase the risk of injury.
Treatment for Achilles tendinitis usually includes rest, medication (e.g. aspirin) to reduce the swelling, and appropriate physiotherapy. A heel pad to restrict the range of movement may provide some relief. In severe cases, surgery may be required. If not treated properly, an acute inflammation of the Achilles tendon can develop into a chronic condition that is very difficult to resolve. You can reduce the risk of injuring your Achilles tendon by including an Achilles stretch in your warm-up routine (figure 1). Although this stretch may be performed freestanding, it is easier to do against a wall.
Figure 1
▪ Stand upright about one large pace away from the wall with your feet parallel and about hip width apart. Place your hands against the wall, at shoulder height. Move your right leg half a pace forward. Lunge forward on your right leg so that the knee is brought directly above the ankle. Stretch your left leg back as far as is comfortable with the foot remaining flat on the floor. Slowly flex your left leg to stretch the lower calf muscles and tendon. Hold the stretch for about 10 seconds, relax, and repeat on the other leg.
Oxford Dictionary of Sports Science & Medicine:
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Achilles tendon
A large tendon at the back of the ankle which connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). The tendon is very susceptible to injuries. An Achilles tendon weakened by lack of exercise may rupture if the calf muscle contracts suddenly; for example, when a badminton player suddenly changes from a backward to a forward motion or when a jogger misjudges a curb, and lands too far forward on his or her foot. A rupture is often accompanied by a loud crack and the victims often think that they have been struck violently behind the heel. In extreme cases, the tendon maybe completely ruptured, leaving the victim incapacitated and requiring surgery. Less severe than a complete rupture, but more common is Achilles tendinitis.
Columbia Encyclopedia:
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Achilles tendon
Achilles' tendon (tendo calcaneus) (tĕn'dō kălkā'nēəs), sinew prominent at the back of the ankle, connecting the tendons of the calf muscles to the heelbone. When the musculature contracts, the pull on the Achilles' tendon elevates the heel in the springy motion essential to running and jumping. Since the effect is to lift the entire body weight against a severely adverse leverage ratio, the Achilles' tendon by necessity is the toughest and strongest of human tendons. The name derives from the mythical Greek hero Achilles, who was vulnerable only in the heel.
Dictionary of Cultural Literacy: Health:
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Achilles tendon
Saunders Veterinary Dictionary:
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Achilles tendon
The group of tendons that insert on the calcaneus near the point of the hock made up of the tendons of the gastrocnemius, soleus, superficial digital flexor, semitendinosus and biceps femoris muscles. Called also common calcaneal tendon. See also gastrocnemius muscle tendon.
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Achilles tendon
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This article has multiple issues. Please help improve it or discuss these issues on the talk page.
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This article is about vertebrate anatomy. For the metaphor of a single vulnerable spot, see Achilles' heel. For injury to the Achilles tendon, see Achilles tendon rupture.
| Achilles tendon | |
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| Posterior view of the foot and leg, showing the Achilles tendon (tendo calcaneus). The gastrocnemius muscle is cut to expose the soleus. | |
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| Lateral view of the human ankle, including the Achilles tendon | |
| Latin | tendo calcaneus, tendo Achillis |
| Gray's | subject #129 483 |
| MeSH | Achilles+tendon |
The Achilles tendon (or occasionally Achilles’ tendon), also known as the calcaneal tendon or the tendo calcaneus, is a tendon of the posterior leg. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone.
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Anatomy
The Achilles is the tendonous extension of 2 muscles in the lower leg: gastrocnemius and soleus. In humans, the tendon passes posterior to the ankle. It is the thickest and strongest tendon in the body. It is about 15 centimetres (6 in) 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 centimetres (1.6 in) 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. The tendon can receive a load stress 3.9 times body weight during walking and 7.7 times body weight when running. [1]
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", now also called "tendo achillies" by anatomists. ("quae vulgo dicitur chorda Achillis")[citation needed]
The name Achilles' heel comes from Greek mythology. Achilles' mother, the goddess Thetis, received a prophecy of her son's death. Hearing this, she dipped him into the River Styx to protect his body from harm. However, she kept hold of his heel, meaning that the water did not touch this part of his body and it was therefore vulnerable. During the Trojan War, Achilles was struck on his unprotected heel by a poisoned arrow shot by Paris, which killed him. In the same war, Achilles is also said to have cut behind Hector's Achilles tendons, having killed him, and threaded leather thongs through the incisions in order to drag him behind a chariot.
The Achilles tendon is also known as the calcaneal tendon. Because eponyms, names relating to people, have no relationship to the subject matter, most anatomical eponyms also have scientifically descriptive terms. The term calcaneal comes from the Latin calcaneum, meaning heel.
Role in disease
The most common Achilles tendon injuries are Achilles tendinosis and Achilles tendon rupture. Achilles tendinosis is the soreness or stiffness of the tendon, generally due to overuse. Achilles tendinitis (inflammation of the tendon) was thought to be the cause of most tendon pain, until the late 90s when scientists discovered no evidence of inflammation. Partial and full Achilles tendon ruptures are most likely to occur in sports requiring sudden eccentric stretching, such as sprinting. 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 immobilization or surgery. Xanthoma can develop in the Achilles tendon in patients with familial hypercholesterolemia.
Treatment of damage
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 worse[citation needed]; 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.[citation needed]
In a case where Achilles tendon rupture is concerned, there are three main types of treatment: the open and the percutaneous operative methods, and nonoperative approaches.
Depending on the severity of the injury, recovery from an Achilles injury can take up to 12–16 months.
Imaging findings
Achilles tendon degeneration (tendinosis) is typically investigated with either MRI or ultrasound. In both cases, the tendon is thickened, may demonstrate surrounding inflammation by virtue of the presence of paratenonitis, retrocalcaneal or retroAchilles bursitis. Within the tendon, increased blood flow, tendon fibril disorganisation and partial thickness tears may be identified. Achilles tendinosis frequently involves the mid portion of the tendon, however may involve the insertion where this is known as enthesopathy. Though enthesopathy may be seen in the context of advancing age, it is also associated with arthritis such as gout and the seronegative spondyloarthitides. Achilles tendinosis is a known risk factor for calf muscle tears.[2]
Evolution and function
The Achilles tendon is short or absent in great apes, but long in arboreal gibbons and humans.[3] It provides elastic energy storage in hopping,[4] walking, and running.[3] Computer models suggest this energy storage Achilles tendon increases top running speed by >80% reduces running costs by more than three-quarters.[3] It has been suggested that the "absence of a well-developed Achilles tendon in the nonhuman African apes would preclude them from effective running, both at high speeds and over extended distances."[3]
Role in postural orientation
Bilateral Achilles tendon vibration in the absence of vision has a major impact on postural orientation.[5] 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.[6] The vibrations stimulate muscle spindles in the calf muscles. The muscle spindles alert the brain that the body is moving forward, so the central nervous system compensates by moving the body backwards.
See also
References
- ^ Giddings, VL; Beaupré, GS; Whalen, RT; Carter, DR (2000). "Calcaneal loading during walking and running". Medicine and science in sports and exercise 32 (3): 627–34. doi:10.1097/00005768-200003000-00012. PMID 10731005.
- ^ Koulouris G, Ting AY, Jhamb A, Connell D, Kavanagh ECfsr4egdggd (2007). "Magnetic resonance imaging findings of injuries to the calf muscle complex". Skeletal Radiol 36 (10): 921–7. doi:10.1007/s00256-007-0306-6. PMID 17483942.
- ^ a b c d Sellers WI, Pataky TC, Caravaggi P, Crompton RH. (2010). Evolutionary Robotic Approaches in Primate Gait Analysis. Int J Primatol 31:321–338 doi:10.1007/s10764-010-9396-4
- ^ Lichtwark, GA; Wilson, AM (2005). "In vivo mechanical properties of the human Achilles tendon during one-legged hopping". The Journal of experimental biology 208 (Pt 24): 4715–25. doi:10.1242/jeb.01950. PMID 16326953. http://jeb.biologists.org/cgi/reprint/208/24/4715.
- ^ Effects of bilateral Achilles tendon vibration on postural orientation and balance during standing, 2007 International Federation of Clinical Neurophysiology. Published by Elsevier Inc.
- ^ ScienceDirect – Neuroscience Letters: Effect of Achilles tendon vibration on postural orientation
Additional images
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Achilles tendon.
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The popliteal, posterior tibial, and peroneal arteries.
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Back of left lower extremity.
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The mucous sheaths of the tendons around the ankle. Lateral aspect.
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The mucous sheaths of the tendons around the ankle. Medial aspect.
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Achilles tendon
External links
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American Heritage Dictionary
The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.
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Oxford Food & Fitness Dictionary
Food and Fitness: A Dictionary of Diet and Exercise. Copyright © 1997, 2003 by Oxford University Press. All rights reserved.
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Oxford Dictionary of Sports Science & Medicine
The Oxford Dictionary of Sports Science & Medicine. Copyright © Michael Kent 1998, 2006, 2007. All rights reserved.
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Columbia Encyclopedia
The Columbia Electronic Encyclopedia, Sixth Edition Copyright © 2012, Columbia University Press. Licensed from Columbia University Press. All rights reserved. www.cc.columbia.edu/cu/cup/.
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Dictionary of Cultural Literacy: Health
The New Dictionary of Cultural Literacy, Third Edition Edited by E.D. Hirsch, Jr., Joseph F. Kett, and
James Trefil. Copyright © 2002 by Houghton Mifflin Company. Published by Houghton Mifflin. All rights reserved.
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Saunders Veterinary Dictionary
Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.
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