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Achilles tendon is the thickest and strongest tendon in the human body. The Achilles tendon is the connection between the calf muscles and the calf bone. The most important function of the Achilles tendon is to contribute to the plantar flexion of the foot - a movement that is repeatedly performed by tiptoeing, running or jumping. Despite high strength, the Achilles tendon is relatively often overloaded and injured. Find out how the Achilles tendon is built, what functions does the Achilles tendon perform, what diseases may affect the Achilles tendon and what tests allow you to assess the condition of the Achilles tendon.

Achilles tendonotherwise calcaneus tendon (Latintendo Achillis ,tendo calcaneus ) to the largest tendon in the human body. Its name comes from Achilles, the Greek hero, the hero of the Trojan War.

Before we get into the description of the Achilles tendon, let's answer a more general question: what is a tendon? In anatomy, a tendon is the structure that connects a muscle to a bone. Tendons are characterized by high endurance and low flexibility, thanks to which they enable the transfer of muscle work to changing the mutual position of the bones.

Although tendons are direct extensions of muscles, the microscopic structure of these structures is extremely different. The main component of tendons are tightly packed collagen fibers, guaranteeing their adequate strength. We already know where the tendons are in our body - where the muscles attach to the bones. How can we describe the location of the Achilles tendon?

Painful shoulder syndrome: symptoms and treatment Achilles tendon - location and structure

The Achilles tendon is located in the posterior-lower part of the lower leg. The structure of the lower leg consists of two bones (tibia and fibula) and numerous muscles, which for easier orientation are divided into anterior, lateral and posterior sections. In the context of the Achilles tendon, the muscles of the posterior group of the lower leg are the most important.

The Achilles tendon is the joint ending of two of them: the gastrocnemius muscle and the soleus muscle. These muscles are often collectively referred to as "calf triceps". These are superficial muscles that tighten e.g. while standing on tiptoe.

Achilles tendon is a trailer abovethese muscles to the back of the calcaneus known as the calcaneus tumor. The name of the Achilles tendon comes from Greek mythology - it was supposed to be the only lethal point of the famous warrior after whom it was named.

The average length of the Achilles tendon is 15 cm, although individually it can reach from 11 cm up to 26 cm. The beginning of the Achilles tendon is roughly halfway down the calf. The Achilles tendon is not uniform in shape. Its initial section is flat and wide, while further sections are gradually narrowing and rounding.

The thinnest point on the Achilles tendon is approx. 4 cm above the heel attachment. The Achilles tendon is surrounded by a thin sheath that allows the tendon to slide freely during movements. The so-called synovial bursae, located in the places where the tendon adjoins the bone.

These are small spaces filled with slime, reminiscent of pillows in shape. Their task is to reduce the friction between the tendon and the bone.

In the anatomy of the Achilles tendon, one more issue needs to be mentioned: vascularization. The Achilles tendon is supplied with blood through two vessels - the posterior tibial artery and the peroneal artery. Unfortunately, the vascularization of the Achilles tendon is not equally efficient in all sections of the tendon.

Especially the middle part of the Achilles tendon has the relatively least developed network of blood vessels. This is an important factor in increasing your susceptibility to injury. The Achilles tendon at a height of 2-6 cm above the calcaneus tumor is most prone to damage, and in extreme cases - complete rupture.

Achilles tendon - features

The Achilles tendon transfers the action of the calf triceps muscle to the calf bone, causing the so-called plantar flexion of the foot. It is a movement in which the toes of the foot move away from the front of the shin - the heel rises and the front of the foot "down". We use the Achilles tendon for normal walking, as well as for running and jumping.

The latter activities are associated with a significant load on the Achilles tendon, reaching even 5-10 times our body weight. The Achilles tendon also has a number of additional functions - it stabilizes the ankle joint, absorbs shocks and is involved in turning the foot (rotation of its outer edge downwards).

Via the Achilles tendon, the soleus allows us to stand. Thanks to it, our lower legs maintain a stable position while standingto the feet and do not lean forward.

Achilles tendon - diagnostic tests

The most common symptom of Achilles tendon abnormalities is pain. How can we find out that the source of the problem is actually the Achilles tendon and not other structures of the ankle or lower leg? The most readily available method is a clinical examination, which may reveal pain on palpation (by touch) of the Achilles tendon and increased tendon contour or swelling in the surrounding tissue.

There are also functional tests that allow the Achilles tendon to function. Their advantage is the possibility of quick execution "on the spot" during a visit to the doctor, while their disadvantage is the detection of only advanced pathologies, such as complete rupture of the Achilles tendon.

An example of a test used in the examination of the Achilles tendon is the Thomson test, which consists in compressing the lower leg at the level of the initial section of the Achilles tendon. In a properly functioning tendon, this maneuver causes a slight plantar flexion of the foot and an upward movement of the heel. In the absence of any foot movement, we may suspect significant Achilles tendon dysfunction, such as rupture.

The clinical examination allows only a preliminary assessment of the condition of the Achilles tendon. Additional imaging studies are usually required to get a closer look at its structure. The choice of the type of examination depends on the specific clinical situation. As the Achilles tendon is made of soft tissues, it is imaged using research dedicated to this type of tissue.

For this reason, it is impossible to visualize the Achilles tendon on a standard X-ray image. X-rays, however, can be useful for assessing the surrounding bone structures, so they are routinely performed, for example in the event of an injury.

Ultrasound examination (USG) can be used to assess the structure and continuity of the Achilles tendon. It is cheap and readily available. Moving the foot during the examination also allows the evaluation of the Achilles tendon in motion. If the Achilles tendon is inflamed, a Doppler ultrasound scan may show increased blood flow to the area of ​​inflammation. The most accurate image of the Achilles tendon and the surrounding soft tissues is obtained by magnetic resonance imaging (MRI). Compared to ultrasound, however, it is much more expensive and less accessible.

Achilles tendon - diseases

Achilles tendon diseases are most often traumatic. Their typical cause is overload during physical activity. The Achilles tendon dysfunction isso mostly athletes are at risk, although there are also other factors that increase their risk. These include overweight, congenital defects in the structure of the lower legs and feet (e.g. flat feet), and the wearing of poorly selected shoes. The most common conditions associated with the Achilles tendon are listed below:

Achilles tendonitis

Achilles tendonitis belongs to the so-called tendinopathy, i.e. diseases affecting the muscle tendons. Inflammation of the Achilles tendon may be acute - then the dominant symptom is sudden, severe pain and swelling in the tendon area. Long-term overload of the Achilles tendon may lead to degenerative changes.

Their most common symptoms are chronic pain and tendon mobility disorders. The causes of Achilles tendinitis are very often related to improperly selected physical activity: performing excessively strenuous exercises or constant repetition of one type of exercise significantly increases the risk of uneven muscle work. In turn, abnormal movement patterns can damage the Achilles tendon and cause inflammation.

The most effective method of preventing Achilles tendon diseases is taking care of proper, balanced physical activity. Remember the key importance of complementing your training, such as warming up, stretching your muscles and tendons, and proper recovery.

But what should we do when we have Achilles tendonitis? Initially, the tendon should be relieved by refraining from physical activity. On an ad hoc basis, we can use painkillers and anti-inflammatory drugs, as well as ice packs. In order to identify the cause of the disease, it is worth going to a physiotherapist for help. Properly selected exercises and various methods of physical therapy are of great importance in the prevention of recurrent inflammation.

Achilles tendon rupture

Achilles tendon rupture is an example of extreme damage, most often caused by high-energy trauma. The tear is typically located 2 - 6 cm above the calcaneal tumor. Achilles tendon rupture is often accompanied by a characteristic "click" followed by pain, swelling and disturbed mobility of the tendon.

Confirmation of an Achilles tendon rupture is usually obtained by ultrasound. Complete rupture of the Achilles tendon requires a surgical procedure to sew the ends of the tendon together and restore its normal anatomy.

After surgery, appropriate rehabilitation is necessary - initially relieving the tendon and allowing it to heal, then gradually restoring mobility of the tendon,and in the last phase - exercises to restore muscle strength and proper motor coordination.

Yellow Achilles tendon

The cause of the last of the presented diseases of the Achilles tendon is not injuries, but metabolic disorders. Yellows (yellow tufts, Latinxanthomata ) Achilles tendons are caused by elevated blood cholesterol levels - hypercholesterolaemia.

The saturation of blood with cholesterol leads to the formation of characteristic subcutaneous cholesterol lumps. Jaundice can form throughout the body, but the Achilles tendon is a very common location. Achilles tendon yellows are not only of cosmetic importance - unfortunately, they can also cause pain and recurrent inflammation within the tendon.

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Anatomy