The Important Role of the Achilles Tendon

Whether or not you’re a student of history, you’ve got to admire the story-telling abilities of the ancient Greeks. Hellenistic civilization created some of the most compelling literary characters in history, including Achilles, a legendary warrior possessing unrivaled strength and skill. According to Greek mythology, Achilles’ received his invulnerability after being dunked into the mythical Styx River by his mother. This rendered Achilles impervious to nearly all attacks on his body. Despite his immense power, this imposing warrior did have one weakness – his heel, which had been grasped so tightly by his mother that the river’s waters did not touch it.

Though the Greek city-states would eventually be swallowed up by conquering armies, Achilles and other Greek legends continued to survive throughout the centuries. As a result, Greek gods and warriors have been used to name everything from cars to the United State’s moon landing program (dubbed the Apollo program, after the Greek god of music). This also explains why Philip Verheyen, a seventeenth-century Dutch surgeon, named the large tendon at the back of the heel after Achilles in 1693. In addition to its historical connotations, the term “Achilles’ heel” rolled off the tongue a lot better than “tendo magnus of Hippocrates,” the tendon’s previous name.

Keeping You Up and Moving

While the heel was Achilles’ only flaw, it would be unfair to characterize the Achilles tendon as some sort of brittle piece of tissue. To the contrary, actually – the Achilles tendon can claim the double honor of being both the largest and strongest tendon in the body. Like other tendons, the purpose of the Achilles’ tendon is to serve as a bridge between muscles and bone, connecting and transferring force between these key bodily components. A long band of fibrous and flexible tissue, the Achilles’ tendon is designed to connect the calf muscles to the heel bone.

Daily life would be much different (and much more difficult) without a fully functioning Achilles’ tendon. Your Achilles allows you to perform a plantar flexion movement; in plain English, this means that you are able to bend your foot and toes in a downwards motion. This may not seem that impressive, but this small feat allows the body to jump, sprint and climb walls. Even the simple act of walking utilizes the Achilles tendon. While performing any these motions, the calf’s two main muscles (known as the soleus and gastrocnemius) contract, subsequently placing pressure on the Achilles and forcing the heel to rise upward.

Injury, Pain and Tendonitis

As tough as the Achilles’ tendon is, it’s still susceptible to wear and tear. In fact, the Achilles is the most frequently injured tendon in the entire body. You might even say that the Achilles does somewhat qualify as a sort of weak spot, given that it is asked to handle such a large workload (although it’s probably not a fatal flaw, like it was for the warrior it’s named after). Furthermore, the Achilles receives a relatively small amount of blood from the body. This poor blood circulation makes it difficult for this tendon (and all tendons, for that matter) to bounce back quickly from injury.

One type of ailment that bothers millions of Americans every day is tendonitis. As its name would indicate, tendonitis is an affliction that strikes the body’s tendons, causing them to become swollen and inflamed. This inflammation is typically accompanied by a fair amount of pain. Unlike other physical injuries, which occur due to the impact of external forces, tendonitis develops after a certain tendon has been overworked.

With the amount of stress regularly placed upon the Achilles, it is not at all uncommon for this tendon to develop tendonitis. There are actually two specific types of tendonitis that can impact the Achilles tendon. Noninsertional Achilles tendonitis concentrates its attack on the middle section of the tendon, causing tiny tears in the tendon’s fibers. These fibers may also swell and thicken in size. In contrast, insertional Achilles tendonitis affects the lower portion of the Achilles, where the tendon attaches to the heel bone.

Aside from inflammation, both types of Achilles tendonitis can cause tendon fibers to harden, a process known as calcification. Further complicating matters is the development of bone spurs in patients with insertional Achilles tendonitis. Bone spurs are growths that from on the surfaces of bones. They can grind against surrounding tissues, leading to noticeable pain and discomfort. Regardless of which type of Achilles tendonitis develops, the patient can usually expect to encounter at least some of following symptoms:

• Pain and stiffness in the afflicted tendon during the morning hours
• Pain in the back of the heel or Achilles tendon. This pain can be further aggravated as the patient walks around.
• Intense pain proceeding an exercise workout
• The tendon becomes thicker
• Visible swelling that increases as the tendon is used throughout the day
• Bone spurs (if the patient has insertional Achilles tendonitis)

Since tendonitis is typically brought about by overworking the body, doctors advise patients to rest inflamed tendons.  This means that the patient must temporarily cease performing activities that could further irritate the injury. In addition, the patient will likely be encouraged to ice the tendon for up to 20 minute intervals. This tactic can be used several times throughout the day. Non-steroidal anti-inflammatory medications (NSAIDs) are another tool for dulling Achilles pain. A few well-known NSAIDs, such as ibuprofen and aspirin, can be purchased without a prescription.

Repairing a Torn Achilles

Nagging tendonitis in the Achilles tendon is certainly no walk in the park; however, it is still preferable to suffering a torn Achilles. As with any other tendon in the human body, the Achilles tendon can be stretched to the point of tearing. Such injuries are referred to as Achilles’ tendon ruptures. Because ruptures are caused when significant stress placed is upon the tendon, Achilles tears usually occur while the patient is playing a sport or otherwise engaged in some athletic activity.

In most cases, a ruptured Achilles makes its presence known (and felt) immediately. Many patients hear a “pop” or snapping sound emanating from their heel, instantly followed by a surge of pain. The damaged heel will probably see at least some degree of swelling. If the rupture is severe enough, the Achilles tendon will be unable to push the heel off of the ground, preventing the patient from walking normally. Patients are often unable to stand on the toes of the injured leg, and bending the damaged foot in a downward motion can become all but impossible.

At first glance, it would seem that surgery would be the first-line treatment for a ruptured Achilles. For a number of patients, this is indeed true. However, a torn Achilles tendon does not always necessitate surgery. The doctor might opt instead to have the patient wear a cast or special boot, which serves to elevate the heel as it heals. While this approach can allow the patient to avoid the surgeon’s knife, it is not without risk. The patient may face a significantly longer recovery period, and could also stand an elevated risk of re-injuring his or her Achilles tendon.

Achilles tendon surgery involves either a large incision in the back of the lower leg or several smaller incisions in the same area. Upon completing this step, the surgeon can then stitch the tendon back into one piece. If necessary, the surgeon can use grafts from other tendons to help reinforce the repaired Achilles. After leaving the hospital, the patient is issued a boot or cast to wear for six to twelve weeks. Physical rehabilitation exercises are also used to help restore the tendon’s strength and flexibility. It takes approximately four to six months for most patients make a full recovery.

Even if you’re not physically active, the Achilles tendon quietly plays a key part in your daily routine. And while his heel proved to be Achilles’ undoing, modern medicine is usually able to repair Achilles injuries in relatively short order.