Achilles tendon


Synonyms: Tendo calcaneus (lat.)

The structure known as the Achilles tendon is the insertion tendon of the three-headed muscle (Triceps surae muscle) of the lower leg. It is the thickest and strongest tendon in the human body.

Achilles tendon anatomy

The Achilles tendon is the thickest and strongest tendon in the human body. A tendon is the part of a muscle that connects the muscle to the bone and is made up of connective tissue. The Achilles tendon measures about 20 centimeters in length, is covered by a tendon sheath and consists of several tendon bundles, which in turn are composed of connective tissue fibers. The triceps surae muscle consists - as the name suggests - of 3 muscle heads. Two of them belong to the calf muscle (Gastrocnemius muscle), one of which belongs to the clod muscle (Soleus muscle).

All three muscle heads combine in their course to form an Achilles tendon with which they are Heel bone (Calcaneus) apply. The Achilles tendon sets on the entire width of the one located here Prominences, the Calcaneal tuberosity, on. The Achilles tendon pulls over the upper part of this protruding bone and then attaches a little further down to the bone. So that the tendon does not lie directly on the bone in this area, is located here a bursa between the Achilles tendon and the bone (Bursa tendinis calcanei). A Bursa is a small liquid-filled sachetthat serves to the Reduce pressure and friction between tendons, muscles and bones.
At the base of the bone is the Achilles tendon widest, in the course upwards it tapers. The the narrowest point is about 4 cm above the bone base, the so-called ´´Achilles tendon waist´´, then it runs in the three-headed calf muscle, becoming wider and wider. This is made up of two individual muscles: a two-headed calf muscle (gastrocnemius muscle), which arises on both sides of the thighbone (femur) in the hollow of the knee, and a single-headed clot muscle (soleus muscle). The clod muscle has its origin at the back of the Shin (Tibia) and am Fibula head (Fibula).
The Achilles tendon transmits the force of this large three-headed calf muscle. This is especially the powerful flexion of the Foot towards the sole of the foot (Plantar flexion) and the Elevation of the inner edge of the foot with simultaneous lowering of the outer edge (Supination) made possible. The Achilles tendon runs at a certain distance from the lower leg bone, embedded between the superficial and the deep sheet of the so-called lower leg fascia, an enveloping layer of connective tissue. Also enclosed by these two fascia sheets is one Fat body (Corpus adiposum subachilleum), the Fills the space between the Achilles tendon and the lower leg bone. The skin above the Achilles tendon is relative thin and easy to move, hence the Achilles tendon itself easily palpable from the outside. The branches of the posterior tibial artery (Arteria tibialis posterior) and the Fibula artery (Fibular artery) supply the Achilles tendon with blood. The Innervation of the three-headed calf muscle and the Achilles tendon is via the Tibial nerve (Nervus tibialis), from the Sciatic nerve (Sciatic nerve) arises.

Illustration of the Achilles tendon

Illustration of the right lower leg and back of the foot with Achilles tendon (red): A - from behind and B - from the outside
  1. Achilles tendon -
    Tendo calcaneus
  2. Internal calf muscle -
    M. gastrocnemius,
    Caput mediale
  3. External calf muscle -
    M. gastrocnemius,
    Caput laterale
  4. Sole muscle - Plantaris muscle
  5. Clod muscle -
    Soleus muscle
  6. Long fibula muscle -
    Muscle fibularis longus
  7. Shin bones -
    Medial malleolus
  8. Flexor tendon retaining strap -
    Retinaculum musculorum
  9. Calcaneal tuberosity -
    Calcaneal tuberosity
  10. Cuboid bone - Os cuboideum
  11. Tibia anterior muscle -
    Muscle tibialis anterior
  12. Long toe extender -
    Muscle extensor digitorum longus
  13. Fibula short muscle -
    Muscle fibularis brevis
  14. Upper strap of the
    Fibula tendon -
    Retinaculum musculorum fibularium superius

Here you get to: Illustration of the Achilles tendon

You can find an overview of all Dr-Gumpert images at: medical illustrations

Function of the Achilles tendon

Contracts the Triceps surae muscle, so this leads - via the Achilles tendon - to a Plantar flexion. That is the movement that you make when you are on Tiptoe represents. Also at the Supination (turning the Footlike trying to see the bottom of the foot) the muscle with its Achilles tendon is involved.

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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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Athletes (joggers, soccer players, etc.) are particularly often affected by the Achilles tendonitis disease. In many cases, the cause of the Achilles tendonitis cannot be identified at first. Therefore, the treatment requires a lot of experience. I focus on Achilles tendonitis.

The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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The Achilles tendon reflex

The examination of the Achilles tendon reflex is part of the standard examination of the patient in neurology. Here the examiner stretches the muscle (and therefore also the tendon) the patient usually suggests something by pushing / pulling the forefoot upwards a little and then striking the tendon with the reflex hammer.
If the reflex is intact, the foot moves downwards (Plantar flexion). The interconnection of the reflex runs via the tibial nerve and the spinal cord segments S1 and S2.

Naming of the Achilles tendon

Achilles (Achilles) was a hero in Greek mythology who was mortal as the son of a divine mother and a human father. His mother Thetis wanted to make him invulnerable at least and bathed him for this purpose in the river Styx, which separated the underworld from the upper world. But the heel on which she held it when she immersed it did not come into contact with the water and thus became its only vulnerable place, the "Achilles' heel". Later it would be a poisonous arrow that hit and killed him right there.

Stretching the Achilles tendon

It is particularly common in the Achilles tendon Tendon shorteningthat very painful could be. The best therapy ask for acute complaints stretching if possible several times a day and each for about 30 seconds. For example, you can use a simple Lunge forward, when the leg on the affected side is back, achieve a stretch of the Achilles tendon. To do this, straighten the upper body and bend the front leg, the back leg is firmly on the floor and the heel is pressed down. Are suitable in everyday life Stairsto stretch the Achilles tendon by standing on the step with only your forefoot and slowly letting your affected heel hang down over the edge. If you experience pain while stretching, you should stop stretching immediately and seek physiotherapeutic advice. But also chronic inflammation the Achilles tendon, as it is common in Athletes can occur through such Stretching exercises are treated and the with it the pain often associated with it subsides.

Taping the Achilles tendon

Under Taping one understands the application of a functional adhesive plaster tapethe treated Joints or Muscles does not completely immobilize, but only prevents unwanted or excessive movement.
Tape dressings can thus support the stability of the muscle and bone apparatus. Regarding the Achilles tendon can Taping help with pain, shortening and overstrain, but plays a role especially in the prevention of Achilles tendon complaints.
So that a tape bandage can actually fulfill its function, it should be under professional guidance be created.
Strip-shaped tapes are stuck parallel to the Achilles tendon on the heel bone, the posterior fibula and under the foot to relieve the Achilles tendon and stabilize the ankle. The decision to tape the Achilles tendon should always be made by a doctor or therapist.
A Kinesio tape bandage the Achilles tendon does not provide support, it is not a substitute for a splint or achilles tendon bandage, it can only relieve discomfort and pain.
Acute injuries and swelling or external injuries speak against the use of a tape dressing and should be examined by a doctor or physical therapist. Also at Achilles tendinitis or partial tears of the Achilles tendon, taping is no longer sufficient.
Only in the final stages of recovery after therapy can a tape be used again to provide mechanical support for the Achilles tendon in order to stabilize the ankle.

You can find further information on this under our topic: Taping for achilles tendonitis