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Portrait of Achilles tendon

Anatomy · Joints & cartilage

Achilles tendon

Named in 1693

Lower limb · back of the leg

The Achilles (calcaneal) tendon is the thickest and strongest tendon in the body. It joins the gastrocnemius and soleus muscles of the calf to the back of the calcaneus, the heel bone, and drives plantarflexion for walking, running and jumping. It is named after the hero of the Trojan War, though the story that gave 'Achilles' heel' its meaning does not come from Homer.

How to spot them

  • ▸A thick cord at the back of the ankle, running from the mid-calf to the back of the heel bone
  • ▸Formed by the merging tendons of gastrocnemius and soleus (with a small contribution from plantaris)
  • ▸A retrocalcaneal bursa lies between the tendon and the heel bone, and a fat pad in front of it (Kager's)
  • ▸About 15 cm long, narrowest a few centimetres above its insertion

What to know

The thickest and strongest tendon of the human body, joining calf muscles to the heel

Achilles tendon — the calcaneal tendon.

A sudden 'pop' at the back of the ankle, a feeling of being kicked, and the calf will not squeeze the foot down in a squeeze test

Achilles tendon — rupture, tested by the Thompson (Simmonds) test.

Named for a Greek hero whose only weak spot, in a later legend, was where his mother held him when she dipped him in the river Styx

Achilles tendon — the Achilles' heel.

Named in 1693 by a Flemish anatomist who dissected his own amputated leg

Achilles tendon — Philip Verheyen.

Certain quinolone antibiotics carry a warning about rupture of it, especially with steroids or in older people

Achilles tendon — fluoroquinolone tendinopathy.

Key ideas

  • The Achilles' heel myth: in Homer's Iliad Achilles is not made invulnerable at all. The dipping in the Styx and the vulnerable heel appear only in later sources, such as Statius in the first century AD.

Quick-fire facts

  • •It is the largest and strongest tendon in the body.
  • •It is formed by the tendons of gastrocnemius and soleus, the triceps surae, and inserts on the posterior surface of the calcaneus.
  • •It has a relatively poor blood supply about 2 to 6 cm above its insertion, the commonest site of rupture and tendinopathy.
  • •In Greek myth Thetis dipped her baby Achilles in the river Styx holding him by the heel; the detail is not in Homer's Iliad and is post-Homeric.
  • •The anatomist Philip Verheyen named it 'chorda Achillis' in 1693.
  • •The Thompson (Simmonds) squeeze test: squeezing the calf fails to plantarflex the foot in a complete rupture.
  • •Ruptures usually happen in middle-aged 'weekend athletes' in sports like squash, tennis and football.
  • •It is the tendon that lets you rise on your toes.

Drill it — 7 cards

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Sources