Inclusive Anatomy
Structure:
The calcaneal tendon, commonly referred to as the Achilles tendon, is a strong fibrous structure located on the posterior aspect of the lower leg. It is formed by the convergence of the gastrocnemius and soleus muscles and inserts onto the posterior surface of the calcaneus. [1] This tendon lies posterior to the ankle joint and is easily palpable beneath the skin at the back of the ankle. [1]
Structurally, the calcaneal tendon is composed predominantly of dense collagen fibers arranged to withstand high tensile forces. [2] The plantaris tendon often courses adjacent to the calcaneal tendon, although it contributes minimally to ankle movement. [3] A key spatial relationship exists between the calcaneal tendon and the calcaneal bursa, which lies between the tendon and the calcaneus and functions to reduce friction during movement. [1] The calcaneal tendon is the thickest and strongest tendon in the human body, reflecting its essential role in locomotion. [3]
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Function:
The calcaneal tendon enables plantar flexion of the foot by transmitting the force generated by the calf muscles to the calcaneus. This action is essential for activities such as walking, running, and jumping.[4] During the gait cycle, the tendon functions as an elastic structure, storing mechanical energy during foot strike and releasing it during push-off, thereby improving movement efficiency.[5]
Due to its role in force transmission, the calcaneal tendon is subjected to substantial mechanical stress and is vulnerable to injury. Common conditions include tendinopathy, inflammation, and rupture, which may significantly impair mobility and athletic performance.[5] Management of these injuries may involve conservative treatment or surgical intervention, depending on severity.[5]
References:
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Salzman SH, O'Keefe RJ, & Fox JM. The Achilles tendon: Function and pathology. Sports Medicine, 2005; 35(4): 293-301.
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Pheasant SK. The spring in the Achilles tendon during human locomotion. Journal of Experimental Biology, 1988; 137: 39-45.
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Baker LA. Biomechanics of the Achilles tendon. Clinical Orthopaedics and Related Research, 1976; 114: 191-195. doi: 10.1080/09638280701785494
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Maffulli N, Khan KM, & Puddu G. Achilles tendon disorders: Epidemiology and treatment. Journal of Orthopaedic & Sports Physical Therapy, 2004; 34(7): 379-386. doi: 10.1016/j.fcl.2005.01.013
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Alfredson H, Pietilä T, & Jonsson P. Chronic Achilles tendinopathy: An overlooked condition in sports medicine. Journal of Sports Science and Medicine, 1998; 1(1): 1-10. doi:10.1016/s0278-5919(03)00010-3
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