Posterior view of the foot and leg, showing the Achilles tendon (tendo calcaneus). The gastrocnemius muscle is cut to expose the soleus. The Achilles' tendon or heel (tendo Achillis) or the calcaneal tendon (tendo calcaneus) is a tendon of the posterior leg. It serves to attach the gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone. Achilles' heel is also a common expression for the single vulnerable spot in something or someone (in reference to the Achilles story from Greek Mythology). Contents 1 Anatomy 2 Nomenclature 2.1 Achilles' heel 2.2 Achilles' tendon 3 Role in disease 4 Treatment of Achilles' tendon damage 5 External links Anatomy In humans it passes behind the ankle. It is the thickest and strongest tendon in the body. It is about 15 cm long, and begins near the middle of the leg, but receives fleshy fibers on its anterior surface, almost to its lower end. Gradually becoming contracted below, it is inserted into the middle part of the posterior surface of the calcaneus, a bursa being interposed between the tendon and the upper part of this surface. The tendon spreads out somewhat at its lower end, so that its narrowest part is about 4 cm. above its insertion. It is covered by the fascia and the integument, and stands out prominently behind the bone; the gap is filled up with areolar and adipose tissue. Along its lateral side, but superficial to it, is the small saphenous vein. Nomenclature Achilles' heel Popular assumption is that "Achilles heel" gets its name from one of the later myths about the hero Achilles, from Greek mythology. His mother Thetis decided to make him invulnerable, so she dipped him as a baby into the river Styx, whose waters had the power to do this. However, she held the baby by his heel and forgot to immerse that too, leaving that as his only vulnerable spot. In this story (but not others), Achilles was killed by an arrow directed at his heel. The use of "Achilles' heel" or "Achilles heel" as an English expression for "area of weakness, vulnerable spot" dates only to 1855 (Merriam-Webster), or, in the form "heel of Achilles," 1810 (OED: Coleridge, "Ireland, that vulnerable heel of the British Achilles".) Achilles' tendon Some try to extend the story about Thetis (above) to explain why the tendon is called the Achilles tendon. Perhaps this legend was applied to the calcaneal tendon owing to how painful it is to have it struck, and how crippling it is to have it severed. The oldest-known written record of the tendon being named for Achilles is in 1693 by the Flemish/Dutch anatomist Philip Verheyen. In his widely used text /Corporis Humani Anatomia/, Chapter XV, page 328, he described its location and said that this tendon is commonly called "the cord of Achilles" ("quae vulgo dicitur /chorda Achillis/". Why would there have been such a common name? A quite plausible reason is that in the Iliad, Book XXII, Achilles cut holes in that area of the feet of his slain enemy Hector, lashed the feet together with ox-hide, and dragged his body behind his chariot. Different translations of the Iliad vary slightly on the details. This translation by Walter Leaf says: "The tendons of both feet behind he [Achilles] slit from heel to ankle-joint, and thrust there through thongs of ox-hide, and bound him to his chariot, leaving his head to trail." The tendons were the dead Hector's, not Achilles', but in this theory, they became the means that served Achilles' ends. Role in disease Achilles tendinitis is inflammation of the tendon, generally due to overuse of the affected limb or as part of a strain injury. Achilles tendon rupture is a partial or complete break in the tendon; it requires immobilisation or surgery. Xanthoma can develop in the Achilles tendon in patients with familial hypercholesterolemia. Treatment of Achilles' tendon damage Initial treatment of damage to the tendon is generally nonoperative. Orthotics can produce early relief to the tendon by the correction of malalignments, non-steroidal anti-inflammatory drugs (NSAIDs) are also known to be effective. Where tendon rupture is concerned, there are three main types of treatment: the open operative method, the percutaneous operative method and nonoperative options. External links Detailed discussion of repair strategies for Achilles' Tendon Rupturede:Achillessehne Search Term: "Achilles%27_tendon" Categories: Eponymous anatomical structures