Evil King Nidud of Sweden captured a blacksmith named Wieland and forced him into labor. To prevent him from escaping, the king severed his Achilles tendons. Years later, Wieland took his revenge in a way that cannot easily be described in a family-friendly manner.1
There is the biblical story of how Jacob wrestled with an angel who injured his hip, resulting in a persistent limp. Due to Jacob’s injury, “the children of Israel do not eat the hip tendon until this very day, for Jacob’s thigh joint was afflicted at the hip tendon.”3
Perhaps the best-known tendon tale revolves around the Greek demigod, Achilles, who was slain by an arrow that impaled his tendon-heel area, the only part of his body that had not been doused in the River Styx and, thus, was vulnerable to injury. Interestingly, the term, Achilles’ heel, was not coined until 1693, by Dutch anatomist Verheyden after he dissected his own amputated leg.1
Tendons Toiling Quietly
As the anatomical structures that connect muscle and bone, tendons transmit the muscle contraction force to the skeleton required to maintain posture or produce motion. Most of us are blissfully unaware of their yeoman efforts. After all, tendons toil quietly behind the scenes, efficiently propelling our bodies by transferring energy forces from the spring in our step upward through our calves and into our thighs. They help us easily pull sweaters over our heads or enable tennis players to accurately serve balls at speeds in excess of 140 miles per hour. The key word is quietly, because an injured or inflamed tendon or bursa can turn the most mundane task into a highly challenging and painful chore.
In fact, soft tissue injuries account for a striking and rising percentage of all healthcare visits. The American Academy of Orthopaedic Surgeons estimated that in 2008, nearly 2 million people consulted a physician just for rotator cuff-related issues.4 This goodly number reflects some important societal trends developing over the past few decades: People are living longer, working hard and playing harder. The vast majority of these patients were likely diagnosed as having tendinopathy, a nebulous descriptor used to denote a chronic tendon injury that fails to provide any clues as to its etiology. The pathogenesis of tendinopathy remains poorly understood and has been variously defined as being either the result of a degenerative disorder, another inelegant medical term used as a substitute for aging, or as a failure of the healing process.5
