title: Evolution of the Achilles tendon: The athlete's Achilles heel?
abstract: The Achilles tendon is believed to have first developed two million years ago enabling humans to run twice as fast. However if the Achilles tendon is so important in terms of evolution, then why is this tendon so prone to injury - especially for those more active like athletes. The Achilles tendon had an integral role in evolving apes from a herbivorous diet to early humans who started hunting for food over longer distances, resulting in bipedal locomotion. Evolutionary advantages of the Achilles tendon includes it being the strongest tendon in the body, having an energy-saving mechanism for fast locomotion, allows humans to jump and run, and additionally is a spring and shock absorber during gait. Considering these benefits it is therefore not surprising that studies have shown athletes have thicker Achilles tendons than subjects who are less active. However, contradictory to these findings that show the importance of the Achilles tendon for athletes, it is well known that obtaining an Achilles tendon injury for an athlete can be career-altering. A disadvantage of the Achilles tendon is that the aetiology of its pathology is complicated. Achilles tendon ruptures are believed to be caused by overloading the tensed tendon, like during sports. However studies have also shown athlete Achilles tendon ruptures to have degenerative changes in the tendon. Other flaws of the Achilles tendon are its non-uniform vascularity and incomplete repair system which may suggest the Achilles tendon is on the edge of evolution. Research has shown that there is a genetic influence on the predisposition a person has towards Achilles tendon injuries. So if this tendon is here to stay in our anatomy, and it probably is due to the slow rate of evolution in humans, research in genetic modification could be used to decrease athletes' predisposition to Achilles tendinopathy.
authors: University College London Medical School, Gower Street, London, WC1E 6BT, United Kingdom.
authors: S
authors: S
authors: Malvankar
authors: W S
authors: WS
authors: Khan
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D001265:Athletic Injuries / Q000150:complications* / Q000453:epidemiology; D014943:Global Health; D006801:Humans; D015994:Incidence; D012420:Running / Q000293:injuries*; D012421:Rupture; D052256:Tendinopathy / Q000453:epidemiology / Q000209:etiology*; D013708:Tendon Injuries / Q000150:complications* / Q000453:epidemiology