Lower limb

Ankle and heel bursae & Achilles tendon (Retrocalcaneal, calcaneal bursae & tendo calcaneus)

Bursae articulationis talocruralis, pedis et tendo calcaneus

Origin

Calcaneal tuberosity, Achilles tendon (tendo calcaneus), subcutaneous over medial/lateral malleoli and deep to tibialis anterior

Insertion

Calcaneus, malleoli, and Achilles tendon insertion

Function

Achilles tendon transmits soleus and gastrocnemius plantarflexion forces; bursae cushion tendon and skin against shoe pressure and bony heel friction

Innervation

Sural, tibial, and saphenous nerves (L5–S2)

Movement & chain

Transfers massive plantarflexion kinetic energy during walking, running, and jumping

Palpation

Palpable as prominent cord on posterior lower leg down to heel

Clinical

Achilles tendon rupture (positive Thompson squeeze test); midportion/insertional Achilles tendinopathy; retrocalcaneal bursitis (Haglund deformity).

Segmental innervation

L5–S2

In clinical practice

Thompson test for rupture, Alfredson eccentric heel-drop protocol, Heavy Slow Resistance training, and heel lifts

Region in the model

Lower limb