Hektoen International

A Journal of Medical Humanities

Achilles and his famous tendon

Krzyś Stachak
Bielsko-Biala, Poland

Marek Citko who injured his Achilles tendon
Photo of Marek Citko. August 2007. Photo by Sławek. Via Wikimedia. CC BY-SA 2.0.

The Achilles tendon is one of the best-known parts of the human body not only because of its name but also because injuries to it are so common. As the largest tendon in the body, it connects the heel bones to the calf muscles and allows vertical movement of the foot, so that without this tendon, for example, there would be no ballerinas. But despite its size, it seems to be one of the most delicate parts of the body. Some believe that around a million athletes injure it every year.

The tendon derives its name from the Iliad, where the death of Achilles is one of the most memorable stories of Greek literature. He fought on the Greek side in the Trojan War and was seemingly unbeatable because to make him immortal his mother had dipped him in the River Styx. Unfortunately, she held him by the heel as she was dunking him in the water. She should have known better—so that even before the tendon was given its famous name it became vulnerable, over two thousand years ago when Paris shot him in the heel with an arrow, or more recently in the world of modern-day athletics.

Mention the name Marek Citko in Poland and you will find most of your listeners sigh over what might have been. Born in 1974, Citko became one of the most famous Polish soccer players. He won the Polish league in the mid-nineties with Widzew Łódź, and scored the opening goal in Poland’s World Cup Qualifiers match against England at Wembley in 1996. Like Achilles, Citko was at the very heart of all that happened around him on the field. He was linked to a possible transfer to the 1995 Premier League champions Blackburn Rovers, but opted for a longer stay in Poland. Liverpool also had an interest in signing him on, but nothing came of it.

Santi Cazorla who injured his Achilles tendon
Santi Cazorla preparing to take a corner in a Premier League match. February 2014. Photo by wonker. Via WikimediaCC BY 2.0

The next year he suffered a horrific injury to his Achilles tendon in a match against Górnik Zabrze. The injury was so serious that he would not play again for nearly eighteen months. He was down, but not out. He rose again, but never to the same heights. He became something of a journeyman player, playing in Israel and Switzerland, and returning at last to play for Polonia Warsaw, where he finished his career in 2007. However, Citko does provide some proof that perhaps all need not have been lost for Achilles when the arrow struck him.

There is another example worthy of analogy with the Greek hero, and his name is Santi Cazorla. Born ten years after Citko, Cazorla rose to prominence in the English game at Arsenal. And like Citko, Cazorla was struck down in his prime by an injury to his Achilles tendon. It happened in 2016 during a match against the Bulgarian team Ludogorets. The match had already been won, with Cazorla sustaining the injury during the build-up to the fourth of Arsenal’s six goals on that night. The tackle that injured Cazorla looked innocuous enough. The attacking midfielder was withdrawn, but after the match Arsene Wenger, the Arsenal manager, spoke to the Standard Sport, saying, “I just wanted to give him a breather. Physically he looks alright.”

Wenger could not have been more wrong: Cazorla would be out of action for 636 days. His situation was dire and went swiftly from bad to worse. The initial operation was a failure, and Cazorla would go under the knife eight times in all. His tendon became infected, gangrene supervened, and the worry was that Cazorla’s leg would have to be removed.

Gangrene works like a poison. It occurs when tissue dies through lack of oxygen when the blood supply is interrupted. Left untreated, it can spread and cause death. When we think of gangrene, we tend to think of soldiers injured during the American Civil War (Kevin Costner’s Lieutenant Dunbar pleads with the army surgeon not to remove his leg when he is injured at the start of Dances with Wolves). It is not the kind of ailment that we usually connect with athletes.

It is likely that many of those who fought in the battle between Greece and Troy would have been wounded and subsequently died of gangrene rather than of blood loss. In fact, the word gangrene comes from the Greek term, gangraina.

If the poison had not killed Achilles, perhaps he would have died of untreated gangrene. Not so Santi Cazorla. He received twenty-first-century medical treatment that would have seemed like magic to the ancient Greeks. So remarkable are the advances that we have seen in recent centuries, that Santi Cazorla was able to return to professional sport. He came back from his injury, and even managed to force his way onto the Spanish national team. Such a story deserves its place alongside the Greek epics. Homer would have been mightily impressed.

Statue of Achilles
Closeup of Achilles thniskon in Corfu Achilleion. August 2006. Photo by Dr. K. Via Wikimedia. CC BY-SA 3.0.

KRZYŚ STACHAK is an accountant, consultant, adventurer, and student of the world. This is Krzyś’s first English-language article.

Highlighted Vignette Volume 13, Issue 3 – Summer 2021

Spring 2021



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