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Is it possible to be born without an achilles tendon? Floppy feet, bending upwards.

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
Is it possible to be born without an achilles tendon? My ten month old grandson has never wanted to weight bear, and his feet are very 'floppy' - they can bend upwards to touch his XXXXXXX and we can't feel his achilles. He was also much slower to start growing than his two very sturdy older brothers - my daughter persevered with breastfeeding and expressed top-ups and he eventually caught up, but the first few months he was considered 'failing to thrive'
Posted Sat, 5 May 2012 in Child Health
Answered by Dr. Hema Yadav 11 hours later

Thanks for posting your query.

Achilles tendon can be commonly contracted, shortened, lax or fibrosed or rarely absent giving rise to congenital ankle and foot deformities.

Your grandson is most likely to have foot deformity and ligament laxity his feet can touch his XXXXXXX though the images you have uploaded do not clearly reveal the problem area. Also by ten months usually majority of children do start weight bearing on feet or stand on their own/with support and some may even start cruising or take few steps.

You need to consult a pediatric orthopaedic surgeon for thorough examination and investigation to rule out foot deformities and ligament or joint laxity.

Failure to thrive should be only mentioned if there is persistent weight loss or inadequate gain, for a significant period of time even after correcting the nutritional deficiencies, and though at two months he did appear thin but at ten months he seems to be of apropriate weight for age.
Though without exact weight monitoring data, I can't say that conclusively.

So its best to consult his pediatrician for charting of weight and height data from birth onwards and assessing his milestones.

A rough indication would be, a child should double his birth weight by 3-5 months and triple it by one year of age.

Hope I have answered your query. Please accept my answer in case you have no follow up queries.

Above answer was peer-reviewed by
Follow-up: Is it possible to be born without an achilles tendon? Floppy feet, bending upwards. 3 hours later
I came across an article about a young man with cerebral palsy which said 'In addition to the cerebral palsy, Hoover was born without Achilles tendons. He said it is a related condition.'
What is the link between cerebral palsy and absent achilles tendons? Most information on CP talks of shortened or tense achilles rather than lax or absent ones.
Answered by Dr. Hema Yadav 5 hours later

Thanks for the follow up query.

Cerebral palsy is a non progressive motor disorder caused by a lesion in cerebral motor cortex of brain. It is not exactly associated with congenital absent Achilles, but rather shortened / contracted, in 50% cases with spastic cerebral palsy.

The achilles shortening might be a pathological consequence of persistent spasticity of hip, thigh, and leg muscles causing pulled up tight achilles and tiptoeing gait in such children. This is commonly seen in spastic diplegia where both lower limb muscles are spastic and the feet are plantar flexed (pointing downwards) due to pulling effect on foot muscles by shortened achilles.

The article might have mentioned it as a coincidental finding and as such no link between cerebral palsy and congenitally absent achilles has been established.

Also cerebral palsy can be diagnosed even in infants by proper neurological examination by the pediatrician including muscle tone, limitation of joint movement and tendon reflexes.

Hope I have answered your query. Please accept my answer if you do not have any further queries.

Above answer was peer-reviewed by
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