Pen Ultimate / Striking a Cord

Of heels, tendons, sinews and nerves and their ties to the Bible.

It was morning at the Jabbok River crossing 3,500 years ago. Jacob was walking back toward the camp he had set up for the night, unsteadily, limping, only to be greeted by his four worried and angry wives. "You said you were just going to bring back some trifles that we left on the other side, and you disappeared for the night," they said. "Where have you been?" "Believe it or not," Jacob answered, "a man just appeared from nowhere, one word led to another and he asked me to step outside. Well, we were already outside, and so we went at each other the whole night. He was quite a pro wrestler, but I slugged him good. He fought pretty dirty, but I managed to hang on until morning. He did hurt my leg, but at the end he told me to change my name, so I let him go. From now on you can call me 'Israel.' That's the whole truth, so help me God!"

For a non-Hebrew reader of the Bible, the weight of the heel in determining Jacob's fate is not that obvious. Jacob was one of twins, and the book of Genesis tells us: "... after that came his brother out, and his hand took hold on Esau's heel; and his name was called Jacob." In Hebrew the word for heel, akev, and the name Jacob (Ya'akov) share the same three-letter (ayin-kuf-bet) root.

Although Jacob is described as a plain man, it soon becomes obvious that he is as cunning as they come. First he maneuvers Esau into selling him his birthright for a bowl of soup, and then he cheats him out of the firstborn blessing of their father. Small wonder that Esau cries out: "Is not he rightly named Jacob? For he hath supplanted me these two times: he took away my birthright; and, behold, now he hath taken away my blessing." In Hebrew the verb for "hath supplanted me," ya'akveni, is based on the same root as Jacob.

In Genesis 3 it says "the serpent was more subtil than any beast of the field." When this creature tricks Eve and Adam into eating the forbidden fruit of the Tree of Knowledge, he is punished by having to suffer strained relations with humankind from then on: "It shall bruise thy head, and thou shalt bruise his heel." Jacob was indeed more "subtil" (i.e., sharp, crafty) than other members of his family, and undoubtedly bruised his elder brother's heel.

On his deathbed, while blessing his own sons, Jacob says to Dan: "Dan shall be a serpent by the way, an adder in the path, that biteth the horse heels, so that his rider shall fall backward" (Genesis 48). And his blessing to Gad also mentions a "heel" in its Hebrew version.

Sciatic scenario

That's it as far as the heel goes. Now on to the tendon. After driving his brother mad, Jacob ran away, only to return 20 years later with two wives (one of them pregnant), two concubines, 11 sons, a daughter and "flocks, and herds and camels." For a very good reason he is scared of what will happen during the siblings' reunion, so he dispatches three messengers bearing sumptuous gifts, and divides his family and property into two camps, sending the women and children on ahead while he remains alone on the other side of the river.

"And Jacob was left alone; and there wrestled a man with him until the breaking of the day. And when he saw that he prevailed not against him, he touched the hollow of his thigh; and the hollow of Jacob's thigh was out of joint, as he wrestled with him" (Genesis 32).

One of the Midrashim tells us that the man in question was the angel Michael, who decided to challenge Jacob without God's permission, and that it was God who made Michael unable to overpower Jacob. From the biblical text it is pretty clear that had a referee been present, Jacob's opponent would have been disqualified.

But as we are told that later Jacob "halted upon his thigh," it is obvious that this part of his body could not actually have been pulled "out of joint" by the angel: No one can walk, or even limp, with a disjointed hip. Experts on human anatomy and hand-to-hand combat claim that this type of injury can be caused only by a fall from a great height or by the thigh and hip being twisted, under a significant weight.

The 32nd chapter ends with the verse: "Therefore the children of Israel eat not of the sinew which shrank, which is upon the hollow of the thigh, unto this day: because he touched the hollow of Jacob's thigh in the sinew that shrank." The original Hebrew uses the term "gid hanashe" to describe a tendon that has been damaged - probably injured or dislocated.

The Greek and Latin turn "gid" into a nerve, and the Hebrew uses gidim as a catch-all word to denote all sorts of cords, nerves and veins in the human body, which incidentally add up to 365: the number of days in the solar year and the number of things that are forbidden to an observant Jew. By the way, "gid" in the singular is the term the Talmud often employs when referring to the male member.

There is a lot of discussion in the halakha (traditional Jewish law) concerning this "gid hanashe" - not in the context of the diagnosis of Jacob's injury, but in relation to the issue of kashrut, the dietary laws. The accepted halakhic view is that "gid hanashe" is the sciatic nerve, which goes down from the spine (between the last of the lumbar and the first of the sacral vertebrae), along the leg. To make the hind part of an animal kosher, the butcher has to extract the sciatic nerve, an arduous and time-consuming procedure. But chicken legs are exempt from this process, so if you use one on your Passover plate you needn't to worry.

Can we infer from this later, kashrut-related practice that Jacob actually suffered from sciatic pain following his struggle with the angel? Probably not, as that kind of pain is caused by a dislocation of vertebrae - something which rarely happens in a rough-and-tumble tussle; furthermore, the text says that the injury was in the "hollow of the thigh," not in the hollow of the back. It is possible, though, that Jacob had a sciatic-pain problem prior to his face-to-face encounter, and that the exertion aggravated his pain. Sciatic pain can make one limp, believe you me.

A physiotherapist whom I know and trust told me that "gid hanashe" is the iliotibial band - a fibrous cord that runs along the thigh on the side and down to the knee, which, when strained, can cause a lot of pain. One thing is clear: "Gid hanashe" has nothing to do with the Achilles' tendon.

A detailed study by Levin Shneir, published in the quarterly "Judaism" in the U.S. in 1995, rejects the diagnoses outlined above. Focusing on what might have been Jacob's castration anxiety prior to the confrontation with Esau, and based on the assumption that "the hollow of the thigh" can be interpreted as the groin, it raises the possibility that Jacob's problem was actually a hernia, thought to be a typical Jewish male ailment that is aggravated by physical exertion.

Another article in a medical journal, which describes the encounter of Jacob with the angel on the river bank in terms of modern medicine, comes to the conclusion that Jacob "appears to have sustained neurological injury to his sciatic nerve as well as musculoskeletal damage to his hip."

Anyway, even incapacitated, Jacob manages to hold his own against his adversary until the next morning, and the stand-off ends with a bargain: The angel changes Jacob's name to Israel, "for as a prince hast thou power with God and with men, and hast prevailed" - an explanation that makes linguistic sense in Hebrew, but sounds meaningless in any other language - refuses to divulge his own identity (which makes Jacob think that he has fought with God himself), and blesses him. And Jacob lets go. As Israel, he then emigrates to Egypt, and that's how we got a story to tell while enjoying our seder meal.