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Achilles Tendon Rupture Ends Many NFL Careers


An Achilles tendon rupture sends more than one third of National Football League (NFL) players to the sidelines permanently, according to a new study published in Foot & Ankle Specialist. NFL players who do return to the playing field after having suffered an Achilles tendon rupture experience about a 50 percent reduction in their power ratings.

It appears that an Achilles tendon injury lives up to the ancient myth for NFL players. According to the story, Achilles’ mother, Thetis, tried to make her son immortal by dipping him in the river Styx. Her mistake was to hold him by one heel as she dunked him and then neglecting to dip him a second time to get the heel wet. Therefore the untouched part stayed vulnerable. Today, any weak point in the body is called an “Achilles’ heel.”

The Achilles tendon is the strong fibrous cord that connects the muscles of the calf of the leg to the heel bone. If the Achilles tendon is overstretched, it can rupture either partially or completely. A rupture can feel like a snap or pop, followed immediately by a sharp pain in the back of the ankle and lower leg that makes it impossible to walk properly or at all. The pain can be severe, and swelling develops near the heel. Victims of an Achilles tendon rupture are unable to bend the foot downward or to push off the injured leg when they try to walk. With a partial rupture, individuals may still be able to move the foot and the pain and swelling are less severe.

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In the new study, investigators wanted to explore the epidemiology of Achilles tendon ruptures among NFL players and determine the impact of these injuries on their performance. Researchers evaluated data on NFL games, statistics, and injuries and identified players who had sustained a complete Achilles tendon rupture. For those players, the researchers compiled information on their position, age, how long they played in the NFL, and performance statistics from both before and after the injury.

The investigators found that nearly 36 percent of players who had suffered a complete Achilles tendon rupture never returned to play in the NFL, and those who did return were never able to meet their pre-injury levels of performance.

Surgery is the treatment for a complete Achilles tendon rupture. According to the Mayo Clinic, the procedure generally involves making an incision in the back of the lower leg and stitching the torn tendon together. Patients need to wear a walking boot, cast, brace or splint for about six to eight weeks post surgery. Rehabilitation involves physical therapy exercises designed to strength the leg muscles and Achilles tendon. Although most people can return to their former activity level within four to six months, this unfortunately is not the case for NFL players who have sustained an Achilles tendon rupture.

Mayo Clinic
Parekh et al. Foot & Ankle Specialist 2009; 2(6): 283