Aaron Rodgers Tears His Achilles Tendon

Achilles tendon tears, especially in athletes, are significant injuries that require careful management to ensure optimal recovery. The approach to treatment depends on the severity of the tear and the specific needs of the individual. There are both non-operative and operative treatment options available. First let’s look at the treatment of achilles tendon tears for all people and the recovery process.  

1. Non-operative Treatment:

• Reserved mainly for partial tears or for patients where surgery might not be appropriate due to age, health status, or personal preference
• Involves wearing a cast or walking boot with the foot pointed downwards to approximate the torn edges of the tendon. This allows the tendon to heal in a shortened position.
• Physical therapy is then utilized to strengthen the tendon and restore range of motion.
• Potential drawbacks include a possible higher rate of re-rupture compared to surgical treatment and possibly a decreased level of functional recovery, especially for high-level athletes.  In professional athletes surgery is almost always indicated for complete tears.

2. Operative Treatment:

• Surgery typically involves making an incision in the back of the leg and suturing the torn tendon together.
• Recent techniques may use smaller incisions which can lead to fewer wound-related complications.
• Surgery might provide a more predictable recovery for those looking to return to high levels of physical activity and may have a lower re-rupture rate compared to non-operative treatment.

Recovery:

1. Immediate Post-injury/Post-surgery:

• The affected leg will typically be immobilized in a cast or boot, often in a plantar flexed position (toes pointed down).
• Weight-bearing may be restricted for several weeks.

2. Physical Therapy:

• Once initial healing has taken place, physical therapy is crucial.
• The focus is on restoring range of motion, strength, and function to the injured leg.
• Therapy usually starts with gentle range-of-motion exercises and progressively includes weight-bearing and strengthening exercises.

3. Return to Activity:

• Athletes can often start running at around 12 weeks post-surgery but this varies based on the individual and the specifics of the injury and treatment.
• Return to full sports activity can take anywhere from 4 to 6 months or longer. A gradual return to activity is essential to avoid re-injury.  Strength improvement can occur for greater than a year.

4. Potential Complications:

• Whether treated surgically or non-surgically, there’s a risk of re-rupture.
• Surgery also carries risks such as infection, nerve damage, or issues related to anesthesia.

As for NFL players, achilles tendon injuries have historically been challenging, and their impact can be significant. The success rate after such injuries can be gauged in several ways: return to play, performance metrics after return, and career longevity post-injury.

1. Return to Play: 

• Studies have shown that a majority of NFL players return to play after an Achilles tendon rupture and subsequent repair. The return to play rate has been reported to be around 60-70%. 

2. Performance after Return: 

•  For those who do return, performance often diminishes. Studies have shown a decrease in power ratings (a combination of various performance metrics) post-injury. The first season back might not be at the pre-injury level, but some players gradually improve in the subsequent seasons. Dam Marino was quoted as saying that after his first season back he felt a difference when he planted his foot to throw as compared to his second season where he saw continued improvement and strength.  
• The decline is more significant for certain positions, especially those that rely heavily on explosive movements, like running backs and wide receivers.

 3. Career Longevity: 

• An Achilles tendon injury can shorten a player’s career. On average, NFL players might play 20-30% fewer games after such an injury compared to matched controls without the injury.

It’s important to note that while statistics provide an overall picture, individual outcomes can vary greatly. Some players come back and perform near or at their pre-injury levels, while others may struggle.

Lastly, advances in surgical techniques, rehabilitation protocols, and sports medicine in general continually evolve, so the prognosis and outcomes for athletes with Achilles tendon injuries may improve over time.  At Total Orthopedics and Sports Medicine we use the latest techniques and recovery programs to get our athletes back to optimal performance.