Milwaukee Bucks guard Damian Lillard appeared to suffer a classic Achilles tendon tear during the first quarter of Sunday`s Game 4. He immediately fell to the court, grabbing his left lower leg and ankle, clearly in significant pain and seemingly surprised by the sudden injury.
Many athletes who experience an Achilles tear report a sensation akin to being kicked hard in the back of the leg. This is due to the sudden rupture of the tendon, which connects the calf muscles to the foot. The Achilles tendon is vital for pushing off the ground, powering everything from walking to explosive jumps like a dunk.
At 34 years old, Lillard fits the typical demographic for elite athletes sustaining Achilles injuries. The nature of basketball, with its constant jumping, running, and quick directional changes, places significant stress on the tendon through repeated cycles of tension, elongation, and powerful contractions, putting players in a higher risk category.
Adding to Lillard`s recent history, he was sidelined in March due to a deep vein thrombosis (DVT) diagnosis. DVTs are blood clots in a vein, often occurring in the calf. Treatment usually involves blood thinners and rest to prevent the clot from traveling. While this treatment is necessary, it often results in deconditioning because the athlete cannot train normally or engage in contact sports due to increased bleeding risk. Athletes can return to play once off the medication.
However, any athlete returning from an absence of several weeks or months requires a careful reconditioning period. The time needed for this ramp-up varies based on factors like the injury`s severity, the duration of inactivity, the athlete`s activity level during recovery, the sport`s demands, and the athlete`s psychological readiness. The timing within a season, particularly the urgency of playoffs, can influence the schedule, but medical staff and the athlete have extensive discussions about potential risks. While we cannot definitively say if his recent absence increased Lillard`s risk for the Achilles tear, it`s likely that a combination of risk factors contributed to the tendon failure.
The immediate focus now is on Lillard`s recovery and his path back to playing, potentially impacting the 2025-26 season. Surgery is the first step, followed by a highly controlled phase of mobility. Initial healing may involve a cast or removable boot, limiting motion to protect the repair while allowing minimal movement for joint health. Crucially, the repair must not be overstretched, as the Achilles` elasticity is essential for its function; over-lengthening damages this “rubber band” effect. Once the initial healing is solid, rehab becomes more aggressive, focusing on restoring range of motion and strength, eventually progressing to running, jumping, and explosive drills.
For elite athletes, return to play following an Achilles tear typically ranges from six months to a full year, with NBA players averaging around 10 months, depending on individual healing rates, fitness progress, and the season calendar. Advances in surgical techniques have improved outcomes, allowing more athletes to resemble their pre-injury selves, but the recovery is highly individual. Many athletes report not fully regaining their pre-injury explosiveness until their second season competing after surgery.
Academic research on NBA players recovering from Achilles tears indicates that among the 70-80% who successfully return to competition, a majority do not consistently reach their pre-injury performance metrics in terms of games played, minutes, or efficiency. This finding is complicated by the fact that many players sustaining this injury are already in the later stages of their careers, where these statistics might naturally be declining anyway.
Looking at the experiences of other NBA players who returned from Achilles tears can provide valuable context for Lillard`s journey:
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Kobe Bryant: One of the most famous examples, Bryant was also 34 when he tore his Achilles in April 2013. He underwent surgery and returned that December. While he came back relatively quickly, he visibly lacked his previous explosiveness. His next season was cut short by a shoulder injury, and the subsequent season was his last.
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Klay Thompson: Thompson`s case is complex as he tore his Achilles in November 2020 while already rehabbing a torn ACL from the 2019 Finals. He missed two full seasons, returning midway through the 2021-22 season at age 31. Initially, his minutes and shooting efficiency were lower than usual. However, he showed significant improvement the following year, playing more minutes and achieving career highs in three-pointers and rebounds.
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Kevin Durant: Durant tore his Achilles during the 2019 Finals. He signed with the Brooklyn Nets during his recovery and missed the entire 2019-20 season, taking an 18-month break before returning for the 2020-21 season. When healthy (though he dealt with other injuries that year), Durant looked like his elite self, suggesting that a longer, careful recovery can facilitate a strong return, even for players in their 30s.
