By Stephania Bell
For the second time in just a few weeks, the NBA has witnessed a star player collapse on the court due to a ruptured Achilles tendon.
Milwaukee Bucks guard Damian Lillard suffered this injury on April 27 during the first-round playoff series against the Indiana Pacers. Just recently, on May 12, Boston Celtics forward Jayson Tatum faced a similar setback in Game 4 of the Eastern Conference semifinals. Visibly in pain and unable to put weight on his injured right leg, Tatum was helped off the court and taken to the locker room in a wheelchair, likely confirming what he already suspected.
Achilles tears have distinct characteristics that make them recognizable. Following the initial shock at the moment of injury – often accompanied by a sudden `pop` sound that might make the athlete look behind them – comes the realization of the severity. Most athletes immediately know they cannot walk, and attempting to do so results in an awkward lifting of a flat-footed leg, unable to push off the ground.
The Achilles tendons connect the calf muscles to the heel bone in the foot. They are crucial for transferring the energy from calf muscle contractions to propel the foot off the ground. This is essential for movements ranging from simple walking to explosive jumps and dunks. The Achilles tendons of NBA athletes endure immense stress due to constant jumping, running, and quick push-off/pivot actions. These movements impose significant load through repeated stretching and explosive contraction, which can lead to acute inflammation or, over time, chronic structural changes within the tendons.
Many Achilles ruptures occur precisely as Tatum`s did. The player steps back into a lunge position, stretching the Achilles of the trailing leg, then pushes off through that foot. At the critical moment where the tendon transitions from extreme lengthening to rapid shortening, it can fail.
Surgical repair is the standard treatment for elite athletes with a torn Achilles tendon. While some expressed surprise that Tatum`s surgery happened less than 24 hours after his injury, this timing is actually considered optimal. A study published in 2020 in Knee Surgery, Sports Traumatology, Arthroscopy supported the benefits of prompt repair, noting improved biomechanical and histological (microscopic tissue structure) outcomes for those undergoing surgery within the first 48 hours post-injury. Although not always feasible, minimizing delays is generally accepted within the sports medicine community to promote optimal Achilles tendon healing.
Post-surgery, Tatum will wear a cast briefly to protect the repair. Once removed, he will begin controlled early motion. While some ankle movement is important, safeguarding the repair from overstretching is vital. The Achilles` elasticity is key to its function; over-lengthening the repair can render it nonfunctional, like stretching a rubber band until it loses its snap.
The recovery progression involves incorporating light strengthening and gradually increasing weight-bearing, eventually moving the athlete from a cast or boot into a regular shoe. After the repair has sufficiently healed, more aggressive range of motion exercises commence, followed by a return to running, jumping, agility drills, explosive movements, and ultimately, basketball activities. Return to play for athletes typically ranges from six months to a year, with NBA players averaging around 10 months, depending on individual healing, regained fitness level, and the league schedule.
The athlete`s mental recovery is also a critical, often overlooked, component. An Achilles rupture is so sudden and completely debilitating that it frequently leaves the athlete questioning whether they will ever return to their previous performance level, especially during the initial recovery phase. Even after successfully returning to competition, reaching pre-injury performance levels may take time. The combination of regaining power and confidence in the injured leg often isn`t fully realized until the athlete is playing consistently again. Most athletes who return from an Achilles tendon repair report not fully regaining their explosiveness until their second season back.
At 27, Tatum benefits from his youth, and his relatively light injury history is a positive factor for his recovery. Beyond the advantage of timely surgery, he was also treated by a leading foot and ankle surgeon. Dr. Martin O`Malley at Hospital for Special Surgery, who consults for numerous NBA athletes and serves on the Brooklyn Nets medical staff, performed Tatum`s repair. Notably, Dr. O`Malley also performed Kevin Durant`s Achilles repair in 2019. Durant`s successful return to elite performance after his injury should serve as an inspiring example for Tatum as he navigates the demanding and lengthy rehabilitation process.
With that in mind, here are some relevant player comparisons for Tatum`s situation:
Kobe Bryant: Perhaps the most famous NBA player to recover from an Achilles injury, Bryant was 34 when he tore his Achilles just before the 2013 playoffs. He had surgery in April and returned to play in December of the same year. Bryant came back relatively quickly but seemed to lack explosiveness. The following season, his year ended early due to a shoulder injury requiring surgery, and the season after that was his last in the NBA.
Klay Thompson: Thompson`s case is somewhat unique as he tore his right Achilles while already recovering from a torn ACL. He tore his ACL during the 2019 NBA Finals and missed the entire subsequent season. As he neared a return at the start of the 2020-21 season, he suffered the torn Achilles. He eventually returned midway through the 2021-22 season at age 31, playing fewer minutes as expected, and his shooting efficiency was initially down. However, Thompson bounced back the following year, averaging more minutes per game and achieving career highs in 3-pointers made and rebounds.
Kevin Durant: Durant tore his right Achilles during the 2019 NBA Finals while with the Golden State Warriors. Notably, he signed a four-year contract with the Brooklyn Nets during his recovery period, showing confidence in his ability to return at an elite level. Durant missed the entire 2019-20 season but returned strong the following year. Although he played only 35 games that season, primarily due to other injuries, he performed like the vintage Durant when on the court. The roughly 18-month gap between his injury and return might have contributed to his performance metrics upon coming back. Durant`s statistics demonstrate that an NBA player over 30 can indeed return to their pre-injury levels following an Achilles rupture.
