Achilles tendon injuries are a frequent concern in professional sports, but this NBA season saw an unusual surge. During the NBA playoffs alone, several high-profile players suffered torn Achilles tendons: Milwaukee Bucks guard Damian Lillard in the first round, Boston Celtics forward Jayson Tatum in the second round, and Pacers guard Tyrese Haliburton in the NBA Finals. Earlier in the season, centers James Wiseman and Isaiah Jackson, along with guards Dejounte Murray and Dru Smith, also sustained Achilles tears.
Beyond the NBA, other prominent athletes have faced similar issues, including USMNT forward Haji Wright, whose recent Achilles injury ruled him out of the Concacaf Gold Cup, and Cleveland Browns quarterback Deshaun Watson, who had surgery this year for his second Achilles tear.
Medical experts point to overuse and accidental circumstances as primary causes for these injuries.
Karin Gravare Silbernagel, a physical therapist and professor at the University of Delaware, compares current calf injuries to hamstring strains observed five to ten years ago. She suggests that while athletes have focused on strengthening their upper legs, their lower legs need comparable strength to handle the demands of their sport.
“At this point, we need to start thinking about the calf and Achilles in the same way,” she commented. “Do we have enough strength… to be able to tolerate the sport that we`re doing? The lower leg is lagging behind some of the other things that we do.”
To understand the phenomenon better, experts discussed Achilles tendon injuries this past NBA season, their inherent vulnerability, and the potential impact of painkillers masking symptoms. Their responses are summarized below:
Expert Q&A
Q: How easy is it to injure a calf?
A: “It`s not hard at all,” according to Dr. Michael Fredericson, director of physical medicine and rehabilitation for sports at Stanford. He explains that the calf is used in almost every movement, making calf and Achilles injuries among the most common. Dr. Nirav Pandya, a professor of orthopedic surgery at the University of California San Francisco, adds that for NBA players specifically, overuse from the explosive nature of the game is a frequent cause. Random accidents during explosive actions like layups can also lead to injuries if the force is too great for the body.
Q: What makes the Achilles tendon so vulnerable?
A: Unlike most muscles and tendons, the Achilles is under constant stress, designed for power and speed, meaning it`s always “wound up and stressed,” says Dr. Justin Greisberg, chief of foot and ankle surgery at NewYork-Presbyterian and Columbia University Medical Center. He notes the Achilles handles incredibly high loads, potentially many times body weight during simple walking, and significantly more for professional athletes running and jumping. When it ruptures, it`s more than a simple tear; the “explosion” severely impacts the working muscle, effectively putting it into a “coma.” Injuries can also result from simple missteps like slipping, landing off balance, or stepping on another player`s foot.
Q: Do calf strains lead to Achilles tears?
A: Not always directly. Dr. Greisberg states that many athletes who tear their Achilles have no prior injury to that leg, suggesting a lack of warning signs. Karin Gravare Silbernagel`s data doesn`t show a direct link, but she notes that a weakness in one part of the leg, like the calf muscle, increases the overall vulnerability. “We don`t necessarily see them going from having a calf strain and then rupturing the Achilles,” she says, “but they`re all attached.” Dr. Fredericson emphasizes that full recovery after a calf strain is vital, as a muscle that doesn`t fully heal remains weaker and less capable of handling high stress.
Q: Could painkillers be masking warning signs?
A: While anti-inflammatories are common in pro sports, Dr. Greisberg doesn`t believe they are the main cause of Achilles injuries, as most ruptures happen without prior symptoms. Dr. Fredericson`s concern is whether medication hinders an athlete`s ability to listen to their body`s signals. Gravare Silbernagel points out that without intense pain, athletes might not have the natural inhibition to limit the load on a potentially vulnerable area. “The concern is if you don`t have the pain,” she says. “If you take away the pain, then do you have these inhibitions or not?”
Q: Why were there so many Achilles injuries this NBA season?
A: Dr. Fredericson attributes the injuries to overuse, suggesting teams need to “look at the amount of load that the athletes are putting on their body and the amount of recovery.” He believes it`s a mix of playing through injuries and insufficient recovery, rather than a conditioning issue for these elite athletes. Dr. Greisberg sees it as a combination of random chance and circumstances, with athletes pushing physical limits at higher levels. Dr. Pandya highlights the increased workload this year, particularly during the playoffs with frequent games, and added offseason commitments like Olympic training. He notes that increased minutes over a period significantly raise injury risk. He also suggests today`s athletes have accumulated more “mileage” from starting high-level play at a younger age compared to previous generations.
Q: How can athletes prevent these injuries?
A: Dr. Greisberg suggests stretching (especially hamstrings and calves) and wearing solid, supportive footwear. Shoes with a slight heel lift might reduce stress compared to very flat shoes, although he notes flat shoes are more likely to cause tendonitis than ruptures. Gravare Silbernagel recommends calf-strengthening exercises to improve tendon strength. Dr. Pandya stresses that players must pay attention to discomfort and pain to avoid catastrophic injuries, emphasizing that even with advanced surgery, an Achilles tear is a career-altering event.
Q: What can teams learn from this season?
A: Experts advise teams to critically examine their strategies for training, monitoring, and resting athletes given the season`s injury pattern. Gravare Silbernagel suggests prioritizing basic calf strengthening exercises. Dr. Pandya stresses the importance of resting star players and managing their workload throughout the season to prepare them for the offseason. He also calls for better communication and transparency from athletes about pain and potential injuries, and for teams to recognize that Achilles injuries are a significant, rather than rare, risk.
Q: How long is recovery?
A: Even with optimal medical care and rehabilitation, returning to peak performance typically takes nine to twelve months, and attempting to rush the process increases the risk of retear, according to Dr. Greisberg. He believes the next major advancement in sports medicine might involve finding ways to prevent the calf muscle from experiencing significant damage after a rupture.
