Achilles Tendon Rupture: The Warrior Injury

Natalie Lowenstein and Elizabeth Matzkin

Kevin Durant is not a typical weekend warrior, but he does have many risk factors concerning for an Achilles tendon rupture as a 30-year-old male basketball player.  He is not the first and will not be the last NBA player to suffer this injury, more commonly seen in our weekend warriors. Statistics demonstrate that 85% of NBA players who have suffered an Achilles tendon rupture will return to play, but rarely last more than 2 seasons.

The Achilles tendon is the strongest tendon in the body connecting the calf muscle to the heel bone. It is a commonly injured tendon in the body with an incidence ranging from 11- 37/100,000 per year. Risk factors for Achilles tendon injuries are aging, certain antibiotics, and steroid injections into the region. Achilles tendon ruptures are most commonly seen in adult males 30 - 40 years old who play sports involving running, jumping, and sudden changes of direction. They can also be seen in those who are sedentary most of the time and engage in infrequent physical activity. A high-risk sport such as basketball puts large amounts of physiologic stress on the lower leg and subjects the Achilles tendon to significant strain and sudden movements, potentially leading to partial tears or complete ruptures. When a rupture occurs, patients typically report a “pop” as well as weakness, difficulty walking, and heel pain.

This injury can be treated with either non-operative or operative measures. If a patient chooses non-operative treatment, they can be placed in a functional weight-bearing boot with the foot pointing down to help re-oppose the tendon edges for healing. This is most commonly recommended for older, more sedentary patients or patients who prefer nonsurgical management.  Operative treatment consists of suturing the torn edges together. This is often recommended for acute ruptures and in active patients. There are potential complications with surgery, such as wound healing and infection, but the risk of re-rupture has been demonstrated to be less after surgical repair. Recent studies have shown that there are not any differences in strength with either treatment after a functional rehabilitation protocol is completed. Complete recovery can take 4-6 months.