For the second time in recent weeks, an NBA star suffered an Achilles tendon rupture, collapsing on the court.
Milwaukee Bucks guard Damian Lillard sustained the injury in the first round of the playoffs on April 27. Boston Celtics forward Jayson Tatum faced a similar fate in Game 4 of the Eastern Conference semifinals on May 12. Visibly distressed 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 anticipating the diagnosis.
Achilles tears have distinctive characteristics. Following the initial shock – often described as a sudden `pop` or feeling like being struck, causing the athlete to look behind them – comes the realization of the severity. Most athletes immediately know they cannot walk, or if they attempt to, they will awkwardly lift their foot without being able to push off.
The Achilles tendon connects the calf muscles to the heel bone in the foot. This connection is crucial for transferring energy from calf contractions to push the foot off the ground, whether for simple walking or explosive movements like jumping. NBA athletes place immense demands on their Achilles tendons through repetitive jumping, running, and sudden changes in direction, leading to significant tension and contraction cycles. Over time, these loads can cause acute inflammation or chronic structural changes within the tendons.
Many Achilles ruptures occur like Tatum`s: the player steps back into a lunge, stretching the rear leg`s Achilles, then pushes off that foot. The tendon fails at this critical moment, transitioning from extreme lengthening to rapid shortening.
Surgical repair is the standard treatment for Achilles tears in elite athletes. While some may have been surprised by Tatum`s surgery happening less than 24 hours post-injury, this timing is optimal. Research, including a 2020 study in Knee Surgery, Sports Traumatology, Arthroscopy, supports the benefits of rapid repair within 48 hours for improved healing outcomes. Avoiding delays is generally considered best practice in sports medicine for optimizing Achilles tendon recovery.
Post-surgery, Tatum will be in a cast briefly to protect the repair. Once removed, he will begin controlled motion exercises. While ankle movement is important, protecting the healing tendon from excessive stretch is crucial. The Achilles` elasticity is key to its function; overstretching the repair is like permanently stretching a rubber band, making it ineffective.
The rehabilitation progresses to incorporating light strengthening and gradually increasing weight bearing, moving from a cast or boot to a shoe. Once the repair is sufficiently healed, more aggressive range of motion, followed by a return to ground running, jumping, agility, explosive movements, and basketball activities, will commence. Return to play for athletes typically ranges from six months to a year, with NBA players averaging around 10 months, depending on individual healing and fitness levels, as well as the sports calendar.
The athlete`s mental recovery is also a significant factor. An Achilles rupture is so sudden and debilitating that it often leads to doubts about returning to pre-injury performance, especially in the early stages. Even after successfully returning to competition, regaining pre-injury performance levels can take time. Full explosiveness and confidence in the leg may not be fully realized until the athlete has played consistently, often not until their second season back from the injury.
At 27, Tatum has youth on his side, and his limited injury history is a positive factor for recovery. Beyond the timely surgery, he also benefited from a top foot and ankle surgeon, Dr. Martin O`Malley at Hospital for Special Surgery. Dr. O`Malley, part of the Brooklyn Nets medical staff and a consultant for many NBA athletes, performed Tatum`s repair. Notably, he also performed Kevin Durant`s Achilles repair in 2019. Durant`s successful return to elite play post-Achilles injury provides inspiration for Tatum as he navigates the lengthy and challenging rehabilitation process.
Here are a few relevant comparisons of other players who recovered from Achilles tears:
Kobe Bryant: One of the most memorable NBA players to return from an Achilles injury, Bryant was 34 when he tore his in April 2013, ahead of the playoffs. He had surgery and returned in December of the same year, a relatively quick return, but he lacked explosiveness. The following season ended prematurely due to a shoulder injury requiring surgery, and the season after that was his last.
Klay Thompson: Thompson`s case is somewhat unique, as he tore his right Achilles while recovering from a torn ACL. He tore his ACL in the 2019 Finals and missed the entire 2019-20 season. As he neared a return for the 2020-21 season, he tore his Achilles. He ultimately returned midway through the 2021-22 season at age 31. As expected, he averaged fewer minutes and had decreased shooting efficiency initially. However, Thompson bounced back the next year, playing more minutes and achieving career highs in 3-pointers and rebounds.
Kevin Durant: Durant tore his right Achilles during the 2019 NBA Finals while with the Golden State Warriors. Significantly, he signed a four-year deal with the Brooklyn Nets during his recovery, demonstrating confidence in his ability to return at an elite level. Durant missed the entire 2019-20 season, returning for the 2020-21 season after an 18-month layoff. He played only 35 games that year, mostly due to other injuries, but performed like the vintage Durant when on the court. The longer layoff may have contributed to his strong return performance. Durant`s statistics support the possibility of an NBA player over 30 returning to pre-injury levels after an Achilles rupture.