Bad news for football fans today: top defensive linebacker Terrell Suggs of the Baltimore Ravens will likely be out for the 2012 season because of a ruptured Achilles tendon. This injury is particularly devastating to an athlete because of the prolonged recovery time, which usually means the player is out for a year.
The Achilles tendon is the biggest and strongest tendon in our body, connecting the two powerful calf muscles, the gastrocnemius and soleus muscles, to the heel bone. Its duty is to handle the force of the calf muscle’s powerful contraction with pushing off to run, jump, and even walk. It is usually torn when someone jumps or makes a forceful push-off movement. Less often, it can be torn by something hitting the tendon. The athlete will commonly say they felt like someone kicked them in the back of the leg when the tendon tears.
Achilles tears are very easy to diagnose. A clinical diagnosis can often be made by feeling the back of the leg and squeezing the calf. This is known as the Thompson test. The clinician is looking for the foot to move when the calf is squeezed. If no movement is detected, an Achilles tear is to blame. The diagnosis can also be confirmed with a MRI or ultrasound.
The management of a tear can be conservative or surgical. Conservative treatment involves casting and extensive rehab, and is usually more favorable for non-athletes. Athletes like Suggs will typically have an Achilles repair surgery because of the demands on their body with athletics. A surgeon will open the back of the leg and suture the torn ends of the tendon back together. The patient is then usually immobilized in a cast or boot and not allowed to bear weight for the first 4 weeks or so (protocols vary). The patient will then begin a rehab program aimed at gradually beginning weight bearing and gentle stretching exercises. Strengthening typically begins around 6 weeks post-op, with gradual increase in resistance. The athlete is usually not allowed to run until 6 months after surgery, and full jumping and sport-specific drills sometimes even longer than that. The reason the recovery is so long is due to tissue healing times and the risk of re-rupture, which would be devastating to an athlete. One study found that the re-rupture rate is about 4.5 %, which is consistent with most literature and happens more often in people less than 30 years of age.1
Fans will have to wait to see the outcome of Suggs’ injury and recovery until next season.