A week ago, the sports world was rocked when quarterback Aaron Rodgers suffered a season-ending injury on his fourth play with the New York Jets. Recovering from an Achilles injury can be arduous.
It was the tendon injury heard ‘round the world.
Dr. Bartlomiej Szczech of Adirondack Health and the Lake Placid Sports Medicine Center, who goes by Dr. Bart, says the injury is serious.
“For him, the option was to treat this operatively. And the point of the surgery is to take this tendon, which basically got ripped in half, and take those two pieces of tissue and stitch them together,” Szczech said.
It’s not a common injury, Szczech says, about 18 per 100,000, but —
“Some studies report the diagnosis being missed in up to 25% of cases,” Szczech said.
Szczech says everyday people not under the glare of a primetime NFL broadcast typically do notice.
“The individual says, hey, you know, I had this acute type of injury, I heard a pop, my ankle just isn't working well, I can't bear weight, or I can't walk on normal ground or especially on uneven ground,” Szczech said.
Szczech says some sports are more prone to Achilles injuries.
“Usually we see it with running sports with jumping sports, or then with just the occasional ‘someone's foot gets planted improperly,'” Szczech said.
Szczech says low blood supply in the area makes the Achilles prone to injury.
“It usually ruptures about four to six centimeters above where your heel bone is,” Szczech said.
Age makes recovery take longer, but each person is unique.
“This injury is most common in individuals in their 30s and their 40s,” Szczech said.
Szczech says people can recovery within a year, but to see Rodgers come back this season isn’t happening.
“This is a months-long process,” Szczech said.
Szczech says Rodgers could return next year, when he would be 40, noting age is not necessarily the biggest factor.
“A lot of this happens in individuals who are kind of weekend warriors, or episodic athletes. And there are a couple of medical risk factors that a good clinician will pick up on, there is an increased risk of these injuries with certain antibiotics, and also with steroid injections around these tendons,” Szczech said.
As for what caused the injury?
“His ankle was trying to go down, but when he fell, it pulled his ankle up. And then that tendon had too much stress on it, and it ruptured,” Szczech said.
When an Achilles ruptures, witnesses will often say it sounds like a gunshot.
“Patients will come in and they'll tell you just that, is, ‘you know, I was walking and then I just heard this pop, this shot, or this snap,'” Szczech said.
Non-operative treatment for a ruptured Achilles tendon may be recommended for less athletic individuals with risk factors, while surgical intervention is favored for younger, healthier patients with no complicating factors.
Matthew Goodemote, a physical therapist with 25 years of experience and regular WAMC Vox Pop guest, says the artificial turf at Giants Stadium was a factor. After the injury, there were renewed calls for the league to phase-out artificial turf.
“If you cut hard enough, you can actually take a divot of the grass, and with turf, there's no give,” Goodemote said.
Goodemote says with a rupture as is the case with Rodgers, surgery is the next step. Afterward:
“They basically would put you in a cast or a walking boot. And when they put you in a walking boot, with the modern technology, they can specify the angle they want you to be in so they can put the angle and a slight dorsiflexion or a neutral or slight plantar flexion,” Goodemote said.
That would help tighten tendons and take anywhere from six to 10 weeks. During that time, the angle of the foot in the boot is gradually adjusted.
After the 12-week mark, rehab begins, which involves: “[b]asic things, getting the full range of motion back, and then starting some isometric strength training. Isometrics are where you don't actually move the joint, you just contract the muscle,” Goodemote said.
But the process does take longer for professional athletes.
“A year from now he should be able to do things,” Goodemote said.
For less severe tears, Goodemote says the tendon can be sewn, but in Rodgers’ case:
“You definitely can use things to anchor it into the bone. They're more like a metal hook where the they sew everything together,” Goodemote said.
Connfirming the severity of the tear, Rodgers posted thanks to Los Angeles-based surgeon Neal El-Attrache on Instagram, accompanied by a picture of himself in a hospital bed. Rodgers wrote he is “completely heartbroken and moving through all of the emotions.”
Rodgers has already been ruled out for the rest of the season, perhaps dashing the Jets’ hopes of a rare deep playoff run.
Goodemote adds Rodgers now faces a heightened risk of re-injury and of rupturing his right Achilles tendon. If that happens?
“That's really hard to come back from,” Goodemote said.
