Terrell Suggs' Torn Achilles Tendon: How His Latest Injury May Impact His Career

After tearing his right Achilles tendon in April 2012 while playing basketball, Terrell Suggs was thought to be lost for the entire season. He ultimately defied all odds and returned to play in October, a mere 5 months and 6 days after surgery. With news that Suggs has suffered the same devastating injury to his left Achilles, he will most definitely be out for the rest for the season. This article will provide an overview of his injury and what impact it could have on his career moving forward.

WHAT IS THE ACHILLES TENDON?

Tendons are tough bands of fibrous tissue that help connect muscles to bone. The Achilles tendon happens to be the strongest and largest tendon in the human body. It is crucial to athletic performance and has been shown to support loads up to ten times one's body weight during running, jumping, and other athletic activity.

It is formed through the conjoined tendons of the gastrocnemius and soleus muscles of the calf, and extends down and inserts onto the calcaneus (heel bone). Its main purpose is to allow for the transfer of power from the calf muscles to the foot. When the calf muscles contract they create plantar flexion at the ankle (the act of pointing the toes downward and elevating the heels); a movement that is essential for someone to be able to "push-off" and perform actions such as sprinting or cutting. Thus, without a functioning Achilles, these movements become impossible to execute.

WHAT CAUSES THE ACHILLES TENDON TO TEAR?

Quite simply, the Achilles tendon tears when an athlete places a load upon it that exceeds what it can handle. This often occurs when the Achilles lengthens too much too quickly. In athletics, this is commonly seen when a player attempts to suddenly propel themselves forward or change directions by "pushing-off" (standing on toes, driving heels to ground).

WHAT IS THE TREATMENT AND RECOVERY TIME FOR A TORN ACHILLES?

Nearly all Achilles tears are treated surgically due to the fact that tendons lack adequate blood supply to heal on their own. In fact, tears treated non-surgically have been shown to have a higher risk of getting re-injured. A 2014 research study found that Achilles tears treated surgically re-ruptured 3.6% of the time while those treated conservatively had a re-rupture rate of 8.8%.

In terms of recovery time, a minimum of 6 months is usually required before an individual can resume normal functional activity. For professional athletes, it often can take up to a year before they are fully recovered and able to handle the rigorous demands of sport.

WHAT DOES THE RESEARCH TELL US ABOUT THE OUTLOOK OF SUGGS' CAREER?

A 2010 research article studied 31 Achilles tendon ruptures in NFL athletes between 1997 and 2002. Of these athletes, 64% returned to play in the NFL at an average of 11 months after injury. The remaining 36% never returned to play at the NFL level.

The study also examined the durability and athletic performance of the athletes who were able to come back and play. To measure performance, the authors developed a "power rating"  which measured each player's productivity by using statistics gathered during game play.

In the three seasons following their return, the players experienced a significant decrease in games played compared to the three seasons preceding the injury (11.67 games per year pre-injury vs. 6.17 games per year post-injury). They also found an average decrease of nearly 50% in power ratings for these players; suggesting that their quality of play declines substantially even if they are able to return to the league.

No one can argue that Terrell Suggs bounced back extremely well after his previous Achilles tear, as he went on to register double-digit sacks in both the 2013 and 2014 seasons. However, given his age and the difficulties that come with this kind of injury, it makes you wonder if he can defy the odds yet again.

- Bobby, Esbrandt, PT, DPT, PES