SLR - April 2010 - Nathaniel J. Voshel

Epidemiology and Outcomes of Achilles Tendon Ruptures in the National Football League

Parekh, S., Wray, W., et al. (2009). Epidemiology and outcomes of Achilles tendon ruptures in the National Football League.  Foot & Ankle Specialist, 2(6), 283-286.

Scientific Literature Reviews

Reviewed by:  Nathaniel J. Voshel, DPM
Residency Program: Botsford Hospital

Podiatric Relevance:
This study examines how an Achilles tendon rupture can be detrimental to an athlete's performance and possibly their career.  Even with access to the best surgical intervention, these elite NFL athletes never returned to their pre-injury performance levels.  This study can help foot and ankle surgeons provide their patients with realistic expectations following surgical repair of complete Achilles tendon ruptures. 

This retrospective study reviewed complete Achilles tendon ruptures between 1997 and 2002 on National Football League players.  Each player was assigned a power rating to compare performance levels before and after injury. Offensive players were assessed on passing, rushing, receiving yards, and touchdowns. Defensive players were assessed on tackles and interceptions.  A control group of 284 NFL players included uninjured running backs and wide receivers in 2000. 

Thirty-one complete Achilles tendon ruptures were reported in 28 NFL players between 1997 and 2002.  The average age of the players at the time of injury was 29 years old which is older than the average age of NFL players, which is 26.5 years old. The mean time in the NFL prior to injury was 6 years.  Fifty-five percent of injuries were in offensive players compared to 45% in defensive players.  Defensive tackles had the highest number of Achilles ruptures at 23%.  Thirty-five percent of injuries occurred during the preseason, while 65% were during games in the regular season.  Fifty-two percent of injuries occurred on natural grass fields, while 48% occurred on artificial surfaces.  Quarterbacks had a 42.6 % decrease in power rating in the 3 years following injury.  Wide receivers, running backs, and tight ends decreased 88%, 83%, and 78% respectively following injury. Linebackers, cornerbacks, defensive tackles, and defensive ends decreased 95%, 87%, 64%, and 55% respectively.  

Achilles tendon ruptures occur infrequently in the National Football League, with an incidence of only 0.93% per game. Achilles tendon ruptures can be career ending.  Thirty-one percent of the players in this study never returned to play in the NFL.  The players in this study who did return to play experienced greater than 50% reduction in performance based on their power rating.  The wide receivers and running backs in this study showed a steady decline in their power rating in the 3 years prior to their Achilles rupture, suggesting that therapeutic intervention may have prevented such injuries.


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