This edition of the FastFact highlights a systematic review evaluating the impact of Achilles tendon (AT) ruptures on professional athletes1 The study aims to determine the rate of return to play (RTP), evaluate the impact of the injury on performance and to evaluate career outcomes following this type of injury.
The authors of this systematic review conducted a literature search to identify studies that reported outcomes related to RTP and post-injury performance following AT rupture in professional athletes. Participants were either playing in the National Football League (NFL), National Basketball Association (NBA), Major League Baseball (MLB), or professional soccer (football) leagues. A total of 15 studies, involving a total of 333 professional athletes, were included in the analysis. The sample included 152 professional football players from Major League Soccer (North America) and various European professional leagues. The mean age of the athletes involved was 29 years. All of the athletes had their injury treated with operative repair. There was a mean follow-up period of two years.
One of the most important findings of this review is that almost 25% of professional athletes who sustain an Achilles tendon rupture are not able to return to sport (defined as one professional appearance after the injury). Compared with athletes from other sports, football players appeared to be more likely to RTP with one study reporting a rate of 94.9%. Of those who were able to return to compete at a professional level, the mean time to RTP was 11 months, almost double the 6-month recovery for RTP that has been described in the general population. Another important finding is that it would appear that the players who did return to play participated in fewer matches and had impaired performance when compared with their non-injured peers.
The study has a number of significant limitations including a reliance on online resources for injury and return to play data, and the lack of detail about each injury and the treatments that were administered. Another limitation, relevant to this audience, is the relatively diverse range of sports that have been included in the review and the lack of female participants. This may limit the generalisability of the study’s findings to professional football players and to women.
Despite the limitations, this study demonstrates the significant impact that an Achilles tendon injury can have on a player’s career. This review should be used to help realistic goals and expectations for RTP following AT injuries. It should also stimulate consideration about how AT injuries can be prevented.
1. 1. Johns W, Walley KC, Seedat R, Thordarson DB, Jackson B, Gonzalez T. Career Outlook and Performance of Professional Athletes After Achilles Tendon Rupture: A Systematic Review. Foot & Ankle International . November 2020. doi:10.1177/1071100720969633