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Optimum Performance: NFL player weakness found in Achilles

Kansas City Chiefs running back Joe McKnight (22) scores a touchdown during the second half of an NFL football game against the Miami Dolphins, Sunday, Sept. 21, 2014, in Miami Gardens, Fla. (AP Photo/Wilfredo Lee)

Kansas City Chiefs running back Joe McKnight (22) scores a touchdown during the second half of an NFL football game against the Miami Dolphins, Sunday, Sept. 21, 2014, in Miami Gardens, Fla. (AP Photo/Wilfredo Lee)

Greek mythology tells the story of the great battle between the Greeks and the Trojans at the gates to the city of Troy. Achilles — the Greek warrior — who was thought to be impervious to injury, achieved his reputation in battle by slaying the Trojan hero Hector.

Toward the end of the Trojan War, however, another Trojan opponent – Paris – found Achilles’ week spot by shooting an arrow into Achilles’ heel causing his demise. From that day forward, we refer to a person’s weakness as his or her Achilles’ heel.

Just last week, former John Curtis and University of Southern California star Joe McKnight was stricken at a Kansas City Chiefs practice with a ruptured Achilles tendon. McKnight — hampered by injuries while at USC, which also followed his career to the New York Jets and now the Chiefs — will be out for the rest of this season.

McKnight was not alone nursing his injured heel. Joining him with the same injury were two other Chiefs – defensive tackle Mike DeVito and linebacker Derrick Johnson – who both sustained their injuries in the Chief’s week 1 loss to Tennessee.

An October 2009 article — Epidemiology and Outcomes of Achilles Tendon Ruptures in the National Football League — which appeared in Foot & Ankle Specialists, looked at the patterns and causes of Achilles tendon ruptures and its effect on the injured NFL player’s future performance.

The researchers reviewed several online NFL registries and identified 31 Achilles tendon ruptures between 1997- 2002. The statistics reflected that 19% of these injuries occurred in the pre-season, while 18% were sustained during the first month of the season.

“On average,” according to this study, “Players experienced a greater than 50% reduction in their power ratings following such an injury. Thirty-two percent (n = 10) of NFL players who sustained an Achilles tendon rupture (1997-20002) did not return to play in the NFL.”

Field Ogden, an Orthopedic Surgeon at Southern Orthopedic Specialists in New Orleans, specializing in foot and ankle surgery, notes that, “While there is a thirty-two percent incidence of players who do not return to play after an Achilles tendon rupture, those that do return may see a reduction in overall strength and performance over the next two seasons.”

During the 2008-2009 NFL season, six players suffered season-ending Achilles tendon ruptures.”

According to WebMD, “The Achilles tendon is a tough band of fibrous tissue that connects the calf muscles to the heel bone (calcaneus).” And, “Is the largest and strongest tendon in the body.

“When the calf muscles flex, the Achilles tendon pulls on the heel. This movement allows us to stand on our toes when walking, running, or jumping. Despite its strength, the Achilles tendon is also vulnerable to injury, due to its limited blood supply and the high tensions placed on it.”

Washington Redskins cornerback DeAngelo Hall found that out the hard way, when he ruptured his left Achilles tendon in the Redskins week 3 loss to the Eagles 37-34. He underwent surgery to repair the damage last Friday. Hall is expected to spend six weeks recovering, before he can begin the rehabilitation process.

Bryan Federico, a doctor of physical therapy (DPT), and a member of St. Charles Parish Hospital’s Outpatient Physical Therapy Department says, “Depending on the severity of the Achilles tendon rupture, the athlete is looking at a six months recovery process, 11 months for an elite NFL athlete to regain the adequate amount of power and function needed in this high level sport.”

Anecdotally, notes Federico, “In 2012, Terrell Suggs of the Baltimore Ravens came back after 5 months from a partial Achilles tear.”

The rehabilitation process is broken into stages. “The first 6-8 weeks,” states Federico, “Are generally for tissue healing and therefore, the ankle should be left alone to do so. After the first 6-8 weeks comes Stage 1: range of motion and flexibility, followed by Stage 2: Strengthening of the Achilles tendon and Calf muscles.”

As for moving the patient along at a steady but safe rehabilitative pace, Federico says, “I look at the amount of flexibility/ ROM (range of motion), scar healing and tissue extensibility before moving on into strengthening and balance exercises. Most protocols call for no running until 5-6 months post-op.”

While the Trojan warrior Paris may have fallen Achilles centuries ago, it appears his arrows still are on target in the NFL.