Sean Weatherspoon's Injury: What to Expect Following His Achilles Tendon Rupture

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Sean Weatherspoon's Injury: What to Expect Following His Achilles Tendon Rupture
Jonathan Daniel/Getty Images

The unfortunate reality of NFL offseason workouts is that injuries—such as Atlanta Falcons linebacker Sean Weatherspoon's ruptured Achilles tendon—will continue to pop up from time to time.

According to Falcons writer Jay Adams, Weatherspoon went down during this week's OTAs, and the team expects he will miss the entire 2014 season. ESPN.com's Vaughn McClure noted the linebacker "had been held out of organized team activities while recovering from a knee injury" and "was running with the medical staff when the injury occurred."

Unfortunately, Achilles tendon ruptures usually require several months to a year of rehab, hence Weatherspoon's grim prognosis for 2014. That said, the 26-year-old's 2015 prospects should remain intact if all goes well.

As the strongest tendon in the body, the Achilles connects the calf muscles to the heel. When the calf muscles contract, they pull on the tendon—which in turn pulls on the back of the heel. The end result of this process is plantarflexion—or pointing of the toes. Plantarflexion allows an athlete to drive his or her toes into the ground to push forward or leap up into the air.

When the Achilles overstretches or pulls too sharply, it can snap—an injury that usually announces itself as extreme pain in the back of the ankle. Pre-existing tendon injury or relative deconditioning may make it more prone to tearing.

Wikimedia Commons.
The Achilles tendon—seen here as a thick white band—attaches the calf muscles to the heel, allowing for plantarflexion.

Without an intact Achilles, effective plantarflexion becomes essentially impossible.

Treatment for Achilles tendon ruptures includes both non-surgical and surgical options. However, surgical repair—a conceptually simple operation of exposing the torn ends and suturing them together—carries a few advantages over the conservative route and is thus frequently the method of choice for elite athletes.

For example, multiple studies—including a 2012 systematic review published by Wilkins and Bisson in The American Journal of Sports Medicine—suggest operative repairs result in less tendon re-ruptures compared to conservative management.

To ensure optimum recovery, a surgeon must reattach the ends of the tendon with the utmost precision in regard to tension. A loosely repaired tendon might not allow an athlete's calf to return to the same effective strength—a weakness that could show up as decreased vertical jump height or forward leg drive. On the other hand, a tight tendon may tear more easily.

Following surgery, the Falcons medical staff will likely keep Weatherspoon's foot immobilized in the neutral position for several weeks while the tendon heals together around the sutures. Then, with time, the tendon will regain its tensile strength, and physical therapists will slowly introduce range-of-motion exercises into his workout regimen. Calf strengthening exercises will soon follow.

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As mentioned, the entire rehab process for Achilles tears in the NFL usually takes upwards of six months—and sometimes approaches a year or more. After all, NFL players place tremendous stress on the tendon day in and day out. If a healing tendon experiences too much of that stress too soon, it may re-tear, resetting the recovery clock.

Nevertheless, while the Falcons already announced Weatherspoon will miss the entire season, a return very late in the year—while incredibly unlikely—may not be impossible. Last year, San Francisco 49ers wide receiver Michael Crabtree tore his Achilles in May and returned in early December. A similar time frame puts Weatherspoon on the field just in time for the playoffs.

That said, every injury—and every player—is unique, and while NFL players sometimes beat their original projected recovery times, extrapolating Crabtree's injury recovery to Weatherspoon's makes far too many assumptions. As such, Falcons fans should, for now, prepare for their star linebacker to indeed watch from the sidelines for all of 2014.

 

Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine. The information discussed above is for informational purposes only.

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