Of the 31 players who sustained an Achilles tendon rupture, 21 (64%) returned to play in the NFL at an average of 11 months after injury. In the three seasons following their return, those 21 players saw significant decreases in games played and power ratings compared to the three seasons preceding the injury.
The percentage of players returning to play at the NFL level is consistent with a meta-analysis performed by Bhandari4 in 2002. The authors reported return to function rates of 63% for patients treated nonoperatively and 71% for those treated operatively. If we assume that all the NFL players were treated operatively, as would be the standard for young athletes, the return to play rate of 64% is slightly lower than the 71% reported in the meta-analysis. This difference could be attributed to the excessive demands placed on the operatively repaired Achilles tendon in NFL players combined with a body size, strength, and explosiveness that would further increase these demands.
The length of time to allow full activity after Achilles tendon repair is generally thought to be four to six months.4-6 The 11 months needed to return to play as a professional football player seems considerably longer. However, there is a major difference between allowing full activity and returning to play in the NFL. Even when the typical patient is allowed to participate in full activity, it does not mean that he or she is adequately rehabilitated to perform at maximal efforts. Studies to determine maximal improvement after surgical treatment are lacking in the orthopedic literature