Sobering article pertinent to J Cornelius

recovery to being able to play at former ability after Achilles injury is actually very rare. Yes, you come back and are still often an elite athlete with more limits than expected: … on-rupture

it is a formal and recognized orthopedic journal, but is readable (tedious?).

Although the incidence of Achilles rupture is low, 0.93% per NFL game, nearly 36% of affected players never return to playing at the NFL level.3

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.

Acute Achilles tendon rupture can be a career-ending injury for athletes. The question arises as to whether we should be more aggressive in treating a prodromal period in an attempt to avoid a subsequent rupture. This treatment would be initiated by pain and symptoms experienced by the athlete. Initial evaluation should consist of taking a history and performing an exam. Ultrasound evaluation or MRI may be considered to evaluate the presence of tendinopathy. If tendinopathy is not present and a prodromal period is suspected, then initial treatment should consist of activity modification, nonsteroidal anti-inflammatory drugs (NSAIDs), a heel lift, and physical therapy concentrating on eccentric strengthening of the gastroc-soleus complex. While some stretching may be beneficial, aggressive stretching may aggravate the symptoms. Further treatment could include vasodilation with topical nitric oxide, which has been shown to reduce pain and improve outcomes in cases of chronic tendinopathy.24,25 Other investigational treatments include pulsed electromagnetic fields and extracorporeal shock-wave therapy. If tendinosis is present, the treatment would be the same; however, further surgical options would include percutaneous longitudinal tenotomy and open debridement.

Achilles tendon ruptures can have dramatic career implications for the athlete. These are complex injuries, with surgical intervention being only the first step in the recovery. The ultimate return to function is based on a variety of variables, some of which are controllable by the surgeon, athlete, and therapists. Ultimately, more research will be needed to examine these injuries and their outcomes to determine the ideal protocols for treatment of the competitive athlete.

Coming from Dukies does not make it immediately the final word, but does suggest tempering expectation for how J Cornelius can expect to return if ever to his former physical levels.

I’d love to know if there were prodromal signs before that rash of broken feet suffered by the Hogs not so far back…