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While real football action is just on the horizon for our Miami Dolphins I wanted to focus my first injury review on the much talked about topic of Cameron Wake’s Achilles tendon rupture. As fans we still remember that tragic Thursday night game where we saw our defensive leader go down. I want to give a quick review of what an Achilles tendon rupture is and what to really expect for Wake’s recovery.

What is the Achilles Tendon?

The Achilles tendon is a cord of connective tissue in the back of the lower leg that connects the gastrocnemius and soleus muscles, also known as the calf, to the foot via the heel bone. The force provided from these muscles is transferred to the foot via the Achilles tendon. We use this muscular tendentious unit daily when pushing a gas pedal or standing on our tiptoes. The ruptured tendon takes longer to heal then muscular tissue due to a poor blood supply, which limits nutritional uptake of the damaged tendon.

What exactly caused the Achilles to rupture?

While the Achilles is the largest tendon in the human body and can take a great deal of force as seen by the explosive nature of Cameron Wake off of the line. An Achilles tendon rupture most commonly occurs in players over the age of 30 with past soft tissue injuries of the leg (Arian Foster and Terrell Suggs come to mind as recent examples). Nagging injuries in large muscles of the body normally lead to compensations from smaller muscles, which are more easily injured. An example of this would be Wake’s hamstring issues, in the early part of the 2015 season leading to more emphasis on the calf muscles to produce his explosive first step off the line. Wakes injury occurred when he was blitzing and you can see Wake start to favor his right leg after coming in contact with the blocker with his left foot firmly on the ground. This moment of contact is the point at which the tendon, under a huge amount of stress, ruptured.

Stats for players returning with Achilles tendon ruptures.
While the Achilles tendon rupture is not as common as the ACL tear for NFL players it does have an impact on player performance once they return to the league. A research study done in 2010¹ followed players from 1997-2002 and saw 66% of players returning to the league after injury. Defensive players saw a distinct drop in stats including a 25.00% drop in games played, 38.20% decrease in tackles, 44.52% in sacks and 82.21% in forced fumbles. While these numbers do sound daunting we need to take in to account that Wake is well-known for his outstanding nutritional regiment and off-season conditioning program. These numbers will likely set the floor for what to expect for Wakes 2016 return.

Time line of injury:

Cameron Wake’s injury occurred on November 1st, a Thursday night game against the Patriots. While the Dolphins have been tight-lipped about when the surgery occurred we can assume based on his current recovery it was some point in December. While in the past these injuries were treated with immobilization, recent research has shown that moderate amounts of movement and weight-bearing activities in the first few weeks have shown to decrease the risk of recurring injuries in players.  The common time line for return to physical activity for this injury is five to six months, but general physical activity and playing in the NFL are two different things. Studies suggest players need an extra five months of football specific activity before returning safely to full game speed action. Based on these time lines Wake is making good progress as reports have shown him active with limitations in training camp. One area of concern would be the increased risk of re-injury if Wake’s return is rushed and the tendon is not fully adapted to the demands of the NFL speed of play.

What to expect this season:

Wake, a veteran player at this point in his career, should expect to see himself be limited in preseason and then to return as a passing down edge rusher in the beginning of the season. Optimistically, with no set backs occurring, Wake should be back to his normal playing time between Week 8-10 right in time for a critical end of the season stretch. Based on stats provided by NFL.com² and the history of players returning with this injury we should expect to see Wake along the lines of 22 tackles, 8 sacks and 1 forced fumble for the 2016 season.

 

Will Merring SPT.

Sources

 

1. Shirzad K MD, Hewitt J MD, Kiesau C MD, Parekh S MD. “Return to Football after Achilles Tendon Rupture. Lower Extremity Review. March 2010 Accessed August 8^th 2016. http://lermagazine.com/article/return-to-football-after-achilles-tendon-rupture

 

2. http://www.nfl.com/player/cameronwake/2506314/profile