Achilles rupture and return to sport in professional athletes

Abstract

Context: Despite Achilles rupture posing a potentially career-threatening injury to professional athletes, limited sports medicine research has been conducted to investigate how to improve the ability of players to return to sport after sustaining the injury. Objective: The main objective of the study is to aggregate the current literature on professional athlete return to play after Achilles tendon rupture in an attempt to identify the current strengths and gaps in knowledge. Materials and Methods: A PubMed literature reviews was performed using the terms “Achilles”and/or “elite,” “professional,” “return,” “sport,” “national basketball association”, “national football league,” “major league baseball,” “major league soccer,” “national hockey league,” “injury” to identify articles of interest. Only studies involving professional athletes in the major United States football, soccer, basketball, baseball, and hockey leagues as well as European Soccer Leagues who sustained a torn or ruptured Achilles tendon were included. Data Sources: PubMed literature search utilizing the key words, “Achilles” and/or “elite,” “professional,” “return,” “sport,” “national basketball association,” “national football league,” “major league baseball,” “Major League Soccer (MLS),” “national hockey league,” “injury.” Study Selection: Studies found using the keywords above were considered for inclusion. Individual case studies, injuries other than tear or rupture, and studies with unclear methodology were excluded. Nine studies met inclusion criteria. Study Design: This study is a review of published literature. Level of Evidence-IV: IV. Data Extraction: Data were taken directly from the included studies and aggregated. The quality and validity of the data is limited by the collection methodology of each individual study included. Results: Overall return-to-play percentage of 67.1% across all included studies with a total of 322 included participants. Soccer athletes were found to have the highest return percentage at 70.8% and baseball with the lowest at 55.6%. The average age of the players returning to play across all studies was 28.9 years, with football players comprising the youngest group at 27.5 years and baseball the oldest at 31.4 years. Conclusions: A lack of reliable data has made the study of professional athlete Achilles rupture and return to play a difficult endeavor. Despite the limitations, studies have shown that over 30% of players do not return to their respective sports, with no statistically significant correlation to age or position played. More research is needed to determine how specific injury patterns, rehabilitation protocols, and functional testing plays into the athletes' ability to return to play.