Antonio Allen: Rehab for an Achilles Tendon Rupture

Antonio Allen was one of the first players this season to be placed on the Jets’ IR. He suffered a torn Achilles tendon at the very beginning of training camp. This article will provide an overview of his injury and what his recovery will look like.

What is the Achilles tendon?

A tendon is connective tissue that attaches muscle to bone. The calcaneal tendon (aka Achilles tendon) attaches the gastrocsoleus complex to the calcaneus. This complex is comprised of two muscles that make up of your calf: the gastrocnemius (the huge calf muscle that everyone sees) and the soleus (the deeper calf muscle that lies underneath the gastroc).

What does the gastrocsoleus complex do?

These two muscles primarily act to plantarflex the ankle, meaning that it moves the toes away from you (as if you were pushing down on the gas pedal while driving). From the athlete to the average person, the complex is responsible for pushing off your toes while you walk/run; as your other leg is landing as it hits the ground, the other foot is pushing off before it swings forward to continue the cyclical motion of walking/running. In sports, the gastrocsoleus complex helps the athlete jump into the air as it requires to the ankle/foot to plantarflex into the ground to generate force to leap into the air. The complex also helps to flex the knee.

How does someone injure their Achilles tendon?

The most common way to injure the Achilles tendon is through explosive movement (i.e. quickly jumping to break up a pass). The force generated through explosive running and/or jumping is too much for the tendon to handle thus causing it to rupture. There are several variables that can contribute to the injury most notably limited dorsiflexion (toes pointing towards you) in the ankle. When the ankle dorsiflexes, the Achilles tendon is in a stretched position; if the tendon is tight, then it limits how well the ankle can pull the toes towards you. Before someone jumps or pushes off when walking/running, the ankle is in a dorsiflexion position before actively using their gastrocsoleus complex to plantarflex/push off. A tight tendon in a stretched position combined with the explosiveness needed to jump or accelerate while running makes the tendon very prone to rupture.

Last year, Milliner suffered the same injury. If you look at the picture/watch the video below, you see that Milliner was very quick to jump off the line thus causing his tendon to rupture. The exact scenario described above is demonstrated. Although the Achilles tendon is the strongest tendon in the body, a rupture is one of the most common sports injuries.

(Picture: http://bleacherreport.com/articles/2229433-breaking-down-dee-milliners-achilles-tendon-tear-mechanism-of-injury)
Video: http://www.nfl.com/videos/nfl-game-highlights/0ap3000000409846/Milliner-suffers-achilles-injury

What does the recovery process look like?

Surgery is the most likely course of action after an Achilles tendon rupture. The person is in a cast for about two weeks before beginning physical therapy. For the first month, the patient will be solely on crutches and instructed to not put any weight on the surgically repaired foot. After this first phase, the patient will wear a boot and weight bear as much as they can on that foot (while still being on crutches). You can start actively moving the ankle/foot at this point and can start riding on the bike (but still wearing the boot). Over the next month, the patient will progressively wean off the crutches and place more weight on that foot. By the start of phase three (2 months post-surgery), you should be full weight bearing on the surgically repaired foot and can begin strengthening the ankle/foot with resistance (i.e. therabands). The patient can start transitioning into an ankle brace and finally get out of the boot.

The last phase occurs about 3 months after surgery and allows you to start stretching the calf once again. The brace will be slowly weaned off the patient as he/she can begin to wear normal footwear and strengthening exercises can be done while standing (i.e. calf raises). It can take 5-6 months to start walking or light jogging again and about 6-8 months to run, jump, and agility train. You can expect a patient to fully return to sports 9-12 months after surgery, meaning that Antonio should be good to go by training camp of next year. He might be limited with OTAs early in the summer but should be 100% by the start of training camp.