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Houston Rockets

Expert medical analysis on returning from a ruptured Achilles tendon

For the first time in over two years - 736 days to be exact - John Wall is set to return to an NBA court.

The Houston Rockets' newest point guard has been sidelined for this time after undergoing surgery on his left heel and subsequently rupturing his Achilles tendon during the rehab period.

After averaging 16.3 points and 5.3 rebounds in three preseason games this year, Wall had another setback in his return to regular-season action as he missed Houston's opener due to mandatory contact tracing per the NBA's Health and Safety Protocols.

Wall, 30, is one of several NBA players returning from Achilles injuries this season, so NBA.com reached out to our medical expert, orthopedic surgeon Dr. Michael S. George of the KSF Orthopaedic Center in Houston, TX, for more on the nature of the injury and how players have historically returned from such a setback.


On the nature of Achilles ruptures and their recovery

"Ruptures of the Achilles tendon are common in basketball. For clarification, Achilles tendon rupture and tear are the same thing.

"Several NBA players have ruptured their Achilles tendon over the past couple of years, including Kevin Durant, John Wall, Klay Thompson, Dwight Powell and Rodney Hood. This injury requires surgical repair to sew the torn edges of the tendon together.

"The recovery is lengthy and most athletes are not cleared for full activity until at least six to nine months after surgery. Ultimate recovery and return to previous level of competition is variable and individual but there are several studies that shed some light on the expectations of recovery."

Historically, how have professional athletes performed after Achilles injuries?

"A study in 2013 in the American Journal of Sports Medicine by Amin and colleagues looked at 18 NBA players that ruptured their Achilles tendon. The average age at the time of injury was 29.7 years old. Seven players never returned to an NBA game, 11 of the players played one season and only eight played more than two seasons after the injury.

"Compared to other players, the Player Efficiency Rating (PER) declined significantly in the first season and even worse in the second season after the injury.

"Another study in 2017 in the same journal by Trofa and colleagues looked at 86 athletes with Achilles ruptures in the NBA, NFL and MLB. 30% never returned to play. For the athletes who returned, game participation averaged 75% in Year 1 and 82% in Year 2 of their pre-injury levels and performance statistics were significantly worse at one and two years after the injury.

"Compared to the other sports, the NBA players performed the worst and the MLB players recovered the best."

What can we take from these studies?

"These studies suggest that on average, these players would be expected to play fewer games and fewer minutes with decreased performance compared to other uninjured players. Additionally, most people jump off of their non-dominant leg, so an Achilles injury on that side would affect jumping more than if it were on the dominant side

"That being said, these are truly elite athletes, so they could certainly return back to form better than the average athlete and their ultimate recovery would have to be seen on an individual basis.

"Hopefully, as surgical and physical therapy protocols continue to improve, so will the recovery from this injury."


Wall is the last of the four aforementioned players to make their return from an Achilles in the 2020-21 NBA season. It's also worth noting that WNBA superstar Breanna Stewart missed the entirety of the 2019 season with a torn Achilles before returning to win her second title and second Finals MVP in 2020.

With Wall being the last to return, here's how the other three players performed in their respective returns to action…

Kevin Durant

Date (days since injury): Dec. 22, 2020 (561 days)

Age: 32

Stat line: 22 PTS (7-16 FG), 5 REB, 3 AST, 3 STL, 1 BLK in 25 MIN

After nearly 600 days without playing, KD looked like KD, picking up right where he left off in the preseason.

He finished with 22 points in just 25 minutes of action after averaging 20.0 points in 25.6 minutes over two preseason games. If Durant's performance in the opener was the floor of what to expect from him this season, he's set to have a memorable year.

Rodney Hood

Date (days since injury): Dec. 23, 2020 (383 days)

Age: 28

Stat line: 0 PTS (0-3 FG), 3 REB, 2 AST in 14 MIN

It had been just a bit over a year for Hood, who was averaging 11.0 points per game when he went down in December of 2019. Portland's forward is easing back into things, as evidenced by a lighter workload in the preseason that was reflected in his return to action.

Over time, things are likely to improve for Hood.

Dwight Powell

Date (days since injury): Dec. 23, 2020 (337 days)

Age: 29

Stat line: 2 PTS (1-3 FG), 2 REB, 1 AST, 1 STL in 18 MIN

Powell came back quicker than anyone else listed, making his return to action less than a calendar year after he went down with the Achilles injury.

The 29-year-old saw just under 20 minutes of action in the preseason, which was again a sign of what was to come as the regular season got started. In addition to having to rehab throughout the NBA Restart and an offseason like no other, Powell returned in a starting role.

Similar to Hood, the timing of Powell's injury indicates that things will only improve moving forward.

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