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Today it was reported that Cam Akers, running back for the Los Angeles Rams, tore his Achilles tendon while training.

Achilles is an injury more commonly seen in middle aged males. While the optimal treatment of ruptures in the recreational athlete is debated, the consensus is surgical repair in elite athletes. Today I will summarize some of the literature regarding Achilles ruptures in NFL athletes.

Trofa et al. looked at NBA, NFL, MLB, and NHL players that underwent operative repair of an Achilles rupture. Using publicly available databases they were able to find 32 NFL players that underwent Achilles repair. Of the 32 players that underwent repair 21 were able to return to play (65.6%). NFL players were found to play in 84.4% the number of games 1 year after injury and 86.3% of games 2 years from surgery compared to preinjury. but did not notice a significant decrease in playing time. The authors used season approximate value to measure compare player performance pre and post injury. They found that NFL players performance was 69.6% at 1 year and 67.1% at 2 years postoperatively. 

Jack et al. searched publicly available databases from 11/16/1958-7/28/2016 and were able include 98 surgeries in 95 players in their study. Eleven of the included players were running backs with only 5 returning to sport (45.5%). The return to sport among all players was 72.4%. The days to return to sport in running backs was 363.6 +/- 119.3. The career length of athletes after repair was significantly reduced compared to matched controls (2.7 +/- 2.1 yrs vs 3.6 +/- 2.1 yrs) For running backs the career difference was 1.3 +/- 0.8 years vs 3.2 +/- 1.8 years. Running backs were found to have significantly worse postoperative performance scores. Performance scores for running backs using the formula : (Receiving yards ÷ 10) + (Receiving touchdowns × 6) + (Rushing yards ÷ 10) + (Rushing touchdowns × 6).

Yang et al. used an established database to identify 80 players with an Achilles tear between the 2009 and 2014 seasons. The percentage of players returning to sport by 18 months postoperatively was 63.75%. Of the 7 running backs in their series only 3 were able to return within 18 months. In the players that returned to sport they found that they played fewer games in their return season compared to preinjury but returned to the same number of games by the second season after injury. 

The overall number of Achilles ruptures in running backs is low. The return to sport for running backs is lower than for other positions and return to the same level of play is significantly lower. Cam Akers certainly has a long road to recovery ahead but will hopefully be able to return within 12-18 months.