By Kerry Grens
NEW YORK (Reuters Health) - Many professional basketball players who rupture their Achilles tendon never make it back for another season, according to a new study.
Researchers also found those who suffer the heel injury and do come back tend to perform at a lower level than they did before getting hurt.
"If you follow the sport you can see it's a devastating injury to these players," said Dr. Douglas Cerynik, the senior author of the study from Drexel University College of Medicine in Philadelphia.
In April, an Achilles tendon rupture ended the season of Los Angeles Lakers star Kobe Bryant, who suffered the injury during a game against Golden State.
The tendon runs along the back of the ankle and heel. A tear often requires surgery to repair it, followed by rehabilitation.
To understand the extent of the impact of these injuries, Cerynik and his colleagues gathered information from press releases, reports of player injuries and player profiles.
They found that from 1988 to 2011, 18 National Basketball Association (NBA) players suffered a tendon rupture. Of those, seven athletes never returned to play another game.
The findings are not surprising, given the age of the injured players, said Dr. Brian Sennett, the chief of sports medicine at the University of Pennsylvania in Philadelphia, who was not involved in this study.
The average age of those who suffered a torn Achilles tendon was close to 30, while the average age of professional NBA players is 27.
"They're already starting to go on the downslide of their careers and they probably don't have a lot of longevity. So in those individuals, when they lose just a little bit (of edge), they sometimes think about retirement," Sennett told Reuters Health.
The overall performance of the 11 players who did return to basketball declined after their injury.
Cerynik's group used a metric called the "player efficiency rating," which takes into account stats such as an athlete's points, rebounds, assists and free throw attempts per game.
Following the injury, the eight players who returned for at least two seasons had an average efficiency rating of 11.69 - down more than four points from their pre-injury rating of 16.1.
In comparison, similarly rated basketball players of the same age - who did not suffer an Achilles injury - saw their efficiency rating decline by just over one point.
However, injured players seemed to do just as well as their non-injured counterparts when it came to rebounding, shooting and other activities that involve explosive jumping movements and the Achilles tendon.
That suggests overall performance is affected by an Achilles tear - not specifically the more physically demanding basketball skills, Cerynik and his colleagues wrote in their report in The American Journal of Sports Medicine.
Dr. Selene Parekh, an orthopedic surgeon at Duke University in Durham, North Carolina, who didn't participate in the new research, said the findings are valuable for understanding the repercussions of these injuries.
The research is "very important because it's not just a matter of, are players able to return, but how well are they able to return, and that has a bearing on contract negotiations for players," he told Reuters Health.
Parekh said surgical treatments for torn tendons have improved dramatically in recent years, previously involving incisions close to five inches long and now requiring as little as a one-inch cut.
In the future, he said, operations might involve only pinholes, which could perhaps reduce patients' trauma and risk for complications.
Cerynik told Reuters Health it would be difficult to intervene and prevent the few Achilles tendon ruptures that happen in the NBA because these players are likely following proper weight and stretching regimens "as best as anyone can."
SOURCE: http://bit.ly/12iHrsx The American Journal of Sports Medicine, online June 3, 2013.