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The Importance of Physical Therapy After an Achilles Rupture

Kobe Bryant has been officially shut down by the Los Angeles Lakers for the remainder of the season. A remarkably durable player for most of his career, Kobe tore his left Achilles tendon last spring. He made a remarkably quick recovery for such a devastating injury. However, upon his return, he injured his left knee shortly after his mid-season debut. These are two major injuries for someone without a history of such. In my estimation, the Achilles injury was a direct cause for his subsequent knee injury. Physical therapy and a return to sports rehabilitation following an Achilles injury, especially in a sport like basketball, is an extremely grueling, painful and long process. I often tell patients that the dreaded ACL tear is actually not as limiting as an Achilles tear, especially for a jumping sport like basketball. Basketball- with all the hard stops, immediate change of direction, and rigorous pace- requires that the joints, beginning with the ankles, to react near instantaneously. The knee is second to react to these sudden changes. When the ankle is limited in its motion and reaction, even by a seemingly small insignificant amount, the next body part - the knee- will have to pick up that slack. This can be in the form of excess motion and/or stabilization. The force that is generated by professional athletes and the repetitive nature of these forces can quickly overstress the joint that is suddenly being asked to overproduce. It could have only taken several weeks for the knee to begin to be overstressed if only because the ankle lacked 5% of motion or reacted .0001 seconds slower than usual. I have never seen a complete traumatic Achilles tear regain 100% prior motion and flexibility, while a knee after an ACL tear can regain full motion and flexibility. Additionally, to return to full contact sports, the Achilles often requires an additional three months of extensive physical therapy more than an ACL tear. It seems apparent to me that Kobe's quick return to the NBA was a significant cause for his subsequent knee injury.

 

Avi K, PT

Healing Rays Physical, Occupational, and Hand Therapy