After all the hype, suspense, excitement, and hope for the New York Jets in acquiring Aaron Rodgers, it failed to live up to expectations to the nth degree. Just four plays into the 2023 season was all that Aaron Rodgers lasted in a Jets uniform before disaster struck. On a sack from Bills EDGE Leonard Floyd, Rodgers’ foot got caught in the turf and his whole body shifted forward, overstretching the Achilles tendon, and causing it to rupture.
You can see it clearly in the play below where the calf reverberates or quivers as the tearing takes place.
On Tuesday, it was confirmed that Rodgers tore his Achilles, ending his season. Moving forward, he has a long road to recovery with many questions regarding his future. This is incredibly unfortunate considering how much potential the Jets had coming into this season with Rodgers under center.
The article today will break down the anatomy, mechanism of injury, risk factors, surgery, rehab, and timeline to return.
Anatomy
The Achilles tendon is a band of connective tissue that connects the gastrocnemius to the calcaneus, allowing the foot to plantarflex or point down. This is essential during walking, jumping, running, and sprinting.
Mechanism of Injury
A rupture of the Achilles tendon occurs when an eccentric load is placed through the area, overloading the muscle, and resulting in the tendon tearing. This commonly occurs when a player is trying to push forward but gets driven back such as blocking on the offensive line, cutting hard and pushing through the foot as one would see in a running back, or landing from jumping in the case of a defensive back.
These movements could lead to forceful dorsiflexion or the foot moving upward. This could also occur if the knee is extended and placing excess force through the front of the foot, overstressing the Achilles area. This is similar to what we saw with Rodgers where the foot was in dorsiflexion along with the body weight of another person led to the rupture. This is less common, but still a way to injure the area.
In fact, looking at the video at regular speed, it’s difficult to see where the Achilles retracts as seen in the video earlier in the article. I had suspected a midfoot injury due to how the forefoot was planted and twisted down.
Risk Factors
These injuries are sudden and typically come without warning, which makes this injury all the more devastating. There is usually a loud pop and immediate pain as if the person was stabbed or shot. Weakness and the inability to flex the foot down are common symptoms and swelling and a possible gap in the tendon when palpating the area.
Prior injuries to the calf region such as a calf strain are thought to contribute to an Achilles injury. Rodgers did have a calf injury that he was working through during OTA’s, though this was to his right side as seen below.
He did have a mild calf strain on the left side during a training camp practice, of which he said that this was his “good calf”
Despite the prior calf injuries, the sudden overload of the tendon as he was falling forward more likely led to the injury than the previous calf strains. Having Achilles tendonitis can weaken the tendon and make it more vulnerable to future tearing, but we have no confirmation or even suspicion that he had tendonitis in either calf. So that means this concern for the prior calf strains leading to the Achilles injury is largely unfounded.
Diagnosis
Achilles tendon tears are easy to diagnose with several special tests including the Thompson test. This is when the person is placed into a prone position and the lower leg hanging off the table. The calf muscle is squeezed and a positive test is when the foot does not plantarflex when the muscle is contracted due to the squeeze.
A more accurate test that was likely performed back in the medical tent or locker room is the Matles test. The person lies on their stomach and bends their knee to 90 degrees. If the foot does not move or moves into dorsiflexion, then that is a positive sign that it is torn. The foot would normally slightly point downward in a negative test, indicating a tightening of the calf muscle that connects at the knee.
Surgery and Rehab
Surgery and rehabilitation take roughly six to nine months to return to normal activities and athletics. The average amount of time takes 8.9 months with some returns as quickly as 5.5 months with RB Cam Akers during the 2021 season. Details of the various types of surgical repair can be viewed here.
Return to Play
The concern to re-tear in the NFL is closer to 15 percent, but this number may be more accurate as there are far more eyes on a smaller group of individuals than the general population that relies on outside data for studies. Normally, the re-tear rate is one-to-two percent in the general population.
Return-to-play rates do vary but levels as high as 78 percent have been reported within the NFL according to studies. Due to more aggressive rehab, there have been advances that have shaved the return to play in the NFL down to six to eight months.
Improvement in performance following the injury has been observed, suggesting that this isn’t as much of a career-ender as it was a decade or two before. Return-to-play rates are north of 80 percent, according to The Athletic on a profile of the Indianapolis Colts’ management of the Achilles injuries.
Looking at quarterbacks who have suffered an Achilles injury, this is a much smaller sample size. There are not a lot of studies that look at how quarterbacks have fared in returning to play. However, there are some examples that are highlighted below:
The best comparables in this situation are Dan Marino and Vinny Testaverde considering the talent level in the case of Marino and age with Testaverde. Both were able to return to play at a high level for four or more seasons, but even both players were not as old as Rodgers when he tore.
Looking at the research, there is a decline in performance upon returning equal to five fewer touchdowns and 60 fewer yards over the course of a season. It’s worth highlighting that there were only five quarterbacks in the study which may have been affected by their talent versus actual performance. What’s promising is that each quarterback that suffered the injury, they were able to return to play the next season, a 100 percent rate.
What this does show is that there aren’t many comparables to show what a return looks like for Rodgers, but there is hope that he can return to play and finish his career on his terms.
Outlook
Rodgers will undergo surgery within the next week or two to begin the repair process necessary to return to the NFL in 2024. The research is favorable for him to return to play at nearly 80 percent, but there is a decline in performance upon return. Rodgers had his worst season statistically last year, though he was battling a thumb injury that affected his grip and in turn, his play.
At his age 40 season, how much longer does he really have to play at a high level? He could certainly walk away and retire, but most players want to end on their own terms, not due to injury.
He wasn’t a very mobile quarterback even prior to the injury and this Achilles injury will only make him more of a pocket quarterback. All off-season, the concern was that the offensive line needed to hold up to protect Rodgers, this will be even more of a need in 2023.
Rodgers should play in Week 1 next year, it’s just what kind of performance issues will linger typically seen in the first year of the Achilles repair.
Aaron Rodgers does not want that injury to be the last image of him as a football player. Despite his talent, we may see his skills diminish as he gets older, potentially losing the Super Bowl window with the Jets.
I wish him well in his recovery and hopefully, he can return to keep the AFC East competitive.
Top Photo Credit: Vincent Carchietta/USA Today Sports via Reuters
