Up 41-20 at the end of the third quarter, the Buffalo Bills were rolling over the Miami Dolphins and life was good. On a 4th & 1 play where Tua Tagovailoa was sacked for an eight-yard loss, cornerback Tre’Davious White turned upfield to stay with wide receiver Tyreek Hill. As White kept with Hill step for step, he suddenly stopped short, turning around as he hopped on his left leg.
White went down with trainers coming out to assess the situation. Moments later, a helmet is seen tossed from the crowd of players gathered around White, a strong reaction to what was perceived to be a serious injury. Highmark Stadium quieted as the cart came out for White, taking him into the tunnel for further evaluation.
Reports began trickling in that White was being evaluated for an ankle injury.
Later, reports were more specific, stating lower leg and that imaging was performed.
Finally, a definitive update of OUT for Tre’Davious White as hope and uncertainty morphed into fear and a sinking feeling.
On Sunday night, national reports all but confirmed that Tre’Davious White tore his Achilles and would be out for the remainder of the 2023 season.
This is the latest significant injury for the former All-Pro cornerback who saw his 2021 season end with a left ACL tear on Thanksgiving. His return lasted just nine games, including playoffs.
Faced with another mountain to climb with surgery and rehab, White faces an uncertain future.
Below are details on Tre’Davious White’s right Achilles tear and outlook for 2024 and beyond.
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 tendon.
In White’s case, he was running and got his weight too far out over his right foot, placing the foot into dorsiflexion while the calf muscle was contracting, trying to push off to have him run forward. Unfortunately, the shift forward with the muscle contracting led to an eccentric contraction that became too much, and the Achilles ruptured.
The video isn’t as clear as several other Achilles tears where the calf can be seen retracting up violently as in others such as Aaron Rodgers.
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 or tendonitis are thought to contribute to an Achilles injury. White has not had a calf designation on the injury report during his career in Buffalo. He has had two ankle injuries one in 2018 and one in 2020, but that would not have contributed to this latest injury.
Having Achilles tendonitis can weaken the tendon and make it more vulnerable to future tearing, but there would have likely been some maintenance days required for White if he had tendonitis or had something nagging.
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 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.
White’s helmet throw and carting to the locker room were pretty notable signs that he knew something major was wrong.
Surgery and Rehab
Surgery and rehabilitation take roughly six to nine months to return to normal activities and athletics. 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. 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.
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 the research, there is a decline in performance which isn’t surprising. Focusing on defensive backs specifically, they averaged fewer games played (12.7 +/- 2.2 vs. 14.1 +/-1.6 games), and career length (2.4, +/- 1.2 vs. 3.9, +/- 1.5 years).
Performance-wise, there was a decrease in production of two interceptions and one pass defended over a 16-game season. On average, careers after an Achilles lasted just another 2.7 years compared to 3.6 against controls.
Return to Performance & Comparable Players
When Tre’Davious White does return in 2024, what does his career look like? Looking at cornerbacks who tore their Achilles and returned to play, it isn’t pretty. He is currently in his age-28 season in 2023.
DeAngelo Hall– Tore Achilles in 2014 in age-31 season, tore ACL in 2016, and retired. No Pro Bowl selections following injury.
Jason Verrett– Tore Achilles in 2018 in age-27 season, tore ACL in 2021, tore Achilles in 2022, and retired. No Pro Bowl selections following injury.
Donte Jackson– Tore Achilles in 2022 in age-27 season. Returned to play in Week 1 of the 2023 season.
Jeff Okudah– Tore Achilles in 2021 in age-22 season, returned to play 15 games in 2022, traded in 2023. No Pro Bowl selections following injury.
Anthony Brown– Tore Achilles in 2022 in age-29 season, signed with San Francisco in 2023, has not appeared in a game yet.
Ryan Mouton– Tore Achilles in 2011 in age-24 season, returned to play in 2012 for 13 games. Retired in 2014. No Pro Bowl selections following injury.
Byron Jones– Achilles injury in 2021 in age-29 season, missed all 2022 season on PUP. Released in 2023 and has not signed with a team.
Richard Sherman– Tore Achilles in 2017 in age-29 season, played until 2021, went on injured reserve with Achilles injury, not clear if another tear, retired. One Pro Bowl selection following injury (2019).
Jimmy Smith– Tore Achilles in 2017 in age-29 season, played 4 more seasons. No Pro Bowl selections following injury.
Leon Hall– Tore Achilles in 2013 in age-29 season, played 5 more seasons. No Pro Bowl selections following injury.
The best outcome that I can see is Richard Sherman who had a Pro Bowl season following his injury and played four more seasons. Jimmy Smith and Leon Hall are decent comparables but the rest mentioned above aren’t great indicators.
A move to safety for White could change his career outlook, but is that the best move coming off two major injuries in three seasons?
Weird Pattern
Tre’Davious White’s Achilles tear following an Achilles tear is just the latest in a disturbing trend we’ve seen in pro football players. He tore his left ACL in 2021 before tearing his right Achilles on Sunday.
Other players who have suffered an ACL tear and followed up with an Achilles tear are below.
WR Tim Patrick
Right ACL (2022) Left Achilles (2023)
RB JK Dobbins
Left ACL (2021) Left Achilles 2023
RB Tarik Cohen
Right ACL (2020) Right Achilles (2022)
CB DeAngelo Hall
Left Achilles (2014) Right ACL (2016)
CB Jason Verrett
Left ACL (2016) Left Achilles (2018)
Right ACL (2021) Right Achilles (2022)
WR Sterling Shepard
Left Achilles (2021) Left ACL (2022)
S Julian Blackmon
Left ACL (2019) Left Achilles (2021)
LB David Ojabu
Achilles (2022) ACL (2023)
OT Jason Peters
Right Achilles (2012) Right ACL (2017)
Final Outlook
This is a crushing injury for Tre’Davious White who was looking like he was back to pre-injury form.
The turn of events for White who before 2021, had only missed 3 games in his career and did not have any notable injury history other than a deep knee bruise in 2015 with LSU.
This is the third Achilles injury for the Bills in two seasons with the others being Bryan Cox Jr. (2021 training camp), and Ike Boettger (2021 Week 16). Prior to that, you had to go back for Kyle Williams who required off-season Achilles surgery in 2011 and 2012, and further back to Takeo Spikes in 2005.
Looking at the timelines, it’s reasonable to expect he could possibly be ready for training camp in 2024 or at the very least Week 1, barring setbacks like we saw with former teammate Ike Boettger who tore his Achilles in 2021.
Looking at the financials, his contract runs through 2025 and his dead cap hit is $10.3 million in 2024 and $4.1 million in 2025. He is likely here in 2024 as he returns, but the team could move on from him after that season. The team does value him as a leader but at the end of the day, the NFL is a business.
While the physical part is more predictable, how will White respond to this mentally? We saw the struggles as he worked back from his ACL tear that saw him take a whole calendar year to return, with later reports indicating there were mental hurdles.
How does he respond to two season-ending injuries in three seasons? Did the ACL rehab harden him for this latest setback? Or does it destroy whatever confidence he regained?
Only time will tell.
I sincerely wish Tre’Davious White the best in his recovery and to find the determination to return to football in 2024.
Top Photo Credit: USA Today
