Return to Play and Player Performance After Achilles Tendon Rupture in UEFA Professional Soccer Players: A Matched-Cohort Analysis of Players From 1999 to 2018

Abstract

Background: Achilles tendon rupture (ATR) is a potentially career-ending injury in professional athletes. Limited information exists regarding return to play (RTP) in professional soccer players after this injury. Purpose: To determine the RTP rate and time in professional soccer players after ATR and to evaluate player performance relative to matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 132 professional soccer players who suffered an ATR between 1999 and 2018. These athletes were matched 2:1 to uninjured controls by position, age, season of injury, seasons played, and height. We collected information on the date of injury, the date of RTP, and player performance metrics (minutes played, games played, goals scored, assists made, and points per game) from official team websites, public injury reports, and press releases. Changes in performance metrics for the 4 years after the season of injury were compared with metrics 1 season before injury. Univariate comparisons were performed using independent-sample, 2-group t tests and Wilcoxon rank-sum tests when normality of distributions was violated. Results: The mean age at ATR was 27.49 ± 4.06 years, and the mean time to RTP was 5.07 ± 2.61 months (18.19 ± 10.96 games). The RTP rate was 71% for the season after injury and 78% for return at any timepoint. Overall, 9% of the injured players experienced a rerupture during the study period. Compared with controls, the injured players played significantly less (-6.77 vs -1.81 games [ P < .001] and -560.17 vs -171.17 minutes [ P < .05]) and recorded fewer goals (-1.06 vs -0.29 [ P < .05]) and assists (-0.76 vs -0.02 [ P < .05]) during the season of their Achilles rupture. With the exception of midfielders, there were no significant differences in play time or performance metrics between injured and uninjured players at any postinjury timepoint. Conclusion: Soccer players who suffered an ATR had a 78% RTP rate, with a mean RTP time of 5 months. Injured players played less and demonstrated inferior performance during the season of injury. With the exception of midfielders, players displayed no significant differences in play time or performance during any of the 4 postinjury seasons.

Achilles Tendon Rupture in Professional Football Player: an Epidemiological Study in European Championship With A Mid-Term Follow-Up

“…This study also revealed that 11.8% of the included players did not maintain their previous levels, playing in lower categories after injury, and 11.8% of players who returned to played sustained an Achilles tendon re-rupture during their careers. The present series found that professional football players who suffered an ATR had a mean age at the time of injury of 28.7 years, whereas other studies found mean ages of 27.49 and 27.2 years (4,10). This may confirm how ATR could be considered an injury of the mature athlete (11).…”

“…Sports that involve frequent acceleration and changes of direction with excessive eccentric loads on the Achilles tendon (AT) are considered to impose a high risk of ATR (3). The incidence of ATR in the general population ranges from 4.7 to 24 per 100,000 and has shown a consistent upward trend over a 15-year period and involvement of middle-aged people (4,5). AT ruptures can be divided into acute, when diagnosed or treated within 6 weeks, or chronic (6,7).…”

“…However, few studies have analysed the effect of ATR on professional football (soccer) players. Forlenza et al (4) showed that soccer players who ruptured their AT had a 78% RTP rate at any timepoint, while Grassi et al (11) found a return to unrestricted training after 7 months and to competition after 9 months. The aim of this study was to evaluate the RTP rate and time after ATR, as well as outcomes after RTP in terms of player performance in the two post-injury seasons compared to the two pre-injury seasons.…”

Percutaneous Achilles Tendon Repair Using Ultrasound Guidance: An Intraoperative Ultrasound Technique

“…Rupture of the Achilles tendon is a common injury among athletes, and the incidence of ruptures has increased over the past four decades. 1 , 2 , 3 , 4 , 5 , 6 A recent population study in Sweden found that over an 11-year time period, the increase of Achilles ruptures in men and women increased by 17% and 22%, respectively. The reported overall incidence for males and females was 55.2 per 100,000 person-years and 14.7 per 100,000 person-years, respectively.…”

The Effect of Immediate Functional Ankle Rehabilitation on a Range of Motion, Muscle Strength, and Stiffness after Achilles Tendon Repair in Soccer Player

“…발꿈치힘줄 파열(아킬레스건 파열, Achilles tendon rupture; ATR)은 반복적인 미세외상, 저혈관 성(hypovascular) 및 퇴행성 변화와 같은 외재적 요인과 신체의 컨디션이 좋지 않은 상황에서 고강도의 달리기나 점프 상황 등 내재적 요인이 결합되면서 발생할 수 있다 [6]. 엘리트 축구 선수는 경기 중에 다양한 뱡향으로 폭 발적인 변화를 수행하기 위해 발꿈치힘줄의 극심한 부 하에 자주 노출되면서 수술이 필요한 급성 ATR 위험이 높아진다 [7].…”