Achilles injuries have vexed the NBA. A Hall of Famer reflects, and doctors analyze

New York Times

29-06-2025

During Game 7 of the 2025 NBA Finals last Sunday, when the basketball world watched Tyrese Haliburton writhe in pain after tearing his right Achilles tendon, Dominique Wilkins sympathized with Haliburton, but wasn't as surprised as others may have been.
Not because Haliburton's rupture marked the third such injury for an NBA All-Star during the 2025 playoffs. Not even because of it being the seventh such tear for a league player during the 2024-25 season alone. Never mind that Wilkins, the Naismith Basketball Hall of Famer, suffered the same fate more than 30 years ago, only to rediscover his basketball superpowers after arduous rehabilitation before such bouncebacks were considered routine.
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Wilkins wasn't surprised because he knows an athlete's body can take only so much before being pushed to its ultimate on-court limit.
'It's just a freak accident. It's something unexplainable,' Wilkins told The Athletic after watching Haliburton's injury. 'Usually, when a guy tears his Achilles, there's already some nagging pain that you don't think about beyond wear and tear. You don't think it's something that's going to blow on you. I sympathize with him because the way he went down, it looked like he completely tore it.'
When Haliburton's injury was confirmed the following Monday, it further established a season-long trend around the league: players are tearing their Achilles more frequently and at younger ages. There is no singular variable increasing the rate at which basketball players are routinely rupturing — at the bare minimum compromising — the longest, strongest tendon in the body. Bodily attrition plays a distinct role, which Wilkins noted as he reflected on AAU basketball being more popular than ever as players enter the NBA with more mileage than those from prior generations.
'There ain't no question it's the wear and tear,' Wilkins said. 'AAU and all that stuff at a very early age, they never give their bodies a chance to rest. So, yeah, it definitely has something to do with it. … With all the technology in the world, why are guys getting more Achilles tears than we had? It wasn't a lot of guys who had them when I was playing.'
For Wilkins, who averaged 24.8 points across 15 NBA seasons stretching from 1982 to 1999, an Achilles rupture then was seen almost as a career death sentence. His rehabilitation, at 32 years old, spanned 282 days between the injury on Jan. 28, 1992, and his return to the court.
On Nov. 6, 1992, he had 30 points and made 13 of 26 shots in his first game back against the New York Knicks. He finished the 1992-93 season with the third-highest scoring average of his career (29.9) and a fifth-place finish in the NBA MVP voting.
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Though it may have seemed like 'The Human Highlight Reel' never skipped a beat, returning to regular form was not easy. He knows it will be difficult for Haliburton, Boston Celtics forward Jayson Tatum and Milwaukee Bucks guard Damian Lillard, who will each navigate their own paths through troubled waters.
But difficult does not equate to impossible.
'First thing I thought was my career was over, because at 32, back in those days, that was an injury you didn't come back from and be what you were,' Wilkins said. 'I quickly determined I'm going to work my butt off to get back to the level I was, if not better. I remember getting sarcastic pats on the back with, 'Yeah, good luck with that.' But I tell people all the time, I worked twice a day, every day, for nine months to get back to the level that I once left it, and I came back with my best all-around year with almost 30 points a game. It was just a wonderful year for me.'
Before seeing the replay of Haliburton falling to the ground, Nashville, Tenn.-based Dr. Nicholas Strasser, an assistant professor in Vanderbilt University's Department of Orthopaedic Surgery, had flashbacks to the 2019 NBA Finals. Strasser, who also serves as a foot and ankle consultant for Vanderbilt athletics, the NHL's Nashville Predators and the MLS' Nashville SC, remembers a then-30-year-old Kevin Durant tearing his Achilles after trying to combat a calf strain.
'It was so similar to the Kevin Durant situation that, without even seeing (Haliburton), I was like, 'Oh, no. Did he tear his Achilles?' Strasser told The Athletic. 'As soon as they showed the replay, you could see it as he took that, what they call, negative step. You could almost see the recoil to it.'
A side-by-side of Tyrese Haliburton's leg injury in Game 7 and Kevin Durant's ruptured Achilles in the 2019 Finals. pic.twitter.com/p9qdi9KRAe
— Blake Niemann (@Blakes_Take2) June 23, 2025
From an orthopedic surgeon's perspective, a negative step refers to a sudden backward shift of the foot, typically when a player pushes or plants their foot behind the body to accelerate or change direction. In such instances, the Achilles tendon both contracts and lengthens, which places great stress on the muscle and makes it vulnerable to rupture, particularly in fatigued or degenerated tendons.
It's a classic setup for a non-contact injury, often described by patients as feeling like getting kicked in the back of the leg.
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'The Achilles is similar to a bow string on a violin. It looks like one structure, but within that structure is a lot of fiber,' said Dr. Kenneth Jung, an orthopedic foot and ankle surgeon at Cedars-Sinai Orthopaedics in Los Angeles and a consultant to the NFL's Los Angeles Rams. 'You can have straining of the fibers, partial tearing or a complete rupture. But the MRI will allow you to see, within the tendon, if there's early changes or early signs of injury. It can also be used to confirm the rupture.'
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In 2013, a 34-year-old Kobe Bryant tore his simply by spinning baseline for a fadeaway bucket. He walked off the floor, but not without first shooting and making two free throws. When Haliburton went down, the basketball world witnessed a major injury for a 25-year-old All-NBA guard.
Advanced technology helps with both diagnosing and anticipating Achilles ruptures. The many variables add up to sound reasoning, even if a diagnosis is never truly a binary endeavor:
In recent weeks, arguments about sneaker usage — ranging from Durant to former NBA guard Nick Van Exel and even rapper/sports analyst Cam'ron — have entered the chat about commonplace Achilles ruptures. Some, like Wilkins, have argued that wearing low-top sneaker cuts has an adverse effect in comparison to mid-quarter and high-top cuts, but the jury is still out regarding a scientific explanation on the effect of footwear.
'That's a hard one for me,' Strasser said. 'I can definitely see the risk of ankle sprains and rolling your ankles and having more support, but it's a different injury. The Achilles spans such a long distance.
'Technically, the muscle goes all the way up to the knee and then comes across two joints, so it would be hard for me to say there's a direct correlation between that portion of the shoe and Achilles tendon ruptures. I'd be more concerned with rolling your ankle or something like that, because it's hard to find anything that can brace an Achilles.'
In some cases, according to Jung, shoe support can play a role, but it's not a black-and-white measure. The popularity of low-top sneakers among basketball players has grown in recent years, so it's unfair to broadly conflate that trend with such a life-changing injury. With sneakers, heel level does play a factor in an Achilles tear, even if other variables influence whether a rupture takes place. Lighter weight in a sneaker can decrease support, leaving a leg at risk for injury. And sometimes, even with the sturdiest sneaker, the danger of a rupture remains because, as Wilkins mentioned, it simply can be a freak accident.
But sports specialization undeniably influences matters, as more hoopers are choosing the game at a younger age, thus increasing the risk of repeatedly stressing the same joints before ever playing an NBA minute.
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'Your body has to have time to recover,' Wilkins said. 'You can't push a body like a machine, because it's not. You push your body to the point where you're getting better, getting stronger.
'But the greats — the Kobes, myself, the Michaels (Jordan) — we took a little downtime to let our bodies rest. Even though we pushed ourselves to the limit, you've still got to let your body rest.'
According to Strasser, surgery for repairing an Achilles tendon normally doesn't take more than two hours. The patient is positioned on their stomach with a generic anesthetic used to subdue them. It often is an outpatient surgery.
The muscle-tendon relationship must be restored before a patient advances to load-bearing to avoid muscle atrophy. Anywhere from six to 12 weeks is when the tendon can eventually take on more, but early loading and eventual motion practice can make a difference.
Beyond a successful surgery, nutrition is an underrated variable. An athlete's diet matters.
'Somebody in the NBA is probably going to have optimal nutrition,' Strasser said. 'But certainly making sure they're getting enough protein and a balanced diet to help promote tendon healing and minimize muscle atrophy is all really key for building blocks in muscle maintenance and tendon repair.'
A player's return to the court can vary by a myriad of factors. Wilkins credits sound patience.
Although Wilkins is recognized as a standard bearer for Achilles recoveries, the recuperation curve remains steep. Bryant and Patrick Ewing had steep decreases in their player efficiency ratings upon returning from their injuries. Durant, who was recently traded to the Houston Rockets, sports 53.1/41.5/88.0 shooting splits since returning from his rupture but has missed almost an average of 26 games per season since the 2019 NBA Finals.
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No matter how ambitious the timetable, the balance between seeing results and prioritizing peace can be the ultimate measure in recovering from what many see as a finisher to an NBA career.
Depending on a player's age, the margins could already be thin. Body parts stiffening is a reality with aging, so a successful recovery becomes tougher sledding — not impossible, of course — when an athlete can't move as accustomed. Fortunately, Achilles rupture recoveries have advanced well enough to expedite load-bearing for players to make better informed decisions as they pursue on-court returns.
But in a league where the best players are thriving while being challenged, peace of mind can be uncommon when it comes to an athlete sniffing a return to familiar form.
'It's the patience that will determine how he will come back,' Wilkins said. 'That patience and hard work. … You learn how to play the game on the ground as well as in the air, becoming more fundamentally sound. (Injured players) will notice those things through development.'