When Milwaukee Bucks guard Damian Lillard collapsed and clutched his left leg during the first quarter of Sunday`s Game 4, it was a classic sign of an Achilles tendon tear. He was visibly in pain and appeared surprised by the sudden collapse.
Athletes often describe the sensation as feeling like they were kicked sharply in the back of the leg, accompanying the distinctive “pop” of the tendon rupturing. The Achilles tendon connects the calf muscles to the heel bone, serving as the primary link for powerful movements like running, jumping, and pushing off the ground. (When the calf muscles contract, the energy is transferred through the tendon to propel the foot, facilitating actions from walking to explosive dunks.)
At 34, Lillard falls into the common age bracket for elite athletes experiencing this type of injury. Basketball, with its constant demands for jumping, running, and quick pivots, places immense, repetitive stress on the Achilles through alternating tension and elongation with explosive contractions, increasing the risk of rupture.
Notably, Lillard had recently missed time after being diagnosed with deep vein thrombosis (DVT) in March. DVTs, blood clots typically forming in a vein, often in the calf, are treated with blood thinners and rest to prevent them from traveling to vital organs. While necessary, this treatment prevents athletes from training intensely, leading to deconditioning. Contact sports are strictly avoided while on blood thinners due to the increased risk of bleeding. Players can return to play only after the medication is discontinued.
That said, returning from any significant injury layoff, especially one lasting weeks or months, necessitates a careful reconditioning phase. The speed and nature of this ramp-up period depend on various factors, including the injury`s severity, duration of absence, activity level during recovery, the sport`s physical demands, and the athlete`s psychological readiness.
The pressure of a tight schedule, like the playoffs, can influence the desire for a quicker return. However, medical teams and the athlete have extensive discussions about potential risks involved in accelerating the process. While it`s impossible to definitively state if the several-week absence due to DVT treatment increased Lillard`s risk for an Achilles injury, the injury was likely the result of an unfortunate combination of pre-existing risk factors.
What matters now is Lillard`s recovery and what he can expect going forward and into the 2025-26 season. Surgery is imminent, followed by a highly controlled period to restore mobility. Some athletes may initially be placed in a cast for a short duration, while others use a removable boot. Either way, motion is strictly controlled in the early weeks to protect the delicate repair as the tendon heals. Controlled movement is crucial for maintaining ankle joint mobility, but preventing overstretching is vital; the Achilles` function relies heavily on its elasticity. Over-lengthening the repaired tendon permanently impairs its ability to function properly, akin to stretching a rubber band until it loses its snap. Once initial healing is complete, rehabilitation progresses to include a broader range of motion exercises and strengthening, culminating in a gradual return to running, jumping, and other explosive movements required in basketball.
The typical recovery timeline for athletes returning to play after an Achilles tear is generally anywhere from six months to a year, with NBA players averaging around 10 months. The specific return date depends on individual healing rates, regaining physical fitness, and the seasonal calendar. Advances in surgical techniques have allowed many athletes to regain performance levels close to their pre-injury state, though each case is unique. Athletes often report feeling they don`t fully recover their explosive power and pre-injury form until their second season of competition after surgery.
The bulk of the scientific literature addressing return to play and performance issues for NBA players after Achilles tears indicates that while a high percentage (ranging from 70% to 80%) do return to the court, the majority do not fully reach their previous statistical performance levels in metrics like games played, minutes, or efficiency. This finding is partially complicated by the fact that many NBA players sustaining this injury are already in the later stages of their careers, where performance decline might naturally occur independent of the injury.
Still, examining specific examples of prominent NBA players who recovered from similar injuries can provide valuable insight into Lillard`s potential path back to the court.
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Kobe Bryant: Perhaps the most widely remembered NBA player to return from an Achilles injury, Bryant coincidentally was also 34 years old at the time of his rupture during the 2013 playoffs. He underwent surgery in April and made a relatively rapid return to action in December that same year. However, upon returning, Bryant visibly lacked his former explosiveness. The following year, his season ended prematurely due to a shoulder injury requiring surgery, and the subsequent season proved to be his last in the NBA.
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Klay Thompson: Thompson`s situation is somewhat unique and complex, in that he tore his Achilles while already recovering from a torn ACL suffered during the 2019 NBA Finals that had forced him to miss the entire subsequent 2019-20 season. Just as he was nearing a return to action to start the 2020-21 season, he suffered his torn Achilles. He ultimately returned midway through the 2021-22 season at the age of 31. As might be expected, his initial statistics showed fewer minutes per game and reduced shooting efficiency compared to his pre-injury form. However, Thompson demonstrated resilience, bouncing back the following year, averaging more minutes and achieving career highs in three-pointers and rebounds.
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Kevin Durant: Durant tore his Achilles during the 2019 Finals while playing for the Golden State Warriors. Notably, the Brooklyn Nets signed him to a lucrative four-year contract during his recovery period, reflecting their confidence in his ability to return at an elite level. Durant missed the entire 2019-20 season but returned to action the following year looking powerful and effective. Although other injuries limited him to just 35 games that season, he performed like vintage Durant when he was on the court. The longer 18-month window between injury and return to play might have contributed positively to his successful performance upon return. Durant`s numbers make a strong case that some NBA players, even in their early 30s, can indeed return to pre-injury elite levels following an Achilles tear.