The thick tendon that connects our calf muscles to our heel bones takes its name from Greek mythology. Achilles was the son of Thetis who dipped him by the heel in the River Styx to grant him invincibility in battle. The spot where she held him on the heel was untouched by the magic water and therefore unprotected. The term "Achilles' heel" symbolizes a critical weakness in an otherwise mighty warrior, which is fitting given the vulnerability for even the strongest athletes to an injury to this tendon. This kind of injury does not discriminate: even elite professional athletes at the top of their game fall victim. In Game 7 of NBA finals, Tyrese Halliburton went down hard with a rupture of his right Achilles tendon following a calf strain a few days earlier. A similar pattern occurred in 2019 when Kevin Durant was cleared to play in Game 5 after a calf injury and went down with an Achilles tear that same night. Dru Smith ended his season in December, Jayson Tatum ended his season early with one in Game 4 of the Eastern Conference semifinals. We saw Damian Lillard go down with an Achilles tear at the start of the 2025 NBA Playoffs, which ended his season and the Milwaukee Bucks’ hopes of another championship.
Achilles tendon injury recovery is a long road and the stakes for the injured athletes and their teams are sky high because the Achilles tendon is critical for walking, jogging and of course for explosive athletic movements like sprinting, jumping, and quick directional changes. Achilles tendon injuries used to be most common in middle-aged recreational athletes, "weekend warriors." However, today, we see these injuries occur in younger and younger athletes each year. Recent studies have confirmed what many coaches and trainers have reported first hand. While men are still statistically more likely to suffer Achilles tendon injuries, the gender gap is closing. Several factors appear to be contributing to this trend, including single sport specialization, changes in playing surfaces and footgear and shorter recovery periods between seasons.
An article in The American Journal of Sports Medicine noted that early specialization and modern training programs utilizing high-intensity plyometric exercises, sprint work, and rapid changes in direction can increase mechanical stress on the tendon beyond what traditional training programs once demanded. Training and playing on harder surfaces with less “give” while wearing the latest minimalist shoes or super spike cleats may be changing the biomechanical dynamics between the athlete and their playing surface in a way that increases the burden on the Achilles tendon. These repetitive explosive loads on still-developing Achilles tendons are implicated in the accumulated microdamage over time which may be contributing to serious ruptures in prime playing years. The tendon itself is very strong, so while recovery is a long process, injury often occurs due to sustained damage. This means there are signals and warning signs we can spot for earlier detection.
Athletes and their coaches and trainers should be attentive to the body’s signals which might indicate a degrading Achilles tendon. Some of these signals include stiffness, soreness, swelling and thickening along the back of the ankle after exercise; pain when pushing off, sprinting, or jumping, or a feeling of "weakness" in the lower leg or calf. Proactive steps can make a major difference in reducing Achilles injury risk. That tells me, as both a former NCAA D-1 athlete and a sports medicine specialist, that the best strategy is Achilles rupture prevention. Trainers and athletes should consider strengthening the Achilles tendon. That means loading exercises utilizing heel-drop movements which have a useful role in building tendon resilience, and diversifying to include cross-training to reduce cumulative tendon microdamage from repetitive loads on the tendon. Finally, add more stretching exercises and proper recovery phases to rest your Achilles tendon.
Take it from me as an elite level athlete and sports-care practice leader, even the strongest warrior-athletes have vulnerabilities, just like the mythic Achilles himself. The rising incidence of Achilles tendon injuries in younger athletes is a clarion call for athletes, coaches and trainers to increase our awareness and deploy more thoughtful training approaches, and earlier interventions. By respecting the loads placed on the tendon and taking evidence-based preventative actions, athletes can protect themselves from one of the most devastating injuries in sports.