Is Kobe Bryant’s Career Over?

Kobe Bryant had already played 45 minutes  and scored 32 points in last night’s game against the Golden State Warriors when he fell to the floor.

When Warrior Harrison Barnes confirmed that he had not kicked him, Bryant, 34,  knew that his Achilles tendon had been injured, and that it was bad:

I made a move that I make a million times and it just popped.

Later, facing the press on crutches, he outlined his next steps: “MRI, surgery and then recovery.”

And as Kobe predicted, the MRI confirmed a “complete rupture” of the Achilles tendon. He underwent surgery today to repair the injury.

As recovery from Achilles tendon surgery can take 3 months to a year, this season is definitely over for Bryant.

But what about his career? The careers of  Hall of Famers Charles Barkley and Shaquille O’Neal were ended with this injury.  On the other hand, Los Angeles Clipper Chauncey Billups was able to return to the game. In any case, sounds like Bryant is ready to put in the work:

I was really tired, man. Just tired in the locker room and dejected and thinking about this mountain to overcome. I mean, this is a long process and wasn’t sure I could do it. Then your kids walk in and you’re like, ‘I need to set an example. Daddy is going to be fine.’ I can do it. Work hard and just go from there.

The Achilles tendon is the strongest and thickest tendon in the human body. It runs from along the back of the calf connecting the large calf muscle (gastrocnemius) with the heel. It aids walking by raising the heel off the ground.  It is the thick band of tissue you feel at the back of your leg just above the ankle.

Achilles tendon ruptures, also known as tears, can be full ruptures or partial ruptures. They are most commonly seen in men, 30-40 years old. About 15-20% of patients have symptoms of Achilles tendonitis (inflammation of the tendon) prior to sustaining an Achilles tendon rupture, but most have no history of prior Achilles tendon problems. Over 75% of Achilles tendon ruptures are associated with playing ball sports (commonly basketball or tennis).

The symptoms of Achilles tendon rupture  comes on suddenly, sometimes with a pop or snap sound. Frequently it is described as being kicked in the heel, even though that is not the case.  In a complete rupture, the calf muscle is no longer connected to the heel, so walking is not possible. On examination, the area of the rupture is often swollen, tender, bruised (ecchymotic), and may actually have a palpable gap in the tendon.

Other risk factors that are associated with Achilles tendon rupture include cortisone injections into the tendon (usually to treat tendonititis, gout, and the use of certain antibiotics, called fluoroquinolones which are commonly used  for treatment of respiratory, urinary tract, and other bacterial infections. These antibiotics, such as Cipro, Levaquin, and others, can be associated with Achilles tendon rupture. Exactly why this is the case is unclear.

Treatment can be either surgical or non-surgical. Non-surgical treatment usually reserved for partial tears of the tendon or for those with a more sedentary lifestyle. This involves wearing a cast or walking boot with a wedge to elevate the heel.  This allows the ends of  the torn tendon to heal. There is a higher risk of re-rupture with non-surgical treatment.

Surgical treatment involves making an incision in the ankle and sewing the two ends of the torn ligament. Sometimes the tendon is re-enforced with additional tendon material. Risks may include infection or nerve damage.

With either method of treatment, a fairly long period of rehabilitation will be necessary with physical therapy to strengthen the leg muscles and Achilles tendon.

For more information, go to the Resounding Health Casebook.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.


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