My heart hurts to write this
week’s blog post.
A few days ago, WNBA Most Valuable Player – and Seattle Storm superstar – and former University of Connecticut standout – and all-around philanthropic and kind person - Breanna Stewart - ruptured her Achilles tendon playing basketball overseas. Since my social media feeds are filled with a combination of women’s basketball gurus and physical therapists/strength and conditioning coaches, there were A LOT of posts on my feed about her injury and the political implications of it. If you're not squeamish, you can watch this video of her injury:
A few days ago, WNBA Most Valuable Player – and Seattle Storm superstar – and former University of Connecticut standout – and all-around philanthropic and kind person - Breanna Stewart - ruptured her Achilles tendon playing basketball overseas. Since my social media feeds are filled with a combination of women’s basketball gurus and physical therapists/strength and conditioning coaches, there were A LOT of posts on my feed about her injury and the political implications of it. If you're not squeamish, you can watch this video of her injury:
breanna stewart landed on brittney griners foot during the euroleague title game and looked in serious pain— dynamo kursk fan account (@WEREONLIVE) April 14, 2019
not clear if it was ankle or knee but she was helped off the floor and put no weight on it pic.twitter.com/AO8ecTLtgJ
(Note: she injures the other leg - not the one that lands on Brittney Griner. And it has now been publically announced that she has ruptured her Achilles on multiple news outlets, by the Seattle Storm, and by Breanna Stewart herself.)
So many people have focused on the fact that her income in the WNBA requires her to play overseas and that if the pay scale was more equitable to what the NBA players make she wouldn’t need to play overseas for more income (meaning WNBA players should earn the same percentage of league income as NBA players – not that they would have equal salaries to the men). I get it. I understand the value of that conversation. I understand many of the challenges the WNBA faces limiting their ability to increase the salaries of their players. I should also mention that I serve as the Seattle Storm team physical therapist, a role I have served in a volunteer capacity for the past four seasons. I would have taken a pay cut to make it so Stewie could have avoided this injury, because in my professional opinion, it's the worst, but alas, I have no funds to defer to even share with her. Instead of looking at the political implications for the WNBA players and their finances, I’m going to look at her injury from the physical therapist perspective to share why this injury means she's not going to be seen in a Storm jersey this season.
So many people have focused on the fact that her income in the WNBA requires her to play overseas and that if the pay scale was more equitable to what the NBA players make she wouldn’t need to play overseas for more income (meaning WNBA players should earn the same percentage of league income as NBA players – not that they would have equal salaries to the men). I get it. I understand the value of that conversation. I understand many of the challenges the WNBA faces limiting their ability to increase the salaries of their players. I should also mention that I serve as the Seattle Storm team physical therapist, a role I have served in a volunteer capacity for the past four seasons. I would have taken a pay cut to make it so Stewie could have avoided this injury, because in my professional opinion, it's the worst, but alas, I have no funds to defer to even share with her. Instead of looking at the political implications for the WNBA players and their finances, I’m going to look at her injury from the physical therapist perspective to share why this injury means she's not going to be seen in a Storm jersey this season.
Just a few days ago, Dr. Tim Hewett at the Mayo Clinic posted this video of an
Achilles tendon rupture.
In real-time, it happens much faster with a high force while the foot is plantarflexed (toes below the heel, as occurs when jumping off the ground) and is generally described as feeling like you were shot in the back of your heel. The video of Stewie's injury certainly looks like it matches the usual description. When I wrote my thesis for PT School, a survey of WNBA and NCAA (Former) Big East Women's Basketball Players, only two people playing in the WNBA had recovered from Achilles Tendon Ruptures. That's good news because it shows that people recover from this severe injury which is so much less common in elite athletes than the ACL tear we more frequently see.How does a Human Achilles Tendon Rupture ...? Here's how ... check it out @MayoClinic Materials & Structural Testing Core @mayoclinicsport ! pic.twitter.com/qM9ZoXJ2Oq— Tim Hewett (@Hewett1Tim) September 22, 2017
Some additional elite-level women's basketball players who returned from Achilles tendon ruptures (I'm sure not an exhaustive list):
1) Nykesha Sales who tore hers in her senior year at UConn in 1998 and then returned to play nine WNBA seasons including six WNBA All Star Game appearances
2) Tamika Catchings - who tore hers in the 2007 WNBA playoffs and returned to play for the Indiana Fever in 2008 as well as in the 2008 Olympic Games
3) Liz Cambage - tore in the Australia vs USA exhibition game leading up to the World Championships in 2014 and ultimately returned to her national team and WNBA
4) Riquna Williams - ruptured abroad in Dubai in 2016 and returned to play for the LA Sparks
5) Brittany Boyd - tore hers in 2017 and returned to the New York Liberty
6) Chiney Ogumwike tore her Achilles in 2016 in China and returned to the Connecticut Sun Lineup in 2018
7) And of course, there are NBA players too. Kobe Bryant tore his Achilles and made it back to the NBA, for about 1.5 more seasons. Fellow Uconn Husky Rudy Gay (weird - he's the 3rd Husky on this list!) made it back with decreased minutes. DeMarcus Cousins tore his last summer and a whole article was written on all the players who had injured their Achilles tendon and how many had made it back to the NBA. The odds were ok... not great... but none of those dudes were Stewie.
For rehabilitation from a surgery, there are often protocols used by physical therapists as guidelines to progress someone recovering from an injury. Protocols are helpful ways to communicate between a surgeon and a physical therapist because the surgeon was actually able to see the extent of damage done and how complicated the repair or procedure was. So, for someone who is young and healthy like Breanna Stewart, her protocol may allow for a faster progression than perhaps the 65 year old dentist I rehabbed from an Achilles repair two years ago because her tissue quality should be better than his. If, however, Stewie had been having aches and pains in her Achilles for years prior to this injury and her tendon quality was not in good shape, it's possible the surgeon would recommend a slower return to activities because of the health of the materials he was working with. Regardless, there are standard healing times for different types of tissues that will need to be followed.
Numerous protocols exist online as guidelines to rehab from an Achilles Tendon Repair, but truthfully, they should all take into account the basic properties of healing and the input of the surgeon based on their findings. For example, this protocol from the University of Wisconsin has the START of running (in a straight line) at 4 months post surgery. That does not mean jumping, cutting, hopping on one foot, turn around jumpers, or doing any sort of awesome acrobatics that Breanna Stewart customarily performs in basketball games.
This protocol from Mass General Hospital starts with two weeks in a cast, then about twelve more weeks in a walking boot, before transitioning to a shoe. Then, it allows for start of run/walk intervals at about five months post op with jumping and sport activities from six to eight months after surgery. There's quite a bit of variability between these programs - but in my experience, nobody is getting back to sports, especially at an elite level like Stewie, in less than six months. Tendon just needs that much time to heel and an annoyingly slow progression in loading it to get back to previous level of activity.
Stewie posted a few things on social media heading into surgery today. I'm sure she knows the road ahead is long, but that she's got a lot of good things on her side, most notably her age and support system. That and she's a fighter. Wishing Stewie a speedy recovery and can't wait to see her on the Storm Sidelines this season as she works her way back to the court for 2020.
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| UConn and the Storm: Me, Breanna Stewart, Kaleena Mosqueda-Lewis, Coach Auriemma, Sue Bird, Coach Dailey |
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