Jayson Tatum will be out of action for the Boston Celtics for at least a year after he ruptured his Achilles tendon in the May 12 game against the New York Knicks in the NBA Playoffs at Madison Square Garden. Photo via Getty Images/Elsa

Fitness

BU Sports Rehab Therapists on Jayson Tatum’s Achilles Injury and Recovery Ahead

Ryan Center physical therapists say the injury is common for pro athletes and weekend warriors

Dan Sieczkiewicz was watching game four of the Boston Celtics playoffs against the New York Knicks at Madison Square Garden on TV when Boston’s superstar Jayson Tatum fell to the parquet floor writhing in agony, clutching his right ankle.

“My first thought was, ‘Oh noooo,’” says Sieczkiewicz (Sargent’07,’09), an adjunct faculty member in the Doctor of Physical Therapy program at Boston University’s Sargent College of Health & Rehabilitation Sciences and a senior physical therapist at the University’s Ryan Center for Sports Medicine & Rehabilitation. 

Tatum had tried to spring for a loose ball and instead he fell, suffering a ruptured Achilles tendon. He was helped off the court in obvious pain, and his team lost to the Knicks, who took a 3-1 lead in the series. The Celtics lost the series 4-2 on Friday night. Tatum’s recovery, meanwhile, makes him all but certain to miss the entire next season.

“As a basketball fan, a Celtics fan, there are many reasons to feel devastated about what happened, not the least is feeling devastated for the human being behind the injury,” Sieczkiewicz says. “He’s a human, and he just happens to be in the spotlight. But this is tough.”

The injury is common among athletes of all levels, he says, from pros to weekend warriors, and it’s one that Ryan Center therapists have experience treating.

Sieczkiewicz says that on TV and the slow-motion replays it looked like Tatum experienced the classic mechanism for an Achilles tear. “His intent was to move forward, but his first step was backward. And when that happens, there’s an immense amount of tension on the Achilles tendon, and when his calf muscle contracts to propel him forward, it puts enough strain on the Achilles tendon where the structure just fails. 

“So instead of him actually moving forward he just falls to the ground. There’s nothing connecting his calf muscle to his foot anymore,” he says. “I saw it on social media, zoomed-in slow-mo video—you can see the calf muscle vibrate once the Achilles tendon tears.”

Caleigh O’Brien (Sargent’15,’17), a senior educational physical therapist at the Ryan Center and also a Sargent physical therapy program adjunct faculty member, explains that the Achilles tendon transmits force that helps us function in both our daily activities and higher level ones like jumping and playing basketball.

“A tear can sometimes be just part of it, but a rupture is a full-thickness tear, so there’s pieces dangling from either end, basically,” O’Brien says. “Two ends that used to be connected are no longer connected.”

Sieczkiewicz and O’Brien emphasize that they aren’t talking about Tatum specifically—they aren’t treating him, and what they know about his injury comes from video and news reports. News outlets reported the Celtics’ announcement: Tatum had suffered a rupture of his right Achilles—and that it was successfully repaired through surgery the next day. 

“I think it tends to happen in a very, very similar way,” O’Brien says. “In our clinic, we see a lot of recreational athletes, so things that involve jumping or a lot of changes in direction on a court. Basketball is super common, even things like gymnastics. A lot of court sports like pickleball and tennis. And then soccer, absolutely.”

Probably the most notable Achilles injury to an NBA star was Kevin Durant back in 2019, and there have been advances in surgical techniques since then, both O’Brien and Sieczkiewicz say.

“When [NFL quarterback] Aaron Rodgers tore his Achilles in the NFL [in 2023], everyone started hearing about this speed-bridge protocol for Achilles tendon repair,” Sieczkiewicz says, a method that uses both sutures and anchors for a stronger, more stable repair that may allow earlier recovery.

“I don’t know if he had this procedure or not, but this is becoming increasingly common among high-level athletes,” he says. “They will suture the tendon together, and then they’ll thread a wire or thread-type of substance from the top of the tendon where it meets the muscle down to the heel bone, providing additional support to the tendon. It just allows people to get into later stages of rehab a little bit sooner.”

Rehab creativity: challenge while protecting 

Although high-level athletes like Tatum may receive specialized care to help them return to their pre-injury form, Sieczkiewicz and O’Brien say that the basics of the recovery process are the same for all, beginning with general conditioning exercises. 

“We work in an outpatient clinic, which is super different from the professional sports world,” O’Brien says, “but I would imagine starting rehab pretty quickly, within a few weeks.”

Physical therapists would start by using upper body muscles distant from the injury to avoid directly stressing the repaired tendon.

“Part of the creativity in these early stages of rehab is finding ways to still challenge this individual from an exercise standpoint while also protecting the repair,” Sieczkiewicz says. “That can be core exercise, cardiovascular exercise that involves the upper extremities, things like that.”

Patients will typically not put any weight on the injured leg for several weeks, he says, and then it’s a gradual progression into weight-bearing activities, usually in a walking boot, to avoid stretching the tendon as it heals.

“That’s one of the most important things to avoid throughout rehab, because if a tendon gets too stretchy, you lose explosiveness,” he says. “For a player like Tatum and his style of play, that would be catastrophic. He’s got a really quick first step and drives to the basket, and he needs that explosiveness back. So that will be a rehab priority as he gets closer to playing.”

Typically, patients will be on crutches for a period before the walking boot, O’Brien says. “Small pads or lifts are used within the boot when they start, to keep the toe pointed down, and, again, avoid stretching the tendon. Then the foot is gradually returned to a more normal position.

“For every week or two weeks, you’re maybe giving them five degrees of change in ankle position, and that’s the way they walk out in the community,” she says. 

After 8 to 12 weeks, they can return to a shoe, but still with heel lifts to avoid stretching the tendon too much, too soon. But it’s a long, slow road to recovery, which is tough for Celtics fans to hear, given Tatum’s importance to the team.

“This is educated speculation, but it’s probably about a year before he plays in an NBA game,” Sieczkiewicz says, echoing NBA analysts. If the Celtics make a playoff run in 2026, Tatum might be able to play, but he’s unlikely to be back in top form yet.

“Think about what the Achilles has to sustain to participate in basketball,” O’Brien says. “Running basically could be anywhere between like six, seven times your body weight of load on the Achilles tendon. And jumping, things like that, can be anywhere between 8 to 11 times your body weight. So we have all these criteria that people should meet to determine when it’s safe for them to progress.”

The worst thing that can happen during rehab is of course a re-rupture of the tendon, but that happens in 5 percent or less of cases, the two say. Much more common is a situation familiar to athletes of all levels: “just that you overdo it a bit with the exercise and the soreness just lasts for too long, so you have to scale back,” O’Brien says.

Given advancements in surgical techniques and Tatum’s age—he’s only 27—both BU physical therapists believe he should be able to return to the same level of play he had before his injury.

“I feel like he’ll come pretty darn close,” says die-hard Celts fan Sieczkiewicz. “Maybe it means a few tweaks in the style of his game, but I think he’ll come back and be one of the best players in the league still.”