What’s Behind The Growing Number Of Achilles Injuries In The NBA?

Has the Achilles tendon become more of an Achilles heel for NBA players lately — meaning more of a vulnerability? Indiana Pacers star point guard Tyrese Haliburton tore his right Achilles tendon during the first quarter of the Pacers 103-91 loss to the Oklahoma City Thunder in Game 7 of the NBA Finals, the very last game of the NBA season, on Sunday night and has subsequently undergone surgery to repair it. This made him the seventh player in the 2024-2025 NBA season to go down with an Achilles injury, joining fellow Pacers James Wiseman and Isaiah Jackson, New Orleans Pelican Dejounte Murray, Miami Heat (or perhaps Hot) Dru Smith, Boston Celtic Jayson Tatum and Milwaukee Buck Damian Lillard on this very unlucky list.

Now, one may be an accident, two a coincidence and three a trend. But seven? Seven is a what-in-the-heavens-is-going-on-here situation. Seven is certainly way higher than the average of 1.36 Achilles tears per season that occurred among NBA players from 1990 to 2023, based on a study published in Orthopedics Journal of Sports Medicine. So the big question is what’s caused this big step up in such injuries this season?

Haliburton Suffered The Achilles Injury During The First Quarter Of Game 7

Haliburton’s injury was like many Achilles injuries: a non-contact one. No one really touched him. He had just received the ball from a teammate when he started making a move against the Thunder player guarding him. But when he planted his right foot, the only place the move took him was to the floor. He lost the ball before falling onto his tummy. There, Haliburton began slapping the court with his hand in what might have been some combination of pain and frustration, because tearing an Achilles is not joy, Skittles and rainbows. Up to that moment, Haliburton had already accumulated nine points in the game, including going three of four on three-pointers.

But the star point guard would not return to the game. That certainly didn’t help the Pacers, which eventually lost the NBA Championship to the Thunder. All of this did steal some of the thunder from what had been a breakout post-season for Haliburton. He was on a different tear, one in which he hit either a game-tying or game-winning shot in each the four playoff rounds the Pacers went through, all the while averaging 17.7 points and 9 assists. But now he will probably miss much of the 2025-2026 NBA season recovering from his injury.

Haliburton Became The Third Player To Go Down With An Achilles Tear This Postseason

The 25-year-old Haliburton was the third player to suffer an Achilles injury during this year’s NBA’s post-season alone. The 27-year-old Tatum’s injury came during the Celtics Game 4 of the Eastern Conference semifinals against the New York Knicks while Tatum lunged for a loose ball. The 34-year-old Lillard also tore his Achilles in a non-contact way during a Game 4 playoff game, during the Bucks first-round playoff series against the Pacers. All three underwent surgery to repair their Achilles tendons shortly after their injuries. None will be back on the court for at least the first part of next season as a result.

Now, being age 34 means that Dame Time, the nickname for Lillard, has already spent quite a lot of time on the basketball court. Lillard has been playing in the NBA for 13 seasons since being drafted by the Portland Trailblazers in 2012 and spending his first 11 seasons there. Although the 30- to 40-year age range is not exactly AARP territory, even for professional basketball players, it is the peak time for Achilles tendon ruptures. That may be because the fourth decade of life is when people are still playing sports in a run-and-jump-with-abandon-because-I’m-still-young type of way, which applies pressure on the Achilles, but are no longer in their more-pliable-bend-whatever-whenever 20s.

A handful of NBA stars in the past have suffered Achilles tendon tears in this 30-40 age range, such as Kobe Bryant at age 34, Dominique Wilkins at age 32 and Isiah Thomas at age 32. Wilkins lost a lot of his trademark explosiveness after the injury but still was a “Human Highlight Film Just Not As High” for several more years afterwards. The same wasn’t true for the other two, though. Such injuries did render Bryant much less effective after his return and effectively ended Thomas’ playing career.

However, age in general can’t really explain the big bump in Achilles injuries this past season. Most of the seven players on the aforementioned Achilles list are still in their 20s. In fact, the average and median ages for NBA players have been trending downwards over the past five years. So what’s going on then in the words of Marvin Gaye? Well, people have been floating around several theories.

One Theory: Achilles Injuries Are Resulting From Playing Through Injuries

First, there’s the not-being-fully-healed-leading-to-a-bad-heel-situation theory. In other words, are players returning to the court before fully recovering from injuries to their lower extremities? And are such premature returns predisposing them to Achilles injuries?

Well, Haliburton’s experience in the recent NBA Finals may have seemed somewhat like déjà vu all over again. Haliburton had already been struggling with a right calf strain for much of the NBA Finals, as I detailed last Wednesday in Forbes. That was somewhat reminiscent of what happened back in 2019 to NBA superstar Kevin Durant when he was with the Golden State Warriors. A calf injury had kept Durant sidelined for a month before he tried to return for Game 5 of the NBA Finals against the Toronto Raptors. However, in the second quarter of the game, Durant suffered an Achilles injury that effectively ended his season.

So was there a connection between both players’ calf injuries and their subsequent Achilles injuries? Well, the two major calf muscles, namely the gastrocnemius and soleus, are literally connected to the Achilles tendon. In each leg, these muscles combine into a single Achilles tendon that is attached to the heel. In order to run or jump, you have to rapidly contract your calf muscles, which then pull on your Achilles tendon to pull your heel upwards and point your toes forward. Therefore, it seems conceivable that a calf injury, which might leave your calf muscles tighter, could make you more susceptible to a Achilles tendon injury.

So far, though, there’s no clear evidence that such calf injuries will necessarily raise the risk of Achilles injuries. There’s also no clear evidence that more players were playing with calf injuries this latest NBA season compared to previous ones. However, this doesn’t necessarily mean that the science here is completely settled. More and better quality scientific studies would be helpful.

A Second Theory: Achilles Injuries Are Resulting From Lengthy Basketball Seasons

The fact that three of the Achilles tears came during the post-season raises a second possibility: that wear and tear and fatigue from lengthy basketball seasons have been making players more susceptible to such injuries. To make the playoffs, a team has to go through an 82-game season. The NBA playoffs then consist of four rounds: the First Round, Conference Semifinals, Conference Finals, and the NBA Finals. With each round being a best-of-seven series, a team would have to play somewhere between 16 and 28 more games to win the NBA Championship.

But this season didn’t have any more games than previous seasons. The NBA season has been 82 games long ever since the 1967-68 season with a few exceptions such when the few times NBA seasons were shortened by player lock-outs and that thing called the COVID-19 pandemic. The format of the NBA playoffs has been the same for a while as well. It was expanded to 16 teams and four rounds in 1984. The first round was a best-of-five series and the rest went best-of-seven until the year 2003 when all rounds became best-of-seven series. Furthermore, this past season did not come after an Olympics or World Championship year when some players might be playing even longer seasons.

And get a load of yet another counterpoint that makes short work of this whole NBA-season-is-too-long theory: load management has actually made the NBA season shorter for many players. In recent years, more and more teams have been practicing load management, which is when a team strategically keeps its players, especially its star ones, out of games so that they are in theory fresher and more injury free later on in the season and during the oh-so-important playoffs. The thought is that such a practice may also extend the careers of players by reducing the wear and tear each season. While it’s not yet clear whether load management is effective in achieving such goals, such a practice does mean that players on average are now playing fewer games than they did in previous decades.

A Third Theory: Achilles Injuries Are Resulting From The New Style Of Play

Another drastic change in the NBA in recent years has been the style of play. In fact, if a fan from the 1980s were to jump into that DeLorean car from the movie Back to the Future and time travel to today to watch the NBA, he or she might find the game unrecognizable in many ways. Due to progressive rule changes, the emphasis now is on much more open play with less defense and players of all sizes, even seven footer, running around the court attempting three-pointers.

This raises a third possibility: that the more open and free-wheeling game is leading to less controlled movements and more quick unexpected changes in direction and jumping that in turn pull on the Achilles tendon in different ways. This is certainly a reasonable possibility to consider. It is difficult to either prove or disprove, though, since there have been no formal scientific studies comparing old school NBA play with this new stuff.

A Fourth Theory: Today’s Shoes Are Making Players More Prone To Achilles Injuries

Let’s “sneaker” in a fourth theory: the shoes worn these days are offering less protection for the ankles. The lack of high top shoes seemed to be on the top of Nick van Exel’s list when the former NBA point guard X’d the following last month:

By “dam lows,” Van Exel was referring to the lower top sneakers that have become more and more popular in the NBA ever since Bryant started wearing them. Such low- and mid-top sneakers can afford more ankle movement than high-tops, allowing for the aforementioned quick changes in direction. However, they may not protect the ankles as well. This concern was supported by a study published in the Clinical Journal of Sports Medicine in 2010. The study used Achilles tendons from four human cadavers and suggested that wearing high-top shoes versus low-top ones could reduce the peak tension on the Achilles tendon by an average of 9.9%. Of course, NBA players aren’t the same as cadavers no matter what you happen to think of your favorite team right now. But it does make sense that more support for your ankle might provide more support for your Achilles tendon. More studies are needed to confirm this concern.

A Fifth Theory: Nutrition And Conditioning Practices May Be Playing A Role In Achilles Injuries

A final big difference between today’s NBA players and those of yesteryear is all the new fandangled nutrition and conditioning things being used these days. Some of it is based on scientific evidence and probably helping players become fitter and more durable. But there’s also a lot of, oh what’s the technical term for it, BS out there. Self-proclaimed nutrition and fitness influencers and gurus continue to make pseudoscientific claims and expend effort to get in good with athletes and other celebrities. Therefore, it’s not always clear what different players may be taking and doing to their bodies. Could some of these things be making players more susceptible to Achilles injuries? Perhaps. But without more data, it is hard to say.

One Season May Not Be A Trend for Achilles Injuries

Of course, one season alone does not make for a trend. The seven Achilles injuries this past season could just be a statistical anomaly. A coincidence. A random jump for only a season. So it will be helpful to see what happens over the next two seasons to determine whether Achilles tears are indeed on an upwards tear.

Regardless of whether this ends up being a trend, it would be helpful to better know how to prevent Achilles injuries. It typically takes three months to walk normally and four to six months to return to sports after surgery to repair an Achilles tear. And as the loss of Haliburton showed the Pacers, the Achilles can be the Achilles for any NBA team.