Summary

Achilles tendon ruptures in Major League Soccer players have position-specific impacts, with forwards and defenders experiencing significant declines in scoring ability post-injury, while goalkeepers demonstrate an increase in clean sheets during the injury year, highlighting the need for tailored rehabilitation and return-to-play strategies.

Abstract

Purpose

Achilles tendon ruptures (ATR) are critical injuries that substantially impair the performance of athletes, particularly those involved in sports requiring explosive movements and rapid directional changes, such as soccer. These injuries can signficantly impair mobility and performance and are often caused by overstretching or forceful contractions. This study aims to assess the long-term impact of ATR on return to play (RTP) and subsequent player performance across various positions in Major League Soccer (MLS) over a 10-year period.

Methodology

This retrospective matched-cohort study evaluated MLS players who sustained ATR between 2010 and 2021. Injured players were matched to uninjured controls in a 1:2 ratio. Performance metrics, including games played, minutes played, goals, assists, and other key statistics, were extracted from MLS databases and compared between injured players and matched uninjured controls. Statistical analyses were performed using t-tests to determine the impact of ATR on RTP and post-injury performance outcomes.

Results

A total of 185 MLS players who sustained ATR were identified and compared to matched controls over a three-year period post-injury. Forwards with ATR mostly had comparable outcomes, but showed a significant decline in goals per season three years post-injury compared to controls (10.75 uninjured [U]; 5.00 injured [I], p=0.044). Midfielders exhibited no significant differences in performance metrics versus their controls. Defenders demonstrated a significant reduction in goals per season during the index year compared to controls (1.08 [U]; 0.62 [I], p=0.009), highlighting an immediate impact on their scoring ability. Goalkeepers displayed a statistically significant increase in clean sheets during the index year compared to controls (8.38 [U]; 8.75 [I], p=0.016).

Conclusion

ATR has a distinct and position-specific impact on RTP and long-term performance in MLS players. Forwards experience a notable reduction in scoring ability three years post injury (-5.75), while defenders demonstrate an immediate decline in goals during the injury year (-0.46). Interestingly, goalkeepers show an increase in clean sheets during the injury year (+0.37), suggesting a differential impact based on position. These findings underscore the necessity for tailored rehabilitation and RTP strategies that address the unique demands of each playing position, facilitating optimal recovery and sustained performance post-injury.