1023 - Elite NBA and WNBA players with dominant limb Achilles tendon ruptures perform significantly better post-injury compared to players with non-dominant ruptures

Objectives: An Achilles tendon ruptures is one of the most detrimental injuries in sports. Studies have found that ~30% of NBA players do not return to play following rupture, experiencing shorter careers and decreased performance. No study has previously compared players with dominant limb Achilles ruptures versus non-dominant ruptures. The objective was to evaluate for any performance differences post-rupture between the groups.

Design: A retrospective analysis of NBA/WNBA players with Achilles tendon ruptures from 1990 to 2020 was performed. To evaluate elite players, only players with an average Player Efficiency Rating (PER) of >15 in either the three seasons before/after injury were included. 17 players were identified. They were classified into dominant versus non-dominant based off their primary shooting hand (i.e right-handed is right-leg dominant) and which tendon was ruptured. There was no difference in PER pre-injury between the groups.

Results: The non-dominant cohort had a significant decline in PER (-5.70, SE 0.90, p< 0.01) and Offensive Rating (-8.25, SE 2.41, p < 0.05) post-rupture. They also had a significant increase in Defensive Rating (+3.13, SE 0.93, p< 0.05), indicating more points allowed defensively. There was no difference in any outcome in the dominant group post-injury. The dominant group performed significantly better post-rupture in regards to PER (+5.22, SE 1.58, p< .01) and Offensive Rating (+9.81, SE 3.19, p< 0.01) versus the non-dominant group.

Conclusions: Elite NBA/WNBA players with dominant ruptures had no change in statistical performance compared to their pre-injury baseline, and performed significantly better post-injury compared to their non-dominant rupture counterparts. Players with non-dominant ruptures declined from baseline both offensively and defensively. To our knowledge, there is no variation in rehabilitation protocol based off whether the dominant or non-dominant tendon is ruptured. Further studies should evaluate if different rehabilitation protocols should be enacted based off limb dominance to maximize future player performance.