Week 18: Cam Akers

At a Glance –
Player: Cam Akers
Position: Running back
Team: Los Angeles Rams
Injury: Achilles Repair (after tearing it during preseason)
Projected Recovery Time: 6-12 months

The LA Rams saw the shocking return of Cam Akers, an exceptional running back who tore his Achilles … during 2021 … in July. Many thought Akers would not return for the 2021-2022 season due to the nature of this injury, which is typically slow-going and limited by tissue healing timeline. Akers, being the exceptional athlete that he is, defied the odds with an incredible return to the Rams just in the nick of time for Wild Card Weekend. Because this recovery time is almost unheard of, Akers is the focus of this week’s injury report.

Achilles tendon ruptures require surgical intervention if a person wants to return to higher level function. It is one of the hardest lower body injuries to rehab. Soon after surgery, in which the tendon is reattached to the insertion site at the heel, physical therapy is incorporated to maintain knee and hip strength, as well to slowly build up ankle strength and flexibility. During the early phases of rehab, calf stretching and active use are restricted, but gentle exercises that avoid calf muscle use and tension can be incorporated to prevent atrophy and tightness in unaffected ankle musculature.

Akers was likely immobilized in a boot for the first 6-8 weeks post-op to protect the repair, and his PT helped him wean off the boot and normalize his walking. Significant focus will be on building calf strength once it is safe to activate the calf muscles, and it can take 6+ months for him to perform a single leg heel raise that is comparable to the unaffected side for most people. Aker’s return to play in that timeframe is so impressive because, by the time most people are able to finally perform a heel raise, Akers was back at practice. Plyometrics and football drills usually are not initiated until 6 months out to protect the repair, but Aker’s strength, flexibility, and balance were adequate enough to return to sport early. He may be back on the field, but Aker’s work in the PT clinic is far from finished, and he is without a doubt still putting the necessary hours into his rehab so that he can continue to play and avoid injury, as well as problem-solve with his PT if certain activities give him trouble. Since total recovery from this injury can take 9 or more months, Aker’s return is an incredible feat and may be just what the Rams need to take on the Cardinals this weekend.

In this video, the 3DPT team demonstrates a Plantar-Flexion progression with progressive loading (exercises that build on each other and progressively get harder with more weight, throughout the recovery process.)