Thanks to Greek mythology, the thickest, strongest tendon in the human body has been associated with vulnerability for millennia. When the warrior Achilles was an infant, the legend goes, his mother dipped him in the River Styx, making his body invulnerable to attackers — except for the heels she held him by.

This week, two veteran Olympians will be performing on repaired Achilles’ tendons at the U.S. Olympic track and field trials in Eugene, Ore. Triple jumpers Christian Taylor, a two-time Olympic gold medalist, and Will Claye, a double silver medalist, will launch themselves toward the sand pit, putting as much as 22 times their body weight on previously ruptured Achilles’ tendons as they try to make the U.S. team for the Paris Olympics one last time.

They have rebuilt their bodies over several years, with the aid of teams of physicians and rehab specialists and constant attention no weekend warrior can dream of accessing. But the sports medicine advances honed on athletes like Taylor and Claye have trickled down to recreational basketball, pickleball and soccer players, reducing recovery time and improving long-term results, according to experts, athletes and coaches.

“In the old days, when someone tore an Achilles’, we used to tell them one full year before you get back to your full level of activity and you may never have the strength and endurance you had before the injury,” said John G. Kennedy, a professor in the department of orthopedic surgery at NYU Grossman School of Medicine who has studied Achilles’ tears. “Now we have shortened recovery times and improved the return to play.”

How the Achilles’ gets injured

The fibrous Achilles’ tendon can become irritated and sore when overused, a condition we know as tendinitis. Feeling pain in your Achilles’ doesn’t mean it has ruptured. A torn Achilles’ is a traumatic injury that may feel like a blow to the back of the lower leg.

Most complete tears occur during recreational sports, particularly among adults in their 30s, 40s and 50s who place too heavy a load on the tendon or twist it suddenly. Men are more prone to Achilles’ ruptures than women.

Statistics vary on how often people tear their Achilles’ tendons, but Michael Karnes, director of product management, foot and ankle trauma for the company Arthrex, which created the SpeedBridge procedure, estimated there are 100,000 to 120,000 each year in the United States, with 65,000 to 70,000 treated surgically.

There is some evidence that ruptures are more common after other leg injuries; NBA stars Kobe Bryant and Kevin Durant, among others, tore their Achilles’ tendons after coping with a sprained ankle and a calf strain, respectively.

Another risk factor may be periods of inactivity. In one small study, Kennedy and other researchers found an uptick in Achilles’ tears after recreational athletes returned from the covid-19 quarantine. In another, researchers reached a similar finding for all kinds of injuries among NFL players.

Fluoroquinolones, a class of antibiotics, may also degrade tendons, especially the Achilles’, research has found.

“It’s a nasty injury,” said Nic Petersen, who will coach U.S. Olympic jumpers in Paris. “And there’s a thought that it’s a death sentence for jumpers. I disagree.”

Fixing a ruptured Achilles’ tendon

Little more than a decade ago, a ruptured Achilles’ meant a decision between allowing the tendon to heal without surgery or an invasive procedure that required a long incision on the back of the lower leg.

The former left sufferers prone to second tears of the Achilles’ and the latter occasionally led to wound infections and other problems. Even today, some people are not candidates for surgical repair.

But in recent years, surgeons have developed new ways to approach the surgery that are less invasive and give the repaired tendon more strength. When an Achilles’ tendon tears, doctors say it looks like strings of spaghetti. In the past, surgeons relied on stitching them back together vertically to restore the tendon’s strength.

Now, surgeons often pass sutures through the tendon horizontally before pulling the upper and lower parts together. Those sutures may also be anchored with screws to the heel bone. That allows the patient to put more load on the tendon much sooner, speeding recovery and improving long-term results, especially among elite athletes.

Jumping on repaired Achilles’ tendons

Taylor, 34, who won gold in 2012 and 2016, tore his right Achilles’ two months before the 2021 Olympic trials. He hopes his attempt to hurl his body nearly 60 feet after such a major injury can be a model for anyone with an athletic goal.

“I think this would be very unique. It could be motivational, inspirational. No injury is going to take you out if you just stay the course,” he said.

Claye, 33, won silver in 2012 and 2016 (as well as a bronze in the long jump in 2012), then ruptured his left Achilles’ playing pickup basketball in 2019. The delayed 2020 Olympics due to the coronavirus worked to his advantage: he recovered in time to place fourth in the 2021 Olympics that Taylor — his friend, former University of Florida teammate and greatest rival — missed. He said treatment advances have allowed him to return from what used to be the worst catastrophe that can befall a jumper, and tells everyday athletes to take heed.

“I don’t think even the average guy should work it back slowly,” he said. “Because you’re getting weaker and weaker as you wait.”

Claye hit almost 55 feet 9 inches in qualifying for the trials. Taylor jumped just over 54 feet to make the competition but has done better at previous events. “The training wheels are off and now we’re going to unload,” he said.

Some research indicates that triple-jumpers place more stress on their legs than any other athlete, as much as 22 times their body weight when they land between the “hop” and “step” phases of the hop-step-jump event.

For a 175-pound man, that is the equivalent of briefly supporting 3,850 pounds on one leg — “the highest measured force that a human limb is exposed to during any intentional activity (so not including accidents such as car crashes),” according to one biomechanics expert.

With increasing age and the time lost to injury working against them, it is far from certain that either Taylor or Claye will be one of the three triple jumpers the United States sends to Paris, said Dwight Stones, a two-time Olympic bronze medalist in the high jump and longtime track and field commentator. But that doesn’t mean they shouldn’t try.

“You’ve got to go for it because you just can’t have regrets,” he said. “You’ve got to play the string out.”

The road to rehabilitation

Last year, aging quarterback Aaron Rodgers returned to practice just 77 days after tearing his left Achilles’ tendon. Previously, no professional athlete had been known to return from a ruptured Achilles’ in less than five months. His speedy recovery made the “SpeedBridge” procedure famous, and now doctors say average patients sometimes ask for it by name.

Claye also benefited from the new surgical methods. Richard Liebel, founder of the Pro Sports Institute in Huntington Beach, Calif., who led Claye’s rehabilitation team, said the new techniques allowed the triple jumper to start rehabilitation less than a week after surgery. “If you wait too long to start rehab, you dig such a deep hole that an elite athlete never gets back to that level,” he said.

Claye was walking without a protective boot about a week after his operation, Liebel said, and soon began working on a wobble board, doing mini-squats and having manual activation of his toes and calf.

So began months of painful, full-time rehabilitation that included just about every therapy known to speed his return to elite status: running (sometimes on an antigravity treadmill), jumping, weightlifting, squats, range-of-motion exercises, agility exercises, massage, active release, even exercising with a tourniquet that is subsequently removed to flood the injured area with blood.

“I literally had to go back and rebuild my left side, my whole body really,” Claye said.

Doctors caution that everyday athletes do not enjoy the same time and resources to devote to rehabilitation and have not spent years perfecting bodies that can bounce back from trauma.

“It’s not an absolute guarantee, and it’s not as easy as people may think it is,” said Brett Sachs, an Arvada, Colo., foot and ankle surgeon. “It’s still a long recovery. We’re always fighting biology. Tendons heal at a certain rate. Bones heal at a certain rate. We can never make it perfectly normal.”

About this story

Editing by Emily Codik and Tara Parker-Pope. Graphics by William Neff. Graphics editing by Manuel Canales. Design by Chelsea Conrad. Design editing by Christian Font. Photo editing by Maya Valentine and Toni Sandys. Copy editing by Thomas Heleba.