On Monday October 24th, Derek Newton, an offensive lineman for the Houston Texans, suffered bilateral (both sides) patellar tendon ruptures: one of the rarest injuries seen in the United States. With approximately 5 cases reported every year, Newton’s injury may put him beyond the odds of returning to the NFL, despite the incredible medical teams, physiotherapy, and rehabilitation available to him.

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Single patellar tendon ruptures are rare but not unheard of – case in point: Jimmy Grahem, Morris Claiborne and Victor Cruz. All three have returned to the NFL, but can are honestly say they are the same players they were? Bilateral ruptures are additionally complicated, because your rehabilitation requires you to be non-weight bearing for an extensive period time. This complicates the treatment protocol and prolongs the length of time Newton will be away from rebuilding the strength and power required to be in the NFL.

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The patellar tendon attaches the bottom of the knee cap (patella) to the top of the shin bone (tibia). The patella then attaches to the quadriceps muscles by the quadriceps tendon. Together, the muscles and tendons straighten the knee. The most common way to rupture the tendon is when the leg is extended and the knee join is overloaded. The quad muscles exert maximal force on the patella and can rupture the tendon.

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Bilateral ruptures occur mostly in patients that have a history of corticosteroid use or systemic diseases, such as chronic patellar tendonitis (inflammation of the patellar tendon). Corticosteroids are not considered performance enhancing substances like HGH. It’s used like a bandaid to decrease swelling and pain, and are very commonly used in the NFL. Frequent use of corticosteroids are known to degrade the tissues of ligaments and tendons. There is no evidence that either of these scenarios are valid for Newton’s injury.

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Recovery

Surgery will be performed to repair the patellar tendon. Evidence demonstrates that the quicker the tendon is re-attached, the better the outcomes.

Full weight bearing will be Newton’s first goal: 2-3 months

Rehabilitation: 6-9 months

Regaining full mobility, strength, and power: unknown

We would like to wish Newton the best of luck in his journey and hope to see him back in the NFL!

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