On Ruben Loftus-Cheek and devastating Achilles injuries

Recovering from a devastating injury is a long, arduous process, wherein the athlete will battle not only the body, but the mind as well. Few of the world’s best athletes will ever have to face such troubles.

Twenty minutes into a friendly against New England Revolution in May 2019, Chelsea midfielder Ruben Loftus-Cheek had to be helped off the pitch by the club’s medical staff. The young, promising England midfielder had ruptured his Achilles tendon, setting the course for a lengthy time on the sidelines and altering his career trajectory.

Loftus-Cheek’s calves had halved in size due to inactivity. Surgery to repair his torn Achilles was much more complicated than Callum Hudson-Odoi’s. It apparently looked “like a horse’s tail”. He had multiple setbacks throughout the second half of 2019. It was an especially cruel blow for a player who had overcome numerous injuries earlier in his career, including a lingering back issue.

COVID-19 would further disrupt his eventual return to match action. He had made the bench for two matches prior to the lockdown. His first minutes finally came over a year after his injury, starting and playing 55 minutes against Aston Villa in the first match of Project Restart.

It did not go well — just as Loftus-Cheek’s tenth appearance since the injury, his start in Monday’s win over Brighton. This time he lasted 59 minutes.

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Photo by Christopher Lee/Getty Images

Defining “recovery”, at this point, is very much a point of debate, judging by the last four months of Loftus-Cheek’s performances.

Getting himself back into training and pushing for minutes is a fantastic achievement. However, return to form may be something quite a ways off for the 24-year-old — or even worse, if even possible.

He had shown a lot of promise in the 2018-19 season, after returning from his Crystal Palace loan. Under former manager Maurizio Sarri, Loftus-Cheek displayed fantastic dribbling abilities, providing a unique combination with his strength, height, and physicality and earning a ton of praise and growing expectations.. In the matches since returning to action, he has not looked like that player at all.

According to Kathryn O’Connor, assistant professor of clinical orthopedic surgery at the University of Pennsylvania Perelman School of Medicine, returning the injured tendon and muscle fibers back to their pre-injury state is not possible.

“You’ve ruptured a major tendon and even if you have it repaired, the way things heal, it’s never the original model. It’s never the same, normal, healthy tendon that it was. Even when you repair it, it still has a level of scar tissue in it that may not have the same amount of pliability to allow for the same amount of explosive activity. It may be that when it heals, it doesn’t heal with the right amount of tension. Sometimes it’s just that muscles atrophy enough that it’s just too difficult to really get the strength all the way back. But no matter what you do, the injured side is never as strong as it originally was, or really as strong as the other side because it’s just a different tendon than it was before.”

“Whenever you’re doing any sort of activity like running or jumping and landing, the Achilles tendon is really loaded and controls the way you explode up and the way you land softly. People who have injuries to their Achilles definitely develop an abnormal gait pattern afterwards if they’re not treated appropriately, or if there’s some residual deficits in strength or flexibility.”

-Kathryn O’Connor, source: UPenn

Loftus-Cheek’s performance against Brighton left a lot to be desired. There were many moments when the pace of the match looked ahead of him. In other moments, it seemed like he and his body were at odds with each other.

One obvious, specific moment that comes to mind is the counter he led in the first half, picking up a pass from Timo Werner well inside his own half. The speed of the attack was rather pedestrian, not helped by the almost comedic speed with which Werner zoomed towards Brighton’s goal at the same time.

But the multiple glances towards Werner and Loftus-Cheek’s indecisiveness of when to release his through ball culminated in a frustrating end that did not yield a goal, let alone a shot on goal that the passage of play certainly warranted.

According to Frank Lampard, patience is a virtue, especially when it comes to the ever growing list of injured players and those in recovery. For Lampard, Loftus-Cheek is still considered in that cohort, as his lengthy time off and return was broken up by the pandemic.

However, many pundits have been very vocal about Loftus-Cheek’s prognosis. Of course, it is important to silence out the noise, but the question of what comes next for the young midfielder is a concerning one, to say the least.

Injuries are unfair and very much unwelcome. For all the promise that Loftus-Cheek had in spades well over a year ago, his future has just as many question marks, most of which are quite warranted.

The conversation regarding Loftus-Cheek’s career outlook should be tempered. But no one truly knows if he will be able to get back to his previous level, let alone resume the growth trajectory he had been showing before that fateful evening in Boston.

In a study published by the Orthopaedic Journal of Sports Medicine, researchers found that football players who did return to action following surgery to repair ruptured Achilles tendons played significantly fewer minutes. Perhaps even more so than an ACL tear, an injury more commonly familiar, an Achilles rupture can be devastating to a career.

“Additionally, athletes able to return to play were found to play fewer minutes 2 years postoperatively compared with their baseline as well as playing less at 1 and 2 years postoperatively compared with uninjured matched controls. The reduction in playing time following an Achilles repair has significant implications for professional players and teams.”

-Source: US National Library of Medicine National Institutes of Health

Achilles injuries tend to occur much later in life for the general public. For athletes playing the top leagues of their respective sport, the age of injury has averaged around 28. The fact that Loftus-Cheek succumbed to his injury at such a young age makes him a significant outlier to the very small population of those who ruptured their Achilles in major sports leagues.

One sport where Achilles injuries have seen a rise in prominence is the NBA. Notable cases in the past decade have included Kobe Bryant, Kevin Durant, and DeMarcus Cousins. SB Nation, our parent site, have found that the post-injury prognosis of those returning from Achilles injuries was not very good for their career. Most NBA players struggled to return to pre-injury form, and many retired within a couple of years after experiencing a dramatic drop in minutes and games played.

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Photo by Darren Walsh/Chelsea FC via Getty Images

So, what’s next for Loftus-Cheek?

Clearly more time is needed for him to work out his body and possibly return to some semblance of his previous form.

A loan could very well be what is best for all parties. Chelsea cannot afford too many performances like Loftus-Cheek’s against Brighton, if we are to seriously challenge for the title this season. Pairing Loftus-Cheek with a club committed to working with him may be the best solution in the short term. Perhaps even in the long term.

This might be a take that no one wants to read, but given his injury situation, Ruben’s days at Chelsea may be numbered. And that may very well be harsh, mixed in with perhaps a mild dose of harsh reality.

At the moment, no one truly knows if Loftus-Cheek can get back to where he once was or even become what the optimists had once hoped he would grow into. For the time being, we wait and hope for the best. May he surprise us all with his comeback!