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Anderson Varejao's latest injury puts his career in jeopardy

Anderson Varejao has spent a lot of time on the sideline with various injuries throughout the last five years. However, his Achilles tendon rupture suffered Tuesday night against the Timberwolves is his most career-threatening injury yet.

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All things considered, Anderson Varejao has actually had some luck with injuries, in a way. While he's missed 169 of a possible 341 games over the last five years, Varejao's multitude of injuries have not been things that affected his performance on the court when he eventually returned. Unlike an ACL tear or a disc problem in the back, Varejao's history, which includes wrist and facial fractures, knee bruising, and a torn tendon in his right ankle, hasn't seemed to lead to long-term issues with his play.*

*His deep vein thrombosis suffered in 2012-2013 is kind of an exception here because it could have killed him if he had played with it. However, once the blood clot was broken up, the injury had a similar effect on his play to his other issues.

However, his Achilles tendon rupture suffered Tuesday night against the Minnesota Timberwolves represents a serious challenge to Varejao's long-term future. Unlike his previous injuries, an Achilles tendon rupture can present major issues for long-term health for athletes, and can completely kill a player's effectiveness on the court.

Achilles tendon ruptures aren't common in the NBA. In fact, since 2012, only five players have been placed on the injured list with this injury as the reasoning, per Chauncey Billups, Kobe Bryant, Elliott Williams, Jeffrey Taylor, and Varejao. Achilles tendinitis, inflammation of the tendon, is much more common, although tendinitis is a risk factor for a tendon rupture. Tendon ruptures most commonly affect older players, who have a history of inflammation to the area which wears down the tendon; The Achilles tendon rupture is classically known as a "Weekend Warrior" injury, one that most commonly affects middle-aged men who are active in athletics.

When the injury hits in the NBA, it can have a profound impact on the player's play if or when he returns to the court. A Drexel University study (abstract) from 2013 analyzed 18 cases of Achilles tendon ruptures from 1988-2011, and found that players who suffered this injury saw a 4.57-point decline in PER in their immediate return season, and 4.38-point decline two seasons post-injury. The players showed a significant decline in PER when compared to healthy controls of the same age, and their minutes per game also significantly decreased. Most alarmingly, seven of the 18 players never returned to NBA action once they suffered their injury.

Now, players can suffer an Achilles tendon rupture and reinvent their career. We've seen Kobe return to a similar level of production in year two post-rupture, and Elton Brand has reinvented himself as a very productive two-way bench weapon since a rupture in 2008. However, other players, such as Billups or Mehmet Okur, never recovered, and those stories are a lot more common than the player who persevered through it.

In Varejao's case, there's major cause for concern about how he can return from this injury. The Achilles is the primary force generator at the ankle, and is important as a shock absorber and stabilizer during running and jump landing. Varejao's mostly a ground-bound player, which helps his case in that regard, but an Achilles rupture can sap lateral quickness and agility, two things Varejao thrives on in rebounding and defense. We've already seen Varejao's defense slowly begin to decline this season, and his rebounding has a big chance of declining. Brand's rebounding rates dropped off significantly after his injury, and the Drexel study found that rebounding and steals were significantly impaired after return from injury in the players analyzed. Seeing as that is Varejao's strongest part of his game, that's a big concern as he moves forward.

Varejao has been nothing if not resilient in returning from his injuries. It takes a lot of courage and determination to be constantly beaten down by the injury bug and continue to come back for more. However, when looking at Achilles tendon ruptures in the NBA, the effects of this injury are often serious, and there's a possibility that Varejao could have played his last game in the league already, even if he does everything he can possibly do to return. If he does, it will be a great success story, certainly. However, more likely, this injury could spell the end of Anderson Varejao, not just as an effective part of the Cleveland Cavaliers, but as an NBA player.

Article updated to provide abstract of referenced journal article.