Doctor: Sitting Out the Season Jayson Tatum’s Best Chance at Full Recovery

Dr. Erek Latzka from Boston Sports & Biologics roots for Jayson Tatum and the Celtics. So even though he believes all signs point toward Tatum returning sometime this season, he hopes Boston’s star sits out.

“I think we will just based on how quick he has been recovering and I’m sure the confidence he has in himself and the repair that he got early,” Latzka said on The Garden Report on Sunday. “As a fan though, I kind of don’t want him to come back yet. I’m in this for the long term and I want another decade of Tatum, so I would not be upset if he doesn’t (return).”

That’s because missing at least 12 months gives Tatum the best chance of avoiding a devastating re-rupture of his Achilles that Dr. Martin O’Malley repaired seven months ago on Saturday. Advanced techniques including the SpeedBridge, Tatum’s age and the timing of his surgery potentially put him in position to make an unprecedented comeback from an Achilles tear. The science still says that each additional month of recovery gradually decreases the chance of another tear.

Latzka said the worst period for re-injury, 4-6 months, already passed, but that risk decreases toward roughly one tear out of 1,000 once one year passes. Even with a SpeedBridge, the risk doesn’t drop between the 6-12 month mark despite being able to return to strengthening exercises earlier, which can reduce muscle atrophy. So despite the advancements in surgery that Kevin Durant mentioned to CLNS Media earlier this season, Tatum’s timeline may not change drastically if he wants to remain as safe as possible. Tatum said he won’t play until he’s 100% healthy, though he reached the ramp-up stage with most of his recovery in the rear view.

“Mostly, yes,” Latzka said. “There is still some collagen strengthening that’s going on in that tendon as he’s loading it more and more, but he’s through the thick of it in terms of the healing.”

The Boston Globe reported on Saturday that Tatum still needs to reach several milestones for the Celtics to consider a return. If his timeline tracks with recent tears suffered by Dru Smith and Isaiah Jackson last season, who both received clearance for basketball activity around the nine month mark before playing in games only nine and 11 months, respectively, following their surgeries. They, however, progressed in full through training camp and the preseason before this regular season.

Tatum will reach nine months around the all-star break, potentially allowing for practice time before playing and 1-2 months of game action before a potential playoff appearance. Latzka expects roughly one month where Tatum will play on a minutes restriction with careful monitoring of how he progresses. Boston could even scale back his activity if they become aware of any physical issues. His biggest hurdle before then remains making unnatural motions, unlike the controlled movement he’s progressing through in his visible workouts and videos. In those highlights, Tatum mostly runs in a straight line.

“It’s that backward motion where they tendon is being stretched, we call that an eccentric load,” Latzka said. “That’s how he tore it, just stepping back. We saw him step back and tear. Now, imagine him coming down from the rim and landing in a backwards position or playing defense. A lot of Achilles injuries happen when people are running backwards and trying to guard a defender. Especially in the NFL, we’ve seen cornerbacks do that as they’re backpedaling. So that, I think, in his head is probably one of the hardest things for him, not the top speed sprinting or jumping.”

Celtics trainers can continue to simulate that activity with forward jumps, backward jumps, bands and one-legged exercises. Boston will continue to track his Achilles and calf strength, the difference between the legs and how his injured leg compares to its former strength. Beyond that, 100% status also includes the mental comfort Tatum finds while going through each basketball motion when he starts playing again. That can take up to a year, if not longer.

The final game of the regular season falls in line with the 11-month anniversary of Tatum’s surgery, which could force him to immediately enter a playoff environment. The Celtics’ season could end before the 12-month mark. Payton Pritchard expects the basketball aspect of that reunion to progress smoothly, given how long Tatum and teammates have played together. The next Achilles Achilles recovery to watch for will be Dejounte Murray’s, who still hasn’t received clearance for basketball activity publicly 10 months removed from his surgery. He had reportedly aimed to play around New Year’s Day, though there was a sense in New Orleans earlier this season that the team’s struggles could allow him to slow play his comeback

Tatum teased a more immediate intention to return throughout the fall, and posted his highlights last week with the caption ‘soon.’ The safest route could prove waiting. While doing so, he already found a way to make an off-court impact on the team with his presence.

“I think if you are just looking at this from a long term benefit, there probably is some benefit to just coming back next season, really getting as far away from that re-rupture risk as possible,” Latzka said. “When we look at other players who came back earlier, everybody could tell. Well Kobe was much older, but most players are not the same after Achilles ruptures. J.K. Dobbins has looked pretty good in the NFL, but not the same. Durant probably had the least drop-off of any player we’ve ever seen and he took the longer (18 month) recovery. So I think if the Celtics are in a realistic position to go far in the playoffs, it would probably be beneficial to take more time.”