Jets' Aaron Rodgers has healthy outlook for 2024 season, several local orthopedists agree

Stephen Silver grew up in Hewlett, right smack in the middle of Jets territory, so he knows the vernacular. He knows the words that matter to the franchise and its fans. He knows there is one word in particular that the Jets cherish above all others: the G-word.

That was the word he decided to use.

“I would have guaranteed Aaron Rodgers would play this season,” Silver told Newsday of his outlook roughly a year ago after the quarterback ruptured his left Achilles tendon and had to undergo surgery and the typically long rehabilitation process that follows.

Just another optimistic Jets backer blindly hoping for the best? Maybe.

But Silver also is Dr. Stephen Silver, chief of sports medicine and assistant professor at Hackensack University School of Medicine in New Jersey. He is one of several local orthopedists whom Newsday spoke with about Rodgers’ imminent return to the football field for the start of the 2024 regular season.

Their consensus? While there are no clinical precedents of a 40-year-old professional football player coming back from an injury such as the one Rodgers suffered, that simply may be because there are very few 40-year-old pro athletes, and quarterbacks in particular, to begin with. And although Rodgers had the latest surgical technology and rehab techniques at his disposal to overcome what might have been a career-ending injury just a few decades ago, his comeback at this point, far from a medical achievement or testament to his will, actually is quite predictable.

“At this point, being [almost 12] months out from surgery, we’d expect him to be back now,” Silver said. “At 10, 12 months, it’s routine and expected . . . At this point, it’s not a marvel. Once you get to that timeline, once you are close to a year, I think pretty much everyone is back and it heals and they do very well.”

“I’m not surprised,” said Dr. Geoffrey Phillips, orthopedist at North Shore University Hospital. “He’s obviously a well-conditioned athlete. I know it’s been his intention to expedite the return to play. There is not that much in the literature on NFL players returning to play, but the good news for him is that in the studies that are out there, the quarterback is one of the best positions in terms of coming back.”

Phillips cited a 2017 study in “Foot and Ankle International,” the specialty’s leading publication, that looked at 95 NFL players who suffered Achilles injuries that required surgery. Of those, 72.4% returned to NFL action. Many of those who never made it back were linebackers, defensive backs or running backs — in other words, players who rely almost entirely on quickness and agility to perform. There were nine quarterbacks in the study. All nine came back to play in the league.

“So it was a 100% return,” Phillips said.

A very small sample size, yes, but Rodgers appears to be maintaining that average.

'I'm not worried about his Achilles'

Furthermore, the doctors agreed that there is very little chance that Rodgers will suffer any serious setbacks to the surgically repaired tendon at this point.

“The Achilles heals really well and re-tear rates are really, really low [about 2% among all patients], so you have the confidence to push yourself a little bit,” said Dr. Craig Levitz, co-chief of sports medicine for Northwell Health. “I’m not worried about his Achilles. As a sports medicine doctor and a Jet fan and a guy who has done this surgery and taken care of hundreds of guys like him, I have zero worries about his Achilles. As a physician, though, I’m more worried about him being a 40-year-old quarterback than a guy coming back from an Achilles tear right now. I’d be worried about his rotator cuff and all the other things that start happening as we get older.”

Levitz said there certainly will be limitations to Rodgers’ mobility, as there are to nearly every patient who suffers an Achilles injury. The nature of the surgery shortens the tendon, which leads to a decrease in flexibility in the ankle and leg. They may be only subtle deficiencies, but they will be there.

“If Pat Mahomes or Lamar Jackson had this injury, I think it would change their game completely because they rely, particularly Mahomes, on pinpoint cutting ability and the push-off on their running,” Levitz said. “The runners who are cutting and pivoting, the loss of that excursion is permanent and they see significant deficits in their game. Aaron Rodgers, not a real running quarterback, this probably won’t affect him at all. Because of the way he plays the game, and it’s not going to really show up in his throwing motion [because the injury was to his left foot, the front one when he passes], I would expect it not to hinder him at all, even though if we measured his Achilles excursion on a machine, I guarantee it would be a deficit.

“If Aaron Rodgers doesn’t have a good year,” Levitz added, “my bet would be that it will have nothing to do with his Achilles, it’ll have to do with being a 40-year-old quarterback.”

None of this is to say there was never any doubt that Rodgers would be at this point, about to embark on a 20th NFL season, even from Rodgers himself.

“There were a lot of disappointing, heartbreaking times,” Rodgers said of the past year. “Obviously, being in the training room after the injury feeling like that might be my last time on the field was disappointing. Coming out of surgery, obviously the surgery went well, but that first week you can't really move, you've got people taking care of you. I'm usually the one that likes to take care of the people in my circle, so there were some tough moments . . . The Groundhog Day aspect of [rehab], driving in in the morning, five hours there, driving back. There were frustrating times.”

Once he decided he wanted to devote himself to a return, though, being on the field this September was about as close to a given as the medical community could offer. The biggest obstacles would have little to do with the Achilles itself but rather Rodgers’ wanderlust and personal aspirations. This is a player who has at least mulled football retirement in recent offseasons to pursue everything from becoming the host of “Jeopardy!” to running for vice president of the United States.

If anything, though, the injury and recovery from it, along with watching the Jets struggle without him during the 2023 season, seemed to spark a renewed appreciation in him for continuing to play.

“I think it just makes you enjoy these moments more,” Rodgers said of being back with the team. “Once I was able to kind of get present in my body and start to look around, there's always little miracles around you. If you just get up and get the [expletive] out of your own way, you can see some of those things.”

'He was never going to get medically cleared'

While Rodgers’ comeback this fall won’t place him in the pantheon of patients who overcame Achilles injuries with astounding speed — running back Cam Akers was back from his tear in just under six months and Kobe Bryant, at age 35, returned to the NBA court in less than eight months — had he been able to achieve his stated goal of playing at the end of last season, it would have been astounding.

Maybe even unbelievable.

“He was never going to get medically cleared,” Phillips said of Rodgers, who was able to practice with the team in December, roughly 3 1/2 months after his injury, and even  was taken off  injured reserve with three weeks left in the season but ultimately was not approved to return to full action as the Jets were eliminated from postseason contention. “I can tell you with 100% certainty. That was his PR. I don’t think you would have heard that from any of the treating team doctors.”

Silver, though, thinks it could have been done.

“That was possible, but you were pushing it,” he said. “If the Jets were in the playoffs, he probably would have played. He wouldn’t have been 100%, but he had all the factors for success to get back. You need the right player, the right mindset, the right motivation, right fitness and nutrition. He was the right position, a quarterback as opposed to a running back. And he injured the correct foot. For all those reasons, he wouldn’t have been 100%, but he could have pulled it off.”

The thing that stood in his way the most, it turned out, was being on the wrong team. Had the Jets managed to win  one or two more games during Rodgers’ absence, he might have been given the chance to play. Instead, they lost six of seven as he was on the verge of his return, including a Dec. 17 loss in Miami that dropped their record to 5-9 and officially eliminated them . . . and him.

Surgery, rehab, repair all key

The keys to getting him so close to such a remarkable return were the surgery and the rehab. Rodgers had the procedure done in Los Angeles by Dr. Neal ElAttrache, a surgeon who specializes in minimally-invasive techniques that include the use of Speed Bridges, a widely employed, trademarked device originally designed to help rotator cuff injuries, to suture the tendon rather than traditional stitches. Having the operation through several smaller incisions instead of a full opening of the back of the leg was significant, too. It meant Rodgers could begin his physical rehab as soon as the wound was suitably healed. All of those pieces allowed Rodgers to begin building up the muscles that are part of the Achilles region earlier than what used to be expected with less fear of infecting the wounds or damaging the needlework on the tendon itself.

“The Achilles tendon repair is healed in about six weeks and that thing is pretty darn solid,” Levitz said. “It’s healed with scar tissue in a big ball and it’s structurally close to normal at about eight weeks. The reason why we don’t let you play at two to three months is, like with any surgery, it takes months to get the strength back to protect you. Even though you are healed in four to six weeks, there is a lot of extensive rehab to build up those muscles.”

Phillips said doctors are beginning to use biologics that help augment the strength of the Achilles and added that through the Feinstein Institute with Northwell, they are looking at coating the sutures with different substances to promote healing of the tendons.

“There is a lot of great research going on,” he said. “It’s really a new frontier in terms of those things. But you can’t have one without the other. You need the advances in surgery coupled with greater enhanced understanding and progress on the rehabilitation side. We’re actually at a good time for these advances.”

And Rodgers, it turned out, found himself right in the middle of this era.

Rodgers’ dash for a possible December return was a risk because he was pushing his body and could have suffered another injury to the leg that would have set him back considerably. But at this point, nine months after Rodgers’ 2023 season officially ended and with him having cleared those early pitfalls, that aggressive rehab schedule is actually a blessing. It’s made him and the tendon stronger than it would have been at a more traditional, relaxed pace.

There still were some details to work though once he got back on the field this summer. Rodgers had to build confidence in his leg and get accustomed to the limitations, small as they may be, that are his new reality. That took place throughout training camp.

“The last 5% of being 100% is just the mental part,” Rodgers said when he reported to camp. “It's hard. It takes a little bit, it takes those banked reps where you do something and that's kind of like an anchor point for you to remember back that you're able to do the things you used to be able to do . . . I'm not sure exactly what it's going to be, but there's going to be a time during training camp where it all starts to line up for all of us. For me, I'm going to need some of those plays to find that rhythm, and once I get the rhythm, then I feel like it'll just fall back into place.”

Just as the doctors figured it would.

Reality vs. fantasy 

Of course, it’s one thing to predict a full and complete comeback and quite another to bank on one. So Newsday asked each of the orthopedists one last question:

Would you pick Rodgers for your fantasy football team?

“Everything I hear out of Jets camp is he looks great,” Levitz said. “I would still sign him and play him. It doesn’t scare me.”

“It depends on what choices I have,” Phillips said with a laugh. “But I’ve always loved Aaron Rodgers. I’m definitely rooting for him to succeed.”

Silver, who Broadway Joe-ed the comeback with his guarantee, was, as you’d expect, the most adamant.

“Oh, yeah, absolutely,” he said of drafting Rodgers. “He’s back.”

By Tom Rock

tom.rock@newsday.com@TomRock_Newsday

Tom Rock began covering sports for Newsday in 1996 and became its NFL columnist in 2022. He previously was Newsday's Giants beat writer beginning in 2008.