Week 3 NFL Injury Najee Harris Achilles Rupture

Rehabilitating a Ruptured Achilles: Lessons from Najee Harris’s Week 3 Injury

Introduction

When a high-level athlete suffers a major tendon injury, it offers a teachable moment for both clinicians and patients alike. In Week 3 of the 2025 NFL season, running back Najee Harris sustained what was later confirmed to be a torn Achilles tendon, ending his season prematurely.

In this post, we’ll walk through:

• How the injury happened (mechanism & timing)
• Diagnosis and imaging
• Treatment options (surgical vs. nonoperative)
• Rehabilitation phases
• Prognosis and return-to-play timelines

Our goal is to provide both the athletic community and general readers insight into what an Achilles rupture demands from a physical therapy lens.

How It Happened: Mechanism & Acute Presentation
Non-contact, sudden “pop” event

According to media accounts, the injury occurred during a play-action pass in the second quarter of the Week 3 game. Harris collapsed suddenly, clutching his calf or lower leg, after what appeared to be a non-contact movement — essentially his leg “gave out.”

Such a presentation is quite common in Achilles ruptures: the athlete describes a sudden “pop” or giving way, often with an audible snap, and immediate inability to continue loading the leg.

Clinical signs on field

• He was unable to walk off the field and had to be carted off.
• Early reports initially suggested ankle involvement, but further imaging confirmed the Achilles tear.

From a clinical perspective, signs suggestive of Achilles rupture include:

• Palpable gap in the tendon (especially when the calf is relaxed)
• Positive Thompson (squeeze) test (no plantarflexion when the calf is squeezed)
• Weak or absent push-off
• Swelling, bruising, and pain in the distal posterior leg

Diagnosis and Imaging
Confirmatory imaging

Following the injury, diagnostic imaging was done to confirm the nature and extent of the tendon damage. Media reports later confirmed the worst-case scenario: a full-thickness (complete) Achilles tendon rupture.

Typically, in clinical practice, the workup would include:

• Ultrasound: dynamic real-time imaging to visualize the tendon fibers, gap, and retraction
• MRI: to assess the location of rupture (insertional, midsubstance), tendon retraction, and involvement of adjacent soft tissues

The imaging helps guide surgical planning (e.g., how much tendon retraction must be bridged) or patient candidacy for nonoperative treatment.

Grading & classification
Ruptures are often classified by:

• Location (mid-substance vs. insertional)
• Degree (partial vs. full thickness)
• Retraction gap
• Quality of tendon stumps

Given media confirmation that Harris’s injury was season-ending, the working diagnosis is a full complete rupture.

Treatment Options

Once confirmed, the clinician and surgical team (orthopedic surgeon / sports surgeon) must decide between operative and nonoperative management. In elite-level athletes, surgical intervention is often favored due to higher demands and the desire for maximal functional recovery.

Operative repair
Advantages in an elite athlete include:

• Better tendon apposition and alignment
• Lower risk of re-rupture relative to non-operative (in many series)
• Possibly earlier rehabilitation protocols due to stronger repair
• Greater confidence in restoring strength, especially under high loads

The surgery typically involves:

• Debridement of tendon ends
• End-to-end suturing (often using strong, nonabsorbable suture technique)
• Augmentation techniques if necessary (e.g. grafts, reinforcement)
• Tension optimization (sometimes with the foot in plantarflexion to reduce stress on the repair)

Nonoperative (conservative) management
In some lower-demand patients or those medically unfit for surgery, nonoperative treatment may be considered. Key elements include:

• Early immobilization in plantarflexion or heel-weighted boots
• Gradual progression to neutral position
• Delayed loading and strengthening

The trade-off is a somewhat higher re-rupture risk and potentially slower or less robust strength recovery. In high-level athletes, this path is less common.

Given the media framing (season-ending, high-stakes), it is extremely likely that Harris underwent or will undergo surgical repair.

Rehabilitation Phases from a Physical Therapy Perspective

Below is a schematic of typical rehab progression for an Achilles tendon repair in a high-demand athlete. Each individual’s timeline may vary based on surgical findings, intraoperative tension, comorbidities, and tissue quality.

• Phase One: Immobilization/protection
  • 0-2 weeks
  • Focus on protecting the repair, controlling pain and swelling
• Phase Two: Early mobilization and range of motion
  • 2-6 weeks
  • Focus on gradual tendon loading, restoring dorsiflexion within safe limits
  • Initiate passive range of motion to regain mobility, begin partial weight bearing as allowed by surgeon
• Phase Three: Strengthening/Loading
  • 6-12 weeks
  • Focus on progressing tendon loading, rebuilding plantarflexoion strength, and neuromuscular control
  • Initiate eccentric and concentric calf loading, closed chain exercises (e.g. heel rises, seated and standing), balance and proprioceptive drills (single leg stance, perturbations)
• Phase Four: Power, plyometrics, return to sport
  • 3-6 months
  • Gradual return to high-load, high-velocity tasks, sporting demands
  • Jumping drills, hopping, agility, sprint progressions, gradual on-field cut and acceleration tasks
• Phase Five: Return to play/performance tuning
  • 6-12+ months
  • Full performance strength, endurance, resilience to sport load
  • Field work, gradual load increase, conditioning, fatigue management, biomechanical analysis/adjustments

* These time windows are typical for high-level athletes; actual progression may be accelerated or slowed based on healing, surgical protocol, and individual readiness.

Key Considerations for PT Clinicians

• Respect the biology: Tendon healing lags; premature aggressive loading can risk gapping or re-rupture
• Gradual overload: Calf musculature endures high forces; progress slowly
• Monitor for compensatory patterns: Watch hip, knee, foot alignment and avoid over-reliance on the contralateral limb
• Address the kinetic chain: Strengthen glutes, hamstrings, core, and foot intrinsic muscles
• Eccentric emphasis: Eccentric loading is often emphasized in tendon rehab literature
• Use objective measures: Strength testing, dynamometry, jump metrics, symmetry indices
• Psychological readiness: Fear, confidence, and pain beliefs matter in return to sport

Prognosis and Return-to-Play Outlook
For elite athletes, Achilles ruptures remain among the more severe musculoskeletal injuries. However, modern surgical and rehabilitation protocols have improved outcomes. Some general observations:

• Many professional athletes return to play at or near previous levels, though timelines are long (often 9–12+ months).
• Some loss in maximal strength or explosiveness may persist, especially in early stages.
• Risk of re-rupture is relatively low with good surgical repair and compliance.
• Close follow-up is required to manage tendinopathy, stiffness, and residual deficits.

Given Harris’s status, it is reasonable to expect that his recovery timeline could stretch into the latter half of a year (or more). Whether he’ll fully recapture his preinjury explosiveness is unknown, but with a well-designed rehab protocol, good surgical repair, and careful loading progression, he stands a solid chance of returning to high-level competition. Charger fans will miss Najee Harris the rest of this season but can look forward to his comeback next season!