Column: How come Cam Akers is already playing? The factors that accelerated his recovery

The Hail Mary was caught in the end zone. The hook and ladder resulted in a touchdown.

Cam Akers is back.

Instead of the average nine months to a year of recovery, Akers returned from a torn right Achilles tendon in less than six months, in time for the Rams' postseason opener Monday against the Cardinals. of Arizona at SoFi Stadium.

The same Los Angeles surgeon who prolonged Tom Brady's career could have saved the Rams' season. Neal ElAttrache of the Kerlan-Jobe Orthopedic Clinic improved upon a procedure he once used to repair Kobe Bryant's tendon to ensure the pass rusher's spectacular comeback.

As miraculous as it may seem, ElAttrache insisted there is nothing supernatural about Akers' return.

“I don't want to sound like a mad scientist,” ElAttrache said with a smirk.

Rather, ElAttrache noted, Akers' recovery was the product of a confluence of factors: the evolution of surgery, advances in rehabilitation and patient determination.

“When you talk about those three things together, you get a special result,” said Reggie Scott, the Rams' vice president of sports medicine.

After being injured in mid-July, before the start of training camp, Akers was given the go-ahead to prepare for Dec. 23. He played in Sunday's regular-season finale for the Rams as their final playoff tune-up, touching the ball eight times.

The speed with which he returned, according to ElAttrache and Scott, could be directly related to the urgency with which he underwent surgery and the speed with which he began to rehab after the operation.

“For every day that muscle stimulation decreases, it takes two days to get back to where it was before,” ElAttrache said.

In other words, decreasing downtime early in the recovery process also reduces the time it takes to regain strength at the end.

Akers was injured while working out in Thousand Oaks, near the Rams' training facility, according to Scott. The relative proximity to ElAttrache was important. So was the athlete's decision.

“Within 24 hours, he comes and looks at me and says, ‘Hey, Reg, let's do this,'" Scott said.

Akers had less than a week torn his Achilles tendon when ElAttrache operated on him, Scott said.

The process was also expedited by ElAttrache's surgical expertise.

When he repaired Bryant's Achilles tendon in April 2013, ElAttrache incorporated a technique he learned from Scottish surgeon Gordon Mackay, who added an additional suture designed to absorb stress.

“So all the stress isn't on the repair line,” said ElAttrache, who also used a “loop” technique when sewing the tendon, with the pattern also designed to absorb stress.

Bryant returned to play less than eight months after his surgery, which at the time was considered quick.

Since then, ElAttrache has increased the use of a braided suture that is flatter, wider, and provides greater security. The medical community also has a better idea of ​​how the body responds to these surgical techniques and devices, allowing trainers and physical therapists to better chart the recovery process.

Two days after ElAttrache operated on him, Akers was able to start physical therapy under the supervision of Rams rehabilitation director Byron Cunningham.

“We started working above the joint,” Scott said. “We started to deal with his quadriceps, treat his hamstring. We use a lot of different neuromuscular stimulations.”

Scott's team also used blood flow restriction therapy, developed to treat wounded veterans.

Soon an anti-gravity treadmill was introduced to Akers' program. A month after the operation, he was already walking in one boot. Between 10 and 12 weeks, he was already jogging. At 12 or 14 weeks, he was already running.

The Rams running back, who hasn't spoken to reporters since he was injured, had a very positive mindset.

“Rehabilitation is tough,” Scott said. "It's a one day at a time, one step approach."

Akers' progress was guided by metrics provided by director of sports science Tyler Williams, who, for example, used plates to test how hard the player could slow down and push off with each leg. (By the time he returned, Akers' surgically repaired right leg was able to generate more force than his left, according to ElAttrache.)

Joey Blake supervised Akers' feeding.

When Akers was taken off the disabled list on Dec. 23, the medical staff's primary concern was rebuilding his psyche.

ElAttrache said he knew Akers was ready when he got a call from Scott before the Rams' Week 17 game in Baltimore.

"Guess who isn't happy not to play?" Scott asked.

“That's music to my ears,” ElAttrache told him.

In his return, Akers' impact in the Rams' 27-24 overtime loss to the San Francisco 49ers on Sunday was modest. He rushed five times for three yards and caught three passes for three more.

What touched Scott was the way players from both teams congratulated Akers on his return.

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