In his first season after tearing his right Achilles tendon in 1993, Dan Marino threw for 4,453 yards and 30 touchdowns en route to his eighth Pro Bowl invitation and the NFL Comeback Player of the Year award.
But even the Hall of Fame former Miami Dolphins quarterback was stunned when he saw Terrell Suggs play Sunday against the Houston Texans — just five months after the Ravens outside linebacker underwent surgery on his right Achilles tendon.
"Yeah, I am [surprised] considering that he practiced — for what — three days?" Marino, now an analyst for CBS, said in a phone interview Sunday. "For him to have an impact on the game, that's pretty special."
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Suggs' accelerated return also shocked his teammates, who were still marveling at his performance two days later.
"To start off, what Terrell Suggs did is amazing," inside linebacker Jameel McClain said Tuesday. "It still baffles me to this day, to this moment. I said to him, 'For you to be out here after going through what you went through,' is something that makes you want to fight even more for that respect and for that man."
Suggs, the five-time Pro Bowler and reigning NFL Defensive Player of the Year, finished with four tackles, one sack, two quarterback hits and one batted ball in 44 snaps in the Ravens' 43-13 loss to the Texans. Suggs, who had only been activated from the team's physically-unable-to-perform list on Wednesday, said he was eager to break off the rust that had accumulated over his extended layoff.
"I wasn't sure if I was going to go, but I just felt good as I first threw the pads on, and then I would do plant, and reverse field," he said after the game. "So I just felt that if I was going to be out there, I couldn't have any excuse."
The wisdom of Suggs' decision to play won't be determined until after the Ravens return from their bye week, but early signs indicate that he may have already beaten the odds.
In March 2010, four orthopedic doctors at Duke University published a study that reviewed the careers of NFL players after suffering a ruptured Achilles tendon between 1997 and 2002. The doctors concluded that only about two-thirds of players returned to the field.
Of the 31 players who tore their Achilles tendons, 21 came back at an average of 11 months after the injury. Those players saw a decrease in the number of games they played and a dip in production in the three seasons after their return.
Khalid Shirzad, one of the specialists who contributed to the study, said the average number of games played by the 21 players slid from 11.7 per year before the injury to 6.2. Shirzad said the data collected also showed that the players' "power ratings" — what the researchers defined as a statistical measure of performance, ranging from passing and rushing yards for an offensive player to tackles and interceptions for a defensive player — decreased nearly 50 percent.
"I think we kind of expected some of that in terms of a decrease, just because of the nature of the injury," Shirzad said, adding that Achilles tendon and Lisfranc injuries are two of the most debilitating for NFL players due to the explosiveness that those ailments rob from them. "Even when we looked at other studies, return-to-function rates for just a normal individual could be anywhere between 60 to 70 percent of fully returning. With an NFL player, you kind of expect the excessive demands put on the Achilles tendon, in terms of the players' size and strength and explosive needs to perform, that they wouldn't be able to return to all of their activities or be able to return to a level of play that they were at prior to their injuries."
Because of recent advancements in medicine and rehabilitation, the number of NFL players who return is growing. Suggs' comeback is slightly different in that he only partially tore his Achilles tendon in April. That distinction — while seemingly minor — is a significant one according to Marino, whose right calf did not recover completely from atrophy suffered after his surgery.
"It didn't really get back to the way it was supposed to," Marino said. "It kind of elongated from the surgery. I had a pretty good year that year [after returning], but I would say it started feeling good right as the season got started. Through camp and the exhibition games, it didn't feel great as far as recovering from it, but as time went on, I was able to adjust to it."
Marino said the key to Suggs' comeback will be his body's ability to adapt to the stress that is placed on the tendon, especially for a linebacker who needs to explode, pivot and change directions almost instantaneously.
"A lot will depend on his confidence," Marino said. "Every time he makes a play, it's about how comfortable he's with his body and how he has to adjust."
Suggs said he felt good after Sunday's game, but the true indicator could come over the next couple weeks. Either way, Suggs said he has no regrets about testing his leg.
"I'm just trying to get it all back," he said. "A lot of guys — they've been doing this at training camp and I'm still trying to get mine right. But, like I said, this was the game I really wanted to come back for. We got the bye, and then we come back against Cleveland."
The Suggs treatment
With his performance Sunday, Terrell Suggs appears to have put aside any doubts about his Achilles tendon tear. The history of NFL players who have attempted a similar comeback is mixed. Here are three defensive players who have enjoyed success after the injury and three who have not.
LB Julian Peterson2004 Returned in 2005; started 89 of the next 94 games and had 24½ sacks in the three years after the injury.
LB Takeo Spikes 2005Returned in 2006; started 91 of 95 games and had at least 85 tackles in four of the last five years.
DE Greg Ellis 2006Returned in 2007; started 40 of 43 games and had 27½ sacks in three-year span.
CB Bryant Westbrook2000Returned in 2001; started four of 17 games and made two interceptions after having 11 in his first four years.
LB LaVar Arrington2006Never played in NFL again.