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The bitter reality of DeMarcus Cousins’ health and latest ACL rupture

I explain how Cousins’ left ACL rupture is connected to his previous injuries and where he goes from here

Los Angeles Clippers v Golden State Warriors - Game Two Photo by Ezra Shaw/Getty Images

DeMarcus Cousins completely ruptured his left anterior cruciate ligament— or ACL—when he “bumped knees” with another player during a workout on Monday, according to Adrian Wojnarowski of ESPN. His agency, Excel Sports Management, confirmed the injury with surgery date and return timelines still being parsed out.

Regardless of those details, Cousins’ injury is a harsh reminder of how health and injuries can take a player from All-NBA levels to potentially out of the league in a matter of eighteen months. Further, it’s a reminder of just how connected and interdependent the body is—a concept known as the “kinetic chain”.


It’s no coincidence that Cousins’ series of injuries all began with a left achilles tendon rupture, then a left partial quadriceps tear and finally the left ACL rupture.

The research on achilles tendon ruptures shows increased risk of injury throughout the lower body, likely due to compensation by stronger body regions which results in excess stress and buoyed by a loss of fitness—muscular strength and endurance—along with deficits in coordination, bio-mechanics, and the neuromuscular system, a system that unconsciously relays joint position to the brain and results in instantaneous muscle activations.

To that point: In my last post on DeMarcus Cousins and what to expect this coming season, I mentioned how the two year mark after an Achilles tendon rupture tends to be the benchmark for when you see players returning to pre-injury levels and therefore I really expected him to ramp up his play after the All-Star break, which would have been right at two years.

The key conditional in that statement was that he would have to make it to the two year mark in the first place. Although he did suffer a partial quadriceps tear last season in the left leg and no injury should be taken lightly, it’s still relatively moderate on the scale of injuries.

An ACL rupture is very serious and although surgery and rehab timelines continue to improve, the average return is seven to nine months. The major problem for Cousins is that this isn’t an ACL injury in isolation; it’s the third injury on that leg in eighteen months.

Further compounding his prognosis is the fact that contact-related ACL ruptures tend to have higher levels of concomitant damage to the friction reducing, shock absorbing tissue known as cartilage that sits between the tibia (shin bone) and femur (upper leg bone). This can result in increased irritation in the knee and the eventual development of mild arthritis.

demarcus cousins acl

For example, Los Angeles Rams running back Todd Gurley is currently dealing with “arthritic changes” to his knee due to his ACL rupture while playing at Georgia.

For all these reasons, I don’t expect Cousins to return to the floor at all this season and, to put it frankly, any reasonable hope of him returning to pre-achilles rupture DeMarcus is all but gone at this point.

If I was to advise him, I’d tell him to take the entire season and summer to recover, rehab, get as physically right as he can, and most importantly in my opinion, get as mentally right as possible.

This is an individual who has invested so much mental energy into rehabbing from injuries during the most inopportune times (a contract year when his achilles ruptured, the playoffs when he partially tore the quad and self) admittedly nearly quit after the latter.

Now you add another major injury and setback while he was just starting to feel like himself again, was in the best playing shape of his career, and extremely motivated to play on a championship-caliber Lakers team and potentially complete some unfinished business with two of his good friends in Anthony Davis and Rajon Rondo.

Beyond him being a Laker or anything basketball related, I feel for him as a person. I’ve seen athletes go into the dumps after one major injury and having their life and passion taken away from them. I can’t even imagine what he’s going through right now after eighteen months of swimming upstream and now facing yet another lengthy rehab process.

All I hope is that he has the support around him and continued resolve to keep on fighting one more time.

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