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What to expect from DeMarcus Cousins in his second season after an Achilles rupture

The data for NBA players in seasons 1 and 2 after Achilles rupture paints a distinct story, and it’s a promising one for new Lakers big man DeMarcus Cousins.

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The Lakers signed former Golden State Warriors center DeMarcus Cousins on a low-risk/high-reward, one-year, $3.5 million deal, with the hope that his second season back from an Achilles rupture will help him regain the form that catapulted him to the 2017-2018 All-Star game alongside then New Orleans Pelicans (and now Lakers) teammate Anthony Davis.

But if Cousins is going to become a facsimile of the player he once was, the question then becomes: How realistic is it that Cousins can return to that level of play this season? Lets take a look at the data for NBA players following an Achilles rupture, and formal research on post-Achilles rupture performance.

The ever-talented @CrumpledJumper — who is a must follow on Twitter — combed through the data for games and minutes played by NBA players in season one and two after an Achilles rupture. Here were the results for games played:

Season one post-Achilles rupture

demarcus cousins achilles rupture Image courtesy of @CrumpledJumper

Season two post-Achilles rupture

demarcus cousins achilles rupture Image courtesy of @CrumpledJumper

From season one to season two after an Achilles rupture, NBA players participated in a paltry three more games in season two, just a 5% increase season-over-season. However, games played tells a very superficial story. Lets go one level deeper and take a look at minutes played:

Season one post-Achilles rupture

demarcus cousins achilles rupture Image courtesy of @CrumpledJumper

Season two post-Achilles rupture

demarcus cousins achilles rupture Image courtesy of @CrumpledJumper

From season one to season two after achilles rupture, NBA players participated in approximately 244 more minutes, a 14% increase in minutes played. That paints a much more positive picture of recovery in season two compared to the previous games played figure.

Additionally, there are two key contextual factors which are likely negatively skewing the data — meaning, the year-over-year difference would be even higher if not for these factors.

The first is that this data reaches all the way back to 2000, and surgical techniques and rehab protocols have come a long, long ways since then. Those nineteen years are like dog years when it comes to medical improvements for Achilles repair and recovery.

Secondly, there are multiple examples of players on the list who were dealing with chronic Achilles and lower body issues — for example, Nikola Pekovic — that never improved due to the chronicity of the injury and numerous consequences that come along with that.

That positive trend of minutes played also aligns with the formal research on post-Achilles rupture performance, which shows that players definitely take a significant hit on their performance during the first two calendar years after, the injury but if you’re able to make it through the first two years, there’s a distinct possibility of returning to pre-injury levels.

That being said, Cousins did have another injury on the same leg — a partial quad tear — during the Warriors’ first round match-up against the Clippers. However, it was only a partial tear and he was able to come back for the Finals.

Even though he was clearly lacking in conditioning — through no fault of his own — and not able to make a significant impact outside of game 2, it still speaks to the fact that a partial quadriceps tear isn’t that serious of an injury. Outcomes after partial quad tears are very good, and Cousins has said that it’s “100 percent” healed and ready to go.

Further, his comeback shows a level of mental resilience, commitment and discipline, a mentality that has carried over to his off-season training as he’s completely committed to getting his mind and body right, losing a significant amount of weight to reduce the stress on his body.

All in all, there are numerous key positive trends that point to Cousins returning to a high-level player at some point this next season. NBA players miss significantly less minutes in season two after an Achilles rupture, have much higher odds of returning to pre-injury form if they make it through two years after the injury, and Cousins has shown the mental and physical commitment required to climb the long mountain back from an Achilles rupture.

The dates I have circled in my calendar pertaining to Cousins’ potential return to full form are February 14th to 16th 2020 — NBA All-Star weekend in Chicago. That will put Cousins at over two years since the original rupture on January 26th, 2018, roughly two-thirds of the way into the season, with a Lakers team likely ramping up for playoff push and a break to get his mind and body ready for the final push.

If we’re going to see a Pelicans-caliber DeMarcus Cousins this season, that post All-Star stretch will be where he begins to consistently show it... And if he does, watch out, NBA.

Dr. Rajpal Brar has a doctorate in physical therapy from Northern Arizona University, and runs his own sports medicine and performance business, 3CB Performance, in West LA and Valencia, CA. He also works at a hospital — giving him experience with patients in the immediate healthcare setting and neurological patients (post stroke, post brain injury) — and has been practicing for 1.5 years. Brar is additionally training at UCLA’s mindful awareness research center (MARC), and analyzes the Lakers from a medical perspective for Silver Screen and Roll.

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