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Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Examining DeMarcus Cousins’ Achilles Tear

All-Star center DeMarcus Cousins suffered a left leg injury late in New Orleans’ win over Houston. Cousins was hauling in a rebound and landed on his left leg and immediately came up limping. It was apparent the non-contact injury was significant as Cousins was helped to the back by teammates.

News spread quickly that the Pelicans feared Cousins had sustained an Achilles injury with Yahoo Sport’s Shams Charania confirming the diagnosis of an Achilles tear with a MRI still pending.

The Achilles tendon is the common tendon of the gastrocnemius and soleus muscles, better known as the calf muscle. Together they are responsible for pointing the toes and play an important component in running and jumping, particularly during acceleration. The calf muscle complex also helps stabilize the ankle. When an Achilles injury occurs, medical professionals will often utilize a clinical test known as the Thompson test.

The assessment simply involves the doctor or athletic trainer squeezing the calf of the injured individual. This simulates the muscle contracting and will cause the ankle to plantar flex and the toes to point. If the Achilles has ruptured, plantar flexion will not occur. Following a positive Thompson test, the injured athlete often undergoes a MRI to confirm the diagnosis.

Achilles ruptures generally require surgery and a lengthy recovery process. According to the InStreetClothes.com/SMART database, Cousins’ Achilles tear is the 20th such incident since the start of the 2005-06 season. The average time missed for qualified NBA players was just under 10 months with the number improving in recent cases such as Kobe Bryant (back in 240 days), Rudy Gay (261) and Wesley Matthews (231). These numbers suggest it is possible for Cousins to return in time for the start of the 2018-19 season. However, these players were at different phases of their career and were all perimeter players.

Recent frontcourt players to sustain a torn Achilles include Anderson Varejao, Darrell Arthur, and DeSagana Diop. However, Varejao and Diop were older than Cousins and Arthur’s return was delayed by a fibula fracture, making it difficult to compare. However, one case does stand out as a reasonable comparison for Cousins, former All-Star Elton Brand. Brand tore his Achilles during the offseason following his eighth NBA season. He missed a majority of the following season, playing in eight games to end the year. Cousins is currently in the midst of his eighth NBA season. Both players were 27 years old at the time of their injury while Brand had played more games and minutes. While Cousins is several inches taller than Brand, both players weigh in between 270 and 275 pounds.

Brand went on to play eight more seasons following his injury, including 81 games in the 2010-11 season in which he averaged 15.0 points and 8.3 rebounds. While his numbers never returned to his pre-injury level, other injuries played a limiting role, including a complex shoulder injury in his first full season after his Achilles injury. Brand never reported complications with his surgically repaired Achilles.

Cousins will undergo surgery soon to get a head start on the recovery process. While he will enter free agency will plenty of questions, history suggests he can still be a productive player moving forward.  As ESPN’s Kevin Pelton pointed out, Cousins should remain a good player even with an expected dip in productivity.

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