Cousins look­ing to beat the odds

Few who suf­fer Achilles tears re­turn to form

San Francisco Chronicle - - SPORTING GREEN - By Con­nor Letourneau

DAL­LAS — Do­minique Wilkins could hear the melan­choly in DeMar­cus Cousins’ voice last June. Five months re­moved from a sea­son-end­ing Achilles in­jury, Cousins’ ca­reer was sud­denly in doubt: Would any­one pick him up in free agency? Could he play at an All-Star level again?

Dur­ing that phone con­ver­sa­tion, Wilkins told Cousins not to worry about his crit­ics be­cause “no one knows your heart like you do.” The Hall of Famer’s mes­sage res­onated. Twenty-six years ear­lier, Wilkins was 32 when he tore his right Achilles ten­don, only to come back nine months later and make two more All-NBA teams.

As Cousins pre­pares for his War­riors de­but Fri­day night against the Clip­pers, he knows that Wilkins’ story is an out­lier. Play­ers with torn Achilles ten­dons are more likely to never play an­other game than to re­turn to their pre-in­jury form. Cousins’ size — 6-foot-11, 270 pounds — only makes his odds of a full re­cov­ery steeper.

But Wilkins, who has men­tored Cousins through­out the re­hab process, is res­o­lute that Cousins will fol­low his ex­am­ple and be­come an ex­cep­tion. This is a 28-year-old who tends to be at his best when oth­ers give him lit­tle chance. Fu­eled by a de­sire to

si­lence his doubters, Cousins has al­ready wowed team­mates in 5-on-5 scrim­mages.

“Peo­ple al­ways doubt peo­ple first be­fore they give peo­ple credit for how quickly they can come back from those types of in­juries, but it de­pends on the per­son,” Wilkins said. “I think DeMar­cus is a guy who’s put the work in and is go­ing to be fine.”

The break­through for Cousins came in the past cou­ple of weeks, when he started to show flashes of dom­i­nance in work­outs. Fi­nally, after al­most 12 months of re­hab, Cousins looked self-as­sured as he leapt for re­bounds and threw down dunks. In­stead of wor­ry­ing about his sur­gi­cally re­paired left Achilles ten­don, the four-time All-Star was able to play on in­stinct.

This was enough for gen­eral man­ager Bob My­ers, Dr. Rick Cele­brini — Golden State’s di­rec­tor of sports medicine and per­for­mance — and head coach Steve Kerr to sit down with Cousins and pin­point that Clip­pers game as his re­turn date. Though fans might see Cousins’ de­but as a vic­tory, the War­riors view it as merely the next phase in his re­hab.

Lit­tle has been de­cided about his role other than that he’ll start. De­pend­ing on how Cousins looks and feels, Kerr will ad­just his min­utes up or down. Those in­side the or­ga­ni­za­tion don’t an­tic­i­pate Cousins be­ing at or near 100 per­cent for weeks, per­haps months.

“I’m get­ting ac­cli­mated with the guys, find­ing my wind, find­ing my legs,” Cousins said. “I’m not ex­pect­ing to come out and score 50 points or any­thing like that. It’ll be great if I could, but that’s not my ex­pec­ta­tions. Just com­ing out and be­ing a part

of the team. That’s good enough for me.”

The Achilles ten­don, which con­nects the calf mus­cle to the heel bone, is the thick­est and strong­est ten­don in the body. It’s de­signed to stretch, al­low­ing the ten­don to ab­sorb force when an ath­lete lands from a jump, then pro­vide power when he or she pushes off the ball of the foot.

Since a bas­ket­ball player’s liveli­hood de­pends on the abil­ity to jump and change di­rec­tion, Achilles in­juries are of­ten ca­reer-al­ter­ing. Much of the re­hab process re­volves around re­build­ing strength in the calf mus­cles post­surgery. Be­fore be­ing cleared for con­tact work, Cousins spent months slog­ging through hy­drother­apy treat­ments, light jogs, weightlift­ing ses­sions and cal­is­then­ics.

“Some­times, peo­ple just never get that strength back,” said Dr. Ken­neth Jung, a foot and an­kle sur­geon at Cedars-Si­nai’s Ker­lanJobe In­sti­tute in Los An­ge­les who con­sults for the Lak­ers. “If you’re a step slow or lose some ex­plo­sion, ob­vi­ously as an elite NBA player, that could de­ter­mine whether you’re able to stay in the league or not.”

A 2013 re­search paper pub­lished in the Amer­i­can Jour­nal of Sports Medicine found that seven of the 18 NBA play­ers (38.9 per­cent) who sus­tained ma­jor Achilles in­juries be­tween 1988 and 2011 did not re­turn to the league. Those who did come back missed an av­er­age of 55.9 games the rest of their ca­reer, with only eight of the 11 play­ing a sec­ond sea­son.

The hand­ful of play­ers who re­sus­ci­tated their ca­reers post-in­jury saw their play­ing time and per­for­mance plum­met. A 2015 CBS Sports study echoed those find­ings, de­tail­ing how the 14 play­ers who re­turned from Achilles in­juries since 1992 saw both their field-goal and three-point shoot­ing per­cent­ages drop, on av­er­age.

Though such in­juries tend to af­fect play­ers over 30 the most (Cousins was 27 when he got hurt), they also es­pe­cially take a toll on play­ers Cousins’ size. El­ton Brand, who was a sim­i­lar age (28) and size (6-foot-9, 254 pounds) as Cousins when he tore his Achilles in 2007, wasn’t the same player after­ward.

A two-time All-Star be­fore the in­jury, Brand didn’t av­er­age more than 15 points or 8.3 re­bounds in any of his eight re­main­ing sea­sons. Brand told In­sid­, “I didn’t have the same ex­plo­sive­ness that I had. I re­gained and then I re-lost it. I didn’t have it. I had to change my game a lit­tle bit where I jumped off two feet, and I was a lit­tle bit slower.”

In the decade-plus since Brand’s Achilles in­jury, med­i­cal ad­vances have upped play­ers’ chances of a suc­cess­ful re­cov­ery. The surgery is con­ducted with smaller in­ci­sions and stronger su­tures. In­stead of wait­ing weeks to put pres­sure on the in­jured foot, play­ers can start re­hab ex­er­cises within days of the pro­ce­dure.

The re­cov­ery process, which tra­di­tion­ally took nine to 12 months, now takes some play­ers only six to eight. But in Cousins’ case, Golden State was in no rush.

He has called the past 12 months the tough­est of his life. Wilkins, who sank into a de­pres­sion after his 1992 surgery, can re­late. Though he tried to con­vey con­fi­dence to the me­dia, he won­dered whether he’d re­gain his elite quick­ness or leap­ing abil­ity.

Dur­ing one of his first pre­sea­son games back, Wilkins crum­pled to the floor while chas­ing a re­bound and grabbed his right an­kle. De­spite that, there was no pain.

“That’s when I knew I would be OK,” said Wilkins, who hopes to catch Cousins’ de­but on TV. “Hope­fully, DeMar­cus will have a mo­ment like that. And when he does, he’ll be him­self again.”

Cody Glenn / Spe­cial to The Chron­i­cle

DeMar­cus Cousins last ap­peared in an NBA game on Jan. 26, when he in­jured his left Achilles ten­don.

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