Sports Rehab Write-Up: WR Cooper Kupp
Uh oh! The NFL season’s just started & we’re already seeing a ton of high-profile players go down with injuries! At the top of that list, we have Los Angeles Rams star WR Cooper Kupp. Fantasy football owners nationwide are sick to their stomachs!
Kupp, heading into his 7th NFL season, suffered a Grade II left hamstring strain during the Rams August 1st training camp practice. According to Head Coach Sean McVay, Cooper "came up a little bit in a red zone route” and had to be helped off the field by the team’s training staff.
The initial plan was for Kupp to make his return within a couple of weeks; but those weeks passed, and after missing all of the team’s scrimmages & preseason games, everyone’s starting to scratch their heads.
We’re beginning to get used to the former Offensive Player of the Year missing action – Kupp missed the back-half of last season with a high-ankle sprain & missed time with a torn left ACL in 2018. In fact, Kupp has had to miss at least one game in 4 of the 6 seasons he’s been in the league!
Now, on the weekend of the first Sunday of the 2023 NFL regular season, the Rams have announced that they are placing their star receiver on Injured Reserve after he’s suffered a setback in his latest injury recovery. So it looks like we can officially call it 5 out of 7 seasons with missed time…
In all fairness to Kupp, hamstring injuries are extremely tricky and there’s a lot of weird confusion & misinformation around hamstring rehab! Hamstring injuries are so tricky, in fact, that Kupp was driven to visit a specialist in Minnesota for some expert analysis of his current ailment.
Well you can get that here too!
Firstly, the hamstring strain is the most common non-contact muscle injury in sports that involve maximal velocity sprinting. There are two agreed-upon classifications of hamstring injuries: sprint-type & stretch-type. Sprint-type hamstring injuries are the ones that occur during those max velocity sprinting activities (Kupp’s injury falls into this group); stretch-type injuries occur at the extremes of the hamstrings’ range of motion.
Similarly to what we’re seeing with other soft-tissue injuries, there is a growing body of evidence that links the negative effects of fatigue -- decreased coordination, form breakdown, etc. -- to increased risk of damage (Huygaerts et. al, 2020). Hard to say if this applies in Kupp’s situation, but it’s definitely possible.
It’s also not exactly shocking that Kupp suffered a setback in his rehab, and that’s not because of anything to do with Kupp! About a third of all hamstring strains will re-strain, and most do so within two-weeks of an attempted return to the field (Erickson & Sherry, 2017). Sounds familiar!
In 2022, Martin et. al put together some clinical practice guidelines for the Journal of Orthopaedic & Sports Physical Therapy following a systematic review of all of the best literature regarding hamstring strain rehab. Some of their key points that we should highlight are:
1) Being 8 or less weeks removed from a hamstring strain is a significant risk factor for an additional hamstring injury;
2) Hamstring rehab for athletes seeking a return to sport should prioritize a progressive, functional exercise program that specifically includes eccentric muscle strengthening;
3) There is insufficient evidence that supports the use of stretching as an isolated treatment when managing a hamstring strain.
So how does the road to recovery look for our fantasy league hero?
For one, a good, focused, well-structured rehab protocol gets most athletes back to the field in about 3 weeks (Hickey et. al, 2022)! Kupp’s got 4, thanks to his IR designation, so there’s no rush now!
Another thing his rehab team should consider is the 2023 study done by Mizutani et. al that looked at college football skill position players. Mizutani’s study found that athletes that had suffered hamstring strain injuries had a lower ratio of hamstring strength to quad strength as well as much less hamstring flexibility than their healthy counterparts pre-injury! This is pretty insightful when it comes time to prevent any further injuries! We can gather that athlete’s that pull a hamstring haven’t thoroughly strengthened the muscles through their full range of motion!
Flexibility is important pre-strain, but consider how little it does for torn, lengthened muscle fibers; during rehab what’s most important is building back that strength & then building back power!
So, if we put all of our findings together, Kupp should be looking at a rehab protocol with a heavy focus on developing eccentric hamstring strength throughout the full range of motion! Strength isn’t everything, though; completing a controlled, progressive return to maximal velocity sprinting is crucial to any proper hamstring rehabilitation for a running athlete!
If you’re dealing with a similar injury & seeking professional guidance, consult your trusted physical therapist to equip you with the appropriate strength & ROM exercises to get you back on the field and keep you there! Hickey et. al have spearheaded a ton of great hamstring research & put together a nice progressive running protocol that’s worth implementing for athlete’s at every level before officially returning to action! Check it out:
Hoping for smooth sailing for Cooper Kupp on his rehab journey! With his additional time off, I fully expect him to continue to dominate once he makes his way back to the field! As all great athletes know, the real work gets done behind the scenes!
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Works Cited & Further Reading
Huygaerts, S., Cos, F., Cohen, D. D., Calleja-González, J., Guitart, M., Blazevich, A. J., & Alcaraz, P. E. (2020). Mechanisms of Hamstring Strain Injury: Interactions between Fatigue, Muscle Activation and Function. Sports (Basel, Switzerland), 8(5), 65. https://doi.org/10.3390/sports8050065
Erickson, L. N., & Sherry, M. A. (2017). Rehabilitation and return to sport after hamstring strain injury. Journal of sport and health science, 6(3), 262–270. https://doi.org/10.1016/j.jshs.2017.04.001
Martin, R. L., Cibulka, M. T., Bolgla, L. A., Koc, T. A., Jr, Loudon, J. K., Manske, R. C., Weiss, L., Christoforetti, J. J., & Heiderscheit, B. C. (2022). Hamstring Strain Injury in Athletes. The Journal of orthopaedic and sports physical therapy, 52(3), CPG1–CPG44. https://doi.org/10.2519/jospt.2022.0301
Hickey, J. T., Opar, D. A., Weiss, L. J., & Heiderscheit, B. C. (2022). Hamstring Strain Injury Rehabilitation. Journal of athletic training, 57(2), 125–135. https://doi.org/10.4085/1062-6050-0707.20
Mizutani, Y., Taketomi, S., Kawaguchi, K., Takei, S., Yamagami, R., Kono, K., Kage, T., Sameshima, S., Inui, H., Fujiwara, S., Tanaka, S., & Ogata, T. (2023). Risk factors for hamstring strain injury in male college American football players -a preliminary prospective cohort study. BMC musculoskeletal disorders, 24(1), 448. https://doi.org/10.1186/s12891-023-06565-w
