Cousins has undergone a total of eight operations, including a knee replacement in his fifties. His problems began at the 1974 World Championships , where he withdrew before the event started and returned to Bristol to have his first of two meniscus surgeries the second came immediately after the 1977 World Championships when his left knee cartilage ripped and locked in place. By 1980, he had undergone major surgery on both his left and right knees.