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USA Today Sports Media Group
USA Today Sports Media Group
Sport
Jimmy Liao MD

James Houston makes the 53-man roster after severe ankle surgery

James Houston, who missed almost all of last year with a severe ankle injury and fibula fracture, has currently made the 53-man roster. As always, the roster is subject to change. By making the roster, it gives hope that we will once again see the pass-rushing demon that terrorized the NFL with 8 sacks in only 7 games his rookie year.

MEDICAL HISTORY

September 17, 2023: Suspected severe right high ankle sprain with associated fibula fracture. Required surgery which may have involved plate & screws for fibula, and tightrope procedure for high ankle. Missed 4 months before returning for the final game of the season vs the 49ers.

 

August 2024:

-Wore a right knee brace during 1st preseason game. Reported after the game to have a bone bruise. Uncertain if the knee brace was related to the bone bruise. This brace was not present in last season’s finale vs the 49ers.

-Did not play in the 2nd preseason game.

-Played in the 3rd preseason game without the right knee brace.

PROGNOSIS

The severe right high ankle injury and fibula fracture is healed but remains a long-term concern. Like most injuries, there can be residual effects and the body may never return back to the previous level. Given the importance of ankle flexibility and strength to his style of pass rush, even a mild impairment could dramatically impact his efficacy.

The mechanism of his injury suggests that it will be easier for Houston to perform an outside rush from the right end position compared to the left end position. This is because an outside rush from the left end puts an external rotation force on his ankle which was the mechanism of his injury as seen in this video.

 

During the preseason, I found it notable that he mostly played at left end. He did register a sack from the left end position in the 3rd preseason game but this was on an inside rush.

The bone bruise may affect him in the short-term but is of minimal long-term concern as he was healthy enough to play in the 3rd preseason game without a knee brace.

OUTLOOK

We have yet to see James Houston display the spectacular pass rushing ability he showed before the injury. It’s still too early to make judgments though especially with a recent bone bruise that likely slowed him down during the preseason.

On August 12, Dan Campbell said that they were ending the experiment of playing Houston at SAM LB and would just focus on him as a pass rushing DE. Hopefully, this focus helps him return to the electrifying pass rusher we saw during his rookie year.

During the regular season, it will be interesting see if Houston plays more on the right or the left side and how it affects his productivity.

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