Tag: injury prognosis

Lions injury breakdown: Dan Skipper makes the 53-man roster with high ankle sprain

Lions injury breakdown: Dan Skipper makes the 53-man roster with high ankle sprain. What is his injury outlook?

Dan Skipper, the NFL’s “most eligible” offensive lineman, has made the initial 53-man roster. He was not one of the 2 players (Moseley, Martin) placed on the “designated-to-return” injured reserve list. Note that rosters are subject to change and he could be placed on I.R. at any time. Skipper is currently recovering from an injury suffered during the Lions 2nd preseason game.

MEDICAL HISTORY

August 17, 2024: Skipper appears to sprain both high ankles on the same play during the Lions 2nd preseason game vs the Chiefs.

Skipper got rolled up on, thus trapping both ankles in external rotation, which is the mechanism of a high ankle sprain. He finished the drive but was limping toward the end of the drive. He never returned to the game, although this may have been precautionary with it being a preseason game.

The ankle sprain is likely of mild severity based on the following:
-Video evidence did not show a severe deformity.
-Continued to play in the game.
-Dan Campbell after the game stated it was a “minor” ankle

SUSPECTED DIAGNOSIS

High ankle sprain – left, right, or both. Mild severity.

PROGNOSIS

-A mild high ankle can sideline a player for 2-4 weeks.
-For comparison, 2 offensive linemen for the Lions last year had similar injuries.

-Taylor Decker was hurt in week 1, finished the game, but missed the next 2 games.

-Jonah Jackson was hurt in Week 5, finished the game, but missed the next 3 games.

OUTLOOK

Expect Skipper to be available within the first 2 weeks of the season. With the season opener being 3 weeks from the date of injury, there is a decent chance Skipper will be ready for game 1. As always, return to play depends on many factors, including the severity of the injury, ability to play through the injury, player importance to the team, and game importance. No long-term issues are expected.

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

James Houston makes the Lions 53-man roster after severe ankle surgery. What’s the medical outlook for Houston?

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.

Lions injury breakdown: Emmanuel Moseley torn pec outlook, possible return from I.R.

Lions injury breakdown: cornerback Emmanuel Moseley and his torn pec outlook, possible return from I.R. timeline

With the news that Emmanuel Moseley has taken one of the two “designated-to-return” IR slots at the 53-man cutdown, here is an analysis of what to expect from the 28-year-old cornerback after his 3rd major injury in three years. By being placed on the “designated-to-return” list, he must sit out at least the first four games of the season.

Medical history

August 5, 2024: Torn pectoral

October 8, 2023: Torn right ACL

October 9, 2022: Torn left ACL

Making an educated guess at a return date is complicated by the wide variety of pec tear types, as well as the possibility of a partial tear that may not require surgery. A full tear with surgery is typically about a 4-month recovery.

For comparison, C.J. Gardner-Johnson was able to return in 16 weeks last year.


If Moseley follows the same timeline, he would be back for Thanksgiving, which would give him 6 games in the regular season plus the playoffs.

There’s a chance he could be back earlier than 16 weeks, as evidenced by these cases:

-J.J. Watt in 2019 had surgery and returned in 9 weeks, but he may have come back earlier than recommended because it was the playoffs.

-T.J. Watt in 2022 did not have surgery and returned in 8 weeks.

-Marcus Williams in 2023 did not have surgery and returned in 4 weeks.

Outlook

Keep an eye out for reports of whether Moseley had surgery or not. If he had surgery, then we should hope to hear him start practicing in early November, with a return starting around Thanksgiving. If he did not have surgery, then a much sooner return is likely.

Once Moseley returns, I would not expect the pec injury to affect his play because of his position at defensive back. It is not an upper-body, strength-dominant position like with a lineman. With how common it is for cornerbacks to be sidelined with injury, as well as the need for multiple cornerbacks to be active for a game, Moseley has a very good chance to be an impactful player for the Lions later this season.

Lions injury breakdown: DJ Reader quad tendon tear and what his activation off PUP list signifies

Breaking down the medical outlook for Lions DJ Reader now that he’s been activated from his torn quad tendon ahead of Week 1

DJ Reader, who has yet to practice this preseason, was removed from the PUP (physically unable to perform) list today which allows him to start the individual drills that Dan Campbell forecasted last week. The Lions did have the option of keeping him on the PUP list into the regular season which would have made him ineligible to play the first 4 games of the season.

Keeping Reader on PUP would have freed up a roster spot at the 53-man cutdown this coming Tuesday. By removing him from PUP now, it suggests the Lions feel Reader’s rehab is going well enough to start ramping up to play in a game. He is available to play as early as Week 1, but there there are a few reasons why this should not be the expectation.

RELEVANT MEDICAL HISTORY

-June 2024: Knee scope, which is often a sign of cartilage damage. This likely affected his rehab.

-December 16, 2023: Tore right quad tendon requiring surgery. This is typically about a 9 month recovery so the start of this season was always in question.

-2022: Knee injury, missed 6 games.

-2020: Tore left quad tendon in game 5. Returned for the start of next season.

QUAD TENDON PROGNOSIS

A quad tendon tear carries durability concerns even after fully healed. Here are some recent case reports of quad tendon tears:

-Anthony Walker 2022: injured in game 3, returned 1st game next season, played 12 games before a knee injury ended his season.

-Gerald McCoy 2020: injured in preseason, returned 1st game next season but hurt opposite knee in that 1st game and never played again.

-Mike McGlinchey 2021: injured in game 8, returned 1st game next season, played all 17 games.

-Dontari Poe 2019: injured in game 11, returned 1st game next season, played 7 games before being released and never played again.

-Beau Allen: injured in 2020, never played again.

A retrospective study in 2004 of NFL players found 14 quad tendon tears over the previous 10 years. Only 50% returned to play in the NFL and the average games played for those who returned was 40.

OUTLOOK

I would not expect DJ Reader to be ready for Week 1, but today’s removal from the PUP list implies he likely will be ready by Week 5. Last year, the Lions had a similar situation with Emmanuel Moseley, who was also coming off a long-term injury (ACL), also had a knee scope during rehab, and also was removed from the PUP list late in preseason (August 23). Moseley did not end up playing in a game until Week 5.

Durability this season and beyond is a concern due to the bilateral quad tendon tears, possible knee cartilage damage, and age (30), so the Lions might be wise to load-manage him either through snap counts or games off if they hope to have him healthy into the playoffs.