One year after making Jadeveon Clowney the No. 1 selection in the NFL Draft, the Houston Texans still are defending the pick.
Not to mention hoping that this season, unlike last, they’ll get something out of it.
“Somebody asked me, did you feel like you were making an excuse for him?” Texans coach Bill O’Brien said. “No, I don’t make excuses for the players. I stand up for them when I think I should because those guys bust their butts for us. He was injured. He had a sports hernia. He had a concussion. Then he had the knee.
“He had an unlucky rookie year.”
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Clowney, a defensive end from Rock Hill who had 24 sacks in three years at South Carolina, only briefly stepped on the field in his first professional season and barely made an appearance on the stat sheet – four games, seven tackles, no sacks.
When the Texans selected Clowney in May, the first sign of trouble was a month away. He was diagnosed with, and underwent surgery to repair, a sports hernia. The recovery from that process caused him to start the season on the team’s PUP (physically unable to perform) list. A week after his professional practice debut, he suffered a concussion that caused him to miss the team’s final two preseason games. Then, in the first week of the regular season, he suffered a torn meniscus in his right knee that required arthroscopic surgery on Sept. 8.
“As clichéd as it sounds, injuries are a part of football,” Houston general manager Rick Smith said. “What you have to do is you have to manage whatever situation happens.”
In 2014, Clowney’s situation kept getting worse and culminated in a worrisome knee procedure that could affect the rest of his football career. When the Texans doctors performed surgery to repair his meniscus in September, they discovered cartilage damage and realized a microfracture procedure might be in his future, Smith said. Increasingly, the word “microfracture” in connection with an athlete’s name, particularly a young athlete whose production is tied to explosive physical activity, is a red flag in the sports world.
“He worked extremely hard to try to combat that, and it just wasn’t working for him, so we decided to shut him down and do this procedure because it gives him the best opportunity to recover,” Smith said.
The Texans made that decision in December, and Clowney underwent microfracture surgery on Dec. 9. Houston finished 9-7 and missed the playoffs last season. It finished No. 7 in the NFL in total defense, led by defensive player of the year J.J. Watt. The Texans drafted Clowney with the idea of pairing him with Watt to create the NFL’s most fearsome pass rush, and it still hopes that’s in the near future.
“The limited amount of time he was out there, he showed the explosiveness and the ability to help us when he’s healthy,” Smith said.
O’Brien added, “You can’t wait to see him, because you know what he can do and you are looking forward to seeing him do what he can do.”
However, if and when Clowney will be able to do all he did as a two-time All-American at South Carolina is a question mark given his injury and the procedure used to address it.
“Cartilage problems, of all the problems we have with any joint but specifically with weight-bearing joints, are probably the most difficult to get people back with,” said Dr. Jeffrey Guy, USC’s team physician and orthopaedic surgeon. “Knee damage with cartilage damage is a whole new ball game.”
A microfracture repair is a simple procedure with an arduous rehab. It is an arthroscopic surgery that often takes fewer than 15 minutes in which small holes are poked in the bare area of bone where cartilage has chipped away. The cells in the blood from the bone then regenerate cartilage (albeit in a weaker form than the original) in the bare area.
There are multiple procedures to repair cartilage damage, each with its own risks and rewards, and microfracture has its proponents and critics alike. A 2007 study by FootballOutsiders.com found that nine of 56 NFL players who had microfracture surgery were still in the league five years later. In 2013, a study of 41 NBA players at Rush University Medical Center in Chicago found that 73 percent of those players returned to the NBA but, as a group, they played in fewer games per season and saw their scoring averages diminish.
“That’s what makes cartilage surgery so difficult, there is no 100 percent answer,” Guy said. “There are people who do well with it and people who don’t. From a philosophical standpoint, if the cartilage fills in and matures and is doing what it is supposed to do, there’s no reason the athlete can’t be back to 100 percent.”
Even as the Texans expressed optimism about Clowney’s rehabilitation at the NFL Combine last month in Indianapolis, a report surfaced casting doubt on that public stance. Tony Pauline of DraftInsider.net reported several league sources, including some in Houston’s organization, have “serious concerns” about Clowney’s recovery.
The Texans chose microfracture surgery for Clowney after having him examined by Dr. James Andrews in Birmingham, Ala. The procedure was performed by Texans surgeon Dr. Walt Lowe, and Clowney is doing his rehabilitation in Houston under the direction of Texans head athletics trainer Geoff Kaplan.
The Texans declined The State’s request to speak to Clowney or Kaplan about the player’s rehabilitation. Clowney hasn’t spoken publicly about his health since the surgery. Guy spoke to Clowney shortly after his surgery and all seemed to be on track at that point, Guy said.
The first six to eight weeks after microfracture surgery are considered the most crucial part of the rehab, because patients are told to put no weight on the knee despite the fact they often feel as good as new after two weeks.
“It’s a really, really difficult thing to ask an athlete to do,” Guy said. “It’s like having a scab. It feels good, and it doesn’t hurt you but if you brush up against it, it will knock it off and you have to start all over again.”
Patients recovering from microfracture surgery often spend hours each day sitting in a machine that bends their knee back and forth.
“It’s very boring,” Guy said. “It’s a very difficult process to go through. It’s hard to get kids to find things for them to do.”
The Texans were pleased by Clowney’s recovery during that period, O’Brien said.
“He had to be very disciplined in doing that and he was,” the Texans coach said. “He’s on the right track, but everybody knows that you have to go out there and do it, you have to show us what you can do.”
Now the Texans must wait and see if Clowney will be ready for the 2015 season-opener and then wonder if he will have the longevity they hoped for when they signed him to a $22.3 million, four-year deal in June.
“I think frustration is the wrong word,” O’Brien said. “You have to fight impatience. You have to be patient, because the guy was injured. We feel good about him as a person, and we feel good about where he is right now in his rehab process.”