Eddie Jones has defended his ongoing selection of Billy Vunipola despite the England number eight's escalating workload.
Vunipola is retained in the back row for Thursday's World Cup clash with the United States at the Kobe Misaki Stadium just four days after Tonga were dispatched 35-3 on the northern Japanese island of Hokkaido.
As the only player to start all four of the summer's warm-up Tests, the Pool C showdown will extend his run of starts to 11, with him having completed 761 of England's last 800 minutes.
The powerful 26-year-old is seen as vital to the nation's hopes of lifting the Webb Ellis Trophy on November 2, but his 2018 was ruined by fracturing his arms on three separate occasions.
Joe Cokanasiga will provide firepower to England's back line in the absence of Manu Tuilagi after being picked on the left wing in place of Jonny May, who has been rested.
Cokanasiga's presence makes up for Tuilagi being omitted from the 23 after the Leicester wrecking ball laid waste to Tonga with a devastating two-try salvo and series of marauding runs.
Captain Owen Farrell drops to the bench so Ford, who leads the team, continues at fly-half inside a new-look centre combination of Piers Francis and Jonathan Joseph.
