Week 14 Bills Injury Review- Ravens

Despite a loss, the Bills still showed a lot on Sunday afternoon. I’m not talking about this was a moral victory or if one thing was different, they could have won. What it simply comes down to is the offense didn’t come alive until it was too late, but what it did show that the Bills weren’t overmatched as in years past.

The Bills simply weren’t as good as the Ravens were Sunday with a 24-17 loss, but it shows that there isn’t a team, at least in the AFC, that the Bills weren’t as good as or can’t keep up with. We have seen this team rebound after a loss & improve their shortcomings, rather than getting stubborn & refuse to realize when something isn’t working. On top of that, the Bills continue to stay healthy & gear up towards an almost certain playoff trip. Below are the updates from the game.

QB Josh Allen (left ankle/foot)

Allen suffered an ankle sprain/foot contusion as the result of C Mitch Morse stepping on his left ankle/foot, attempting to keep the pocket clear. However, friendly fire strikes again & Allen was briefly down, limping off before getting his ankle wrapped & returning. He was able to play the entirety of the game & did not appear to be fazed by it, but this is more of a pain issue than anything else. It’s possible he may be limited one of the practice days if they work outside or he may not even show up on the injury report.

During Monday’s press conference, it wasn’t noted that he was dealing with anything concerning. Regardless, this isn’t something that I anticipate will hold him back from playing & at most, keep him in the pocket, reducing the need to run.

OT Ty Nsekhe (right ankle)

Nsekhe continues to work back from an ankle injury that has already cost him 3 games. He has yet to practice with him returning in a limited fashion possible Wednesday. Detailed in previous articles, outlines of why he was able to avoid an ankle fracture, why it takes so long for a ligament injury to heal, & when he will return. As I write this, it is possible that he could begin practicing Wednesday for the Steelers game, but it’s more realistic he comes back against the Patriots. Until he shows up as a limited participant, it will only be an educated guess. Though when he does return, he will be close to, if not, 100%.

The Bills continue to stay healthy down this final stretch as they look to finally clinch their playoff spot. While we can’t prevent injuries from happening, the medical staff will do their best to keep the players in one piece. The big hope is that major injury continues to escape the Bills. If this does occur, this team is deep enough to overcome some losses but would certainly dash hopes to make a playoff run. All we can do is take it week to week & have the Bills control their own narrative.

Top Photo Credit:

Pennlive.com

Week 14 Bills Injury Preview- Ravens

Breaking down why Nsekhe is out so long.

9-3. What a sight to behold!

The Bills are 9-3 heading into the month of December. That’s pretty incredible after all the years of cold meaningless football. While the Bills still have more work to do this month, this has turned into quite a special season, making the national media take notice on the team from Western NY. As the Bills embark on vital December games, the team continues to stay healthy following a rash of injuries around a well-timed Week 6 bye. But the Bills, they’re incredibly healthy now & in prime position to capitalize on teams limping into the playoffs. With the Ravens coming to town on an 8-game winning streak, this is a true test for the Bills to create an opportunity to capture an elusive AFC East crown.

OUT

OT Ty Nsekhe (right ankle)

Nsekhe continues to rehab back from his severe ankle sprain suffered against the Dolphins back on November 17th. On Wednesday, it was reported that Nsekhe would be out on the practice field in some role, however, he was a DNP all week. This is not surprising considering the severity of the ankle sprain he suffered, assessed out at least as a Grade 2 inversion ankle sprain. 

The reason this ankle continues to require more time is due to how ligaments heal. Like all tissues, they are made up of various building blocks. In the case of ligaments, water, collagen, & amino acids create the makeup of the tissue. During normal use, the ligaments crimp & uncrimp based on the tensile loads placed through the joint as they connect bone to bone for structural support. As the joint is progressed through the range of motion, the ligaments elongate until they are maximally stretched. Prior to the injury, the striations of the ligaments are linear and allow for support during the full range during joint motion. Think of the striations in a nice steak, all linear and uniform as seen below.

blood cell types
Credit: Sportsinjuryclinic.net

When an injury occurs, the ligaments are either overstretched or outright tear. When a joint is taken to its end range, the proprioceptive nerves in the ligament start signaling for the muscles around the area to contract to prevent the joint from injury. While this attempts to reduce injury, the muscles are not always able to overcome the forces from the injury. Based on the severity, anywhere from several fibers to the entirety of the ligament can tear. 

During healing, the body attempts to heal quickly by putting scar tissue down in a haphazard fashion to heal the tissue. Because the tissue is not linear, the elasticity decreases & the tissue is not as strong as what was originally torn. What happens then is if the tissue is reinjured, it takes less force for the tissue to tear or it stretches out & does not regain its normal shape as easily. You can see below how the makeup of the tissue changes with injury.

scar-tissue-image-300x175
Credit: oregonmassageandwellnessclinic.com

All this tissue healing takes time, anywhere from 6 weeks to a few years for the tissue to fully mature. Fortunately, progressive loading movements help remodel the tissue as it heals in order to return to activity sooner. This is why we are able to gauge return to play timelines based on the severity of the injury. At the end of the day, Nsekhe needs proper rest with increasing loading of the surrounding tissue and ankle joint to ensure that he regains full function in the ankle without causing further damage to the healing tissue.

According to ESPN’s Marcel Louis-Jacques, Nsekhe is out of the walking boot this week, hopefully walking without pain. Ideally, he begins to practice in a limited capacity next week with an outside chance to play against the Steelers but more realistic chances to return against the Patriots. 

CLEARED

OG Quinton Spain & RB TJ Yeldon (illness)

Both Spain & Yeldon missed Thursday’s practice with what was described as an illness. Considering its flu season, that’s likely the cause. Neither were ruled out and while Spain won’t be 100%, enough fluids & Vitamin C should get him through the game. Just another reason to get the flu shot so you don’t get the flu. If you can’t get the shot, you know you can’t. But if you’re able, it helps keep you & others around you healthy. 

Possible Inactives:

TE Tommy Sweeney

OG Ike Boettger

OT Ty Nsekhe

WR Duke Williams

RB TJ Yeldon

S Dean Marlowe

DT Vincent Taylor

The Ravens are on an 8 game winning streak coming into New Era Field. Winning streaks in the NFL like this are rare & need to end at some point. I believe the Bills with their elite defense are primed to stop Lamar Jackson & Greg Roman’s offense. The Ravens are dealing with injury, but the Bills are healthier which with that and the ability to contain Lamar Jackson, could propel the Bills to victory. Here’s to a competitive game with the home crowd advantage, leading to a defining Bills win.
Top Photo Credit:

Baltimore Sun

Week 13 Bills Injury Review- Cowboys

How healthy will be Bills be heading into Week 14?

How bout dem Bills!! McDermott & crew landed in Dallas with questions about how good they were despite their 8-3 record. They leave Dallas with a 9-3 record after having shown 32 million people why they should be taken seriously. Outside of that opening Dallas drive that ended with a score, Buffalo then took control & never looked back, walking away with a 26-15 victory. On top of that, the Bills didn’t even suffer any notable injuries compared to the Cowboys coming into the game beat up & left even worse with Connor Williams going down with a torn ACL & Amari Cooper getting knocked out with a knee injury. Despite there being no significant injuries for the Bills, there are still several players to review as the final stretch of the season ramps up. 

S Micah Hyde (left leg)

Hyde sent a scare into Bills fans early on when he was tended to by trainers late in the 1st quarter. On replay with :38 left, it appeared that he got kicked or had his lower leg hit as he attempted to complete the tackle during the play. He was attended to by the trainers, slightly favoring the left leg as he walked off. He was briefly getting replaced by S Kurt Coleman for 1 play before returning for the rest of the game. Considering he returned so quickly, I don’t anticipate this being a concern moving forward, especially with the extra few days to recover. 

WR Robert Foster (right hamstring)

Foster was a surprise activation for Thursday’s game despite dealing with a right hamstring injury sustained in the win over the Broncos. He was questionable going into the game but managed to suit up & be quite effective. The fact that he was active bucked the trend of the conservative approach that the team takes towards hamstrings. This doesn’t mean that the team is making poor decisions, it just shows that there are variables when managing these injuries.

Either he suffered cramping during Sunday’s game & was fine for Thursday or he really only sustained a mild strain that allowed him to play through. He was able to play in 42% of the offensive snaps with 2 targets for 1 reception for 20 yards & 43% snaps on special teams. Foster also drew a key defensive pass interference early in the 1st quarter which helped keep the drive alive but did not result in any points. 

Regardless, Foster did his job & will have extra time to rest between now & December 8th when the Bills host the talented Baltimore Ravens. 

C Mitch Morse (right 5th digit)

Morse didn’t appear fazed by his finger injury which led him to be questionable heading into Thursday’s matchup. He was able to play in 100% of the offensive snaps & seemed able to handle his duties as normal. I don’t anticipate that this injury will linger & with the extra time off, this should be a non-factor heading into Week 14.

OT Ty Nsekhe (right ankle)

Nsekhe missed his 2nd straight game with the sprained ankle sustained in the win over the Dolphins. While he wasn’t active as expected, Marcel Louis-Jacques reported that Nsekhe made the trip down to Dallas to support his teammates. The significance of this is that Nsekhe was observed walking, albeit, with a noticeable limp but without a boot on following the game. 

This is promising to indicate that his swelling & pain appear to be improving, requiring less use of the walking boot. Considering he is still limping walking around, this means that he is still a ways off before returning. He will have to be walking pain-free & begin practicing on the sidelines before it is even considered that he returns to playing. I have not examined him but I don’t really see where he practices next week & misses the Baltimore game.

It’s possible that he resumes practice for the Steelers game with him going through the paces & at best ruled questionable. He could be active at that point but be used as an emergency backup if needed. A more realistic return may be in time for the Patriots game where he would be closer to 100% & be effective as a rotational player. He would have missed 4 weeks which isn’t unreasonable for an injury such as this. This timeline could obviously change as his practice status is updated, but this is what I believe will be a realistic approach in his recovery. 

The Bills are 9-3, a win away from double-digit wins for the first time in 20 years. There are more than several ample opportunities to win with possible chances over Baltimore & New England with higher probabilities over Pittsburgh & New York. This is a fantastic feeling to have, I really don’t know what to do with myself! This could end in 5 weeks in the Wild Card round, this could end in the conference championship, hell, even the Super Bowl. Right now, I’m ready to believe anything. This kind of success has long eluded this fan base & it’s about time we finally got to enjoy something. I’m looking forward to this next month win, lose, or draw. 

Top Photo Credit:

Bloggingtheboys.com

Week 13 Bills Injury Preview- Cowboys

How are the Bills looking as they go down south?

The Bills travel down to Dallas with a lot at stake. Win, move to 9-3 & gain the national “respect” that they deserve? Or lose, drop to 8-4, and have continued questions whether they are actually a playoff-caliber team. With both teams playing on short weeks, this game will come down to who makes fewer mistakes & can capitalize on the opportunities given to them. Fortunately, the Bills are far healthier than the Cowboys & can make the most with their roster to secure a win before hosting Baltimore in Week 14. 

OUT

OT Ty Nsekhe (right ankle)

Nsekhe continues to work back from the sprained ankle suffered in the win over the Dolphins. He missed the Broncos game & won’t be back for the foreseeable future. He will continue to rehab & begin working on increasing his workloads to eventually return to practice with the hopes that he returns before the Patriots or Jets game. 

QUESTIONABLE

C Mitch Morse (right 5th digit)

Morse appeared to jam his right 5th digit or pinky on a play late in the 1st quarter, striking his hand into the ground towards the end of the play, coming up & grabbing at the area. He was unable to return for the rest of the game but was at times observed snapping to QB Matt Barkley & getting his finger buddy taped to the ring finger for support. He is likely dealing with some minor loss of range of motion, pain, & swelling. It also doesn’t help that 40% of grip strength comes from the muscles that move the 5th digit, significantly limiting Morse’s ability to grip & snap the ball. 

It’s possible he broke his finger, but without clear video, hard to say. However, he has been limited Monday-Wednesday with the finger injury, indicating that this may not be the case. It is very possible that he still plays with the fingers buddy taped together for support to play effectively. If he is unable to go or re-injures the finger, then G Jon Feliciano would slide back over with G Spencer Long taking his place.

WR Robert Foster (right hamstring)

Foster suffered a right hamstring injury on his biggest play of the day Sunday on a 24-yard catch & run down the sideline. Unfortunately, he got pushed out, forcing him to catch himself on his right side from falling over. As he was doing this, he was decelerating, regrettably overloading the eccentrically contracting hamstring and he suffered a strain. The team has been incredibly conservative with hamstring injuries this season with great success. 

Despite practicing in a limited role Tuesday & Wednesday, soft tissue injuries need time to heal up & with 5 days between games, the time simply is not there. As Foster is ruled questionable, WR Duke Williams will likely get the start after 4 games inactive. Hopefully, Foster’s strain is a minor one & he can return to play against Baltimore. 

CLEARED TO PLAY

S Siran Neal (concussion)

Neal managed to progress through the concussion protocol quickly, only missing the Dolphins game & not practicing at all last week. Last we knew, he was in Stage 2 of the protocol going through a pregame workout on Sunday. For him to progress to practicing in full & clearing the protocol is promising, indicating that he will resume as a vital cog in the special teams play.  

Possible Inactive’s:

TE Tommy Sweeney

DT Vincent Taylor

WR Robert Foster

OT Ty Nsekhe

S Dean Marlowe

RB TJ Yeldon

OG Ike Boettger

There isn’t much to discuss moving forward other than the Bills have to go down to Dallas & take care of business. Ideally, the Bills move to 9-3, shutting up the critics as the Bills march towards the playoffs despite a tough stretch of games. Either way, the Bills have taken care of business, winning the games they need to & putting themselves into opportune positions, rather than relying on others screwing up for the Bills to have a favorable outcome. Bills Mafia, enjoy your Thanksgiving & GO BILLS!!

Week 12 Bills Injury Review- Broncos

Are Morse & Beasley going to play Thursday?

No one circles the wagons like the Buffalo Bills! Circle the wagons they did with a convincing win over the Denver Broncos 20-3 on Sunday at New Era Field! From my observations, I did not see a play, series, or point in time where the Broncos were ever in control. It was not a blowout but a rather convincing win to move the Bills to 8-3, the best mark through 12 games since 1996. Think about where you were at that time; I was 8 & still watched Power Rangers. The original ones, with Jason the Green Power Ranger. Yea, that takes you back. 

download
Credit: https://powerrangers.fandom.com/

Anyway, it’s a great feeling to be 8-3 with a march towards the playoffs despite a tough schedule in the coming weeks. However, to make matters difficult, the Bills have to turn around and play Thursday in prime-time against the Dallas Cowboys. Thankfully, the Bills did not suffer a major injury which gives them a better shot to compete. Below are the injuries from Sunday.

C Mitch Morse (right 5th digit)

Morse suffered a right 5th digit or pinky finger injury with 1:56 left in the 1st quarter when Broncos DE Von Miller sacked QB Josh Allen for a 5-yard loss. Morse was engaged with his blocker before falling down, landing with his right hand. He came up grabbing it & did not return for the rest of the day. He was later observed on the sideline practicing snapping to QB Matt Barkley, then going to the locker room before halftime.

I did manage to see that his 4th & 5th digits on his right hand were buddy taped indicating that he possibly jammed his finger when he fell down. To note, this is the hand that he snaps with. He did not return to play in the game but appeared to be available in case of injury. Suffering an injury to the 5th digit or pinky is crucial to Morse’s ability to play. Having pain or weakness in the hypothenar eminence which is the intrinsic hand muscles that account for 40% of grip strength really affects his ability to snap the ball. Think how painful it is when you can’t fully use your hand after it’s been hit. Now try to fully grip & squeeze an NFL football. 

It’s not to say that he couldn’t come back, but with OG Jon Feliciano as a very capable backup, there wasn’t a need for him to return. Morse stated after the game that he would take it day-to-day and that he should be fine. All he will need is some brief rehab to make sure he has full motion & strength return, possibly buddy tape the area for support & be able to play Thursday.

WR Cole Beasley (left ankle)

Beasley scared everyone when he went down late in the 2nd quarter on a designed run play by RB Devin Singletary. Beasley was blocking his assigned man when Broncos LB Todd Davis kicked his left ankle out from under him while diving trying to tackle Singletary. Beasley was in obvious pain & quickly attended to by trainers on the field. He was able to walk off under his own power & eventually return, scoring a TD in the 3rd quarter.

He finished the day 6-76-1, signaling that his ankle contusion was not going to be a problem. Like Morse, he may require brief rehab, more for pain & possible swelling in preparation for Thursday. He could possibly wear a compression sleeve under his sock but I see no scenario in where he doesn’t play against his former team Thursday.

WR Robert Foster (right hamstring)

Foster finally broke out with by far his best game in an overall disappointing season with a 22-yard run followed by a 24-yard catch in the 3rd quarter in where he was injured. He managed to catch the ball with 14:17 left in the 3rd quarter, streaking down the sideline before getting pushed out by Broncos S Justin Simmons. Foster was forced to load up his right leg to account for the sudden hit & attempted to slow down. Unfortunately, as he decelerated, he suffered what appeared to be pulled hamstring, requiring assistance from the training staff to get off the field. 

This is a common way to suffer a hamstring injury & his return was questionable, but he did not return the rest of the game. It’s possible that he was dealing with cramping in the area, but considering how he suffered the injury, it appears to be more of a strain. Barring a miraculous recovery, I do not see him suiting up Thursday against the Cowboys. Fortunately, the Bills have WR Duke Williams who is healthy & quite eager to play, having been inactive the past 4 games. 

Foster may miss the Baltimore game based on past hamstring management by the team, but considering he will have extra time to rest & rehab, there’s an outside chance he returns. We will have to see how available he is in practice following the Cowboys game.

Other notes:

As expected, OT Ty Nsekhe (right ankle) & S Siran Neal (concussion) were ruled out before Sunday. Nsekhe is nowhere near being ready to play & had shown on Instagram that he was getting rehab daily, seen below. Neal is in Stage 2 of the concussion protocol & it is unknown if he will progress fast enough to be ready to play Thursday. 

DE Jerry Hughes was held off the stat sheet Sunday by Broncos OT Garett Bolles & dealing with a groin injury. Hughes was able to provide some pressure today but overall didn’t have the impact that he typically has in the game. It’s possible that his groin may be slowing him, it’s not something I can clearly see on film. Either way, I still expect him to play Thursday because he’s playing already, why not play Thursday & then he will get 9 days off.

On a special note, congratulations to RB Frank Gore who ran into 3rd place on the NFL all-time rushing yards list. He passed the immortal Barry Sanders & continues to show everyone how the job gets done. The career he has had despite all the early injuries including ACL tears to both knees in college before entering the NFL. From a fan perspective, it’s incredible watching historic events such as that.

The Bills will have practice this week like usual but it will obviously be condensed. I expect most practices to be walkthroughs as they heal their bodies up. Besides Foster, there shouldn’t be any big losses unless someone developed concussion symptoms after the game. It will be a quick 3-day turnaround before the Bills play on Thanksgiving. By Wednesday, there will be a much clearer injury picture heading to Dallas.

Top Photo Credit:

Rochesterfirst.com

Week 12 Bills Injury Preview- Broncos

Get the comprehensive timeline on Nsekhe’s ankle & rehab process.

It was expected that the Bills couldn’t stay healthy forever. NFL games are a brutal endeavor & not everyone can avoid injury. While the Bills are down a few players going into Sunday’s game, they still appear to be on track towards making the playoffs which means they could get timely reinforcements when the health improves. The injury report is pretty cut & dry this week but there are still details to discuss especially as we are rapidly approaching 2 games in 5 days. Below is the injury breakdown prior to the game & outlook for the short week.

RULED OUT:

S Siran Neal (concussion)

Neal suffered a concussion with 7:41 left in the 2nd quarter on a routine kickoff following the 2nd FG of the day by K Stephen Hauschka. He appeared to bullrush his assignment and hit his head in the process before getting up appearing to be dazed. In a twist of irony, one of his teammates patted him on the head after the play, not exactly the ideal thing to do after a possible concussion. Neal’s day ended early, getting ruled out & placed into the concussion protocol. 

He was unable to practice all week & was observed watching practice from the sidelines which indicates that he is in Stage 2 of the protocol. He has already been ruled out & it is a guess when he will progress through the protocol to be cleared.

OT Ty Nsekhe (right ankle)

Nsekhe managed to avoid a severe ankle injury when Dolphins DE Avery Moss landed on the back of his foot during a routine run play midway through the 3rd quarter. I had originally stated that he suffered a fracture/dislocation & that his season would likely be done. I have the receipts to prove I am wrong. My buddy, Dr. Chao, aka @ProFootballDoc, also had thought the same thing but thankfully we are now looking at a week-to-week injury instead of season-ending IR. Below is a video detailing why he avoided a fibular fracture.

There were reports that Nsekhe was out at practice in a walking boot which appeared to rile up the masses in a good way thinking that the injury wasn’t as serious as it appeared to be. At the end of the day, he suffered a low ankle sprain which comes with it a still very real & arduous rehab timeline. The reason he was out in a walking boot was the fact that he didn’t have any restrictions in weight-bearing. In the rehab world, it’s encouraged to resume weight-bearing as tolerated unless specifically contraindicated in order to allow for the healing process to take place.

Yes, everyone has heard of PRICE (Protection, Rest, Ice, Compression, Elevation), but after that initial 24 hours of rest, exercise & mobility activities are encouraged for better outcomes. Multiple studies have shown that introducing exercise shortly after the injury reduces the time that one is out compared to immobilization with a 4-7 day reduction in the timeframe for return. Right now, that could be the difference between going to IR versus playing on Wild Card Weekend. 

Allowing weight-bearing allows for joint approximation is vital for the healing process. This allows the muscles in the ankle and lower leg to cocontract & increase joint stability. This also allows the joint to begin to regain proprioception which is the perception of awareness of the body in space in relation to its surroundings. These are all fancy terms, but what does this mean? This means that just by weight-bearing, he is improving his strength and joint positioning with each step he takes. As the pain & swelling reduces, he will continue to perform active strengthening in the area along with balance exercises, increasing the difficulty until he is able to begin walking without the boot. 

As he progresses to higher-level activities, jogging, running, football-specific drills will continue to increase until he is ready to resume playing. This process can take anywhere from 4-6 weeks for a Grade 2-3 sprain. As I previously mentioned in my article from Tuesday, Nsekhe is a big dude, all of 6’8” & 325 lbs. A human that big will require some extra time to fully recover from any lower-body injury. 

While this is not a great injury down this tough stretch of games, having OT Cody Ford with experience helps until Nsekhe is able to come back. The hope is that he’s back in time for the playoffs, but he could realistically come back in time for the Patriots game on the 21st. We’ll see how he progresses, but it’s hopeful that the new training center allows for him to shave more time off to shore up the offensive line. 

Final thoughts on Nsekhe, the team has been bringing in a multitude of offensive tackles to work out including former Bills Sam Young & Seantrel Henderson as possible options in case OT Ryan Bates can’t cut it as a backup or if Ford struggles. 

SUITING UP SUNDAY

DE Jerry Hughes (groin)

Hughes continues to battle through a nagging groin injury suffered sometime earlier in the season which forced him to pop up on the injury report late last week. He was able to play in a season-high 53 snaps on defense. Considering that Hughes is a right defensive end, it’s possible that he is dealing with a left-sided groin strain. He lined up most of his snaps at his natural right side but did line up several times on the left, most likely due to the particular scheme. 

Lining up on the right side means that his power is coming from his right leg driving around the corner. He appeared to not have any issues driving off the left side, but when the adrenaline is pumping, anyone can work through some pain. He was not ruled out or had any injury designation, always an excellent sign. Some may wonder why he was a DNP Wednesday & Thursday but practiced in full on Friday. This was due to veteran maintenance & to save him for Sunday. Hughes may have benefitted from sitting out the Dolphins game, but both he & the training staff felt he was ready to go.

This will be an injury that he continues to play through, unlikely practicing unless it’s a walkthrough practice in the several days between Sunday & Thursday, but barring any further injury should play Thursday as well. While Hughes has not had the stat-bursting season that was expected, he still continues to force teams to game plan for him & pressure the quarterback each and every snap. 

S Jaquan Johnson (hand)

Johnson was a full participant this week despite a hand injury that popped up on the injury report Wednesday. Trying to identify a minor hand injury on film is quite difficult & it’s not clear when he suffered the injury. Johnson is a very physical player & there were many instances where he could have got his hand caught in a jersey, fell to the ground, or during tackling. Either way, he will be able to contribute to special teams & hopefully make an impact.

DT Jordan Phillips (toe)

Phillips showed up on the injury report Thursday with a toe injury. We don’t know which side, which toe, or when it happened. My guess is that this happened Thursday in practice & that it was an injury to the big toe. The big toe accounts for 50% of body weight during walking & without the toe, significant balance & walking issues arise. Injury to the other toes are rather minor & wouldn’t warrant reporting unless they were stepped on, making it a pain issue.

If this an injury to the big toe, the team can give him a stiff-soled shoe to take the pressure off the area during running and blocking. He also did practice in full on Friday which may show that this wasn’t all that serious & that he missed some drills Thursday, but didn’t have issues Friday. If he has issues in the game Sunday, we will see them. 

Possible Inactive’s:

TE Tommy Sweeney

DT Vincent Taylor

WR Duke Williams

OT Ty Nsekhe

S Siran Neal

RB TJ Yeldon

OG Ike Boettger

The Bills host the 3-7 Broncos who despite their abysmal record, carry an elite defense into the game with several pieces on offense, making them still a very dangerous team to play even at home. Like many other games this season, this is a winnable game & the Bills have to control the run game like they did last week. To move to 8-3 would be huge as the next stretch of games against the Cowboys, Ravens, Steelers, & Patriots are no easy task. Continuing to stack wins will be vital in the march towards the playoffs. 

Top Photo Credit:

broncoswire.usatoday.com

Week 11 Bills Injury Review- Dolphins

How severe is Nsekhe’s injury?

Another week, another win. The Bills move to 7-3 on the season with a convincing win over the Miami Dolphins in Miami Sunday afternoon. This is the best start for the Bills since 1999 & 10th time in franchise history that they started 7-3, all previous Bills teams made the playoffs with varying degrees of success. While the Bills are continuing to march towards the postseason, they will be without a key contributor moving forward. This & other injuries will be detailed below. 

WR Isaiah McKenzie (left knee)

McKenzie suffered a left knee injury when he caught a pass going out of bounds with :55 left in the 2nd quarter. CB Nik Needham was close by but unable to break up the pass, instead falling & hitting McKenzie’s lower leg. It appeared to hyperflex his left knee, causing McKenzie to get up & limp off the field. 

Thankfully this was close to halftime where he was able to get some rest & get a quick assessment to ensure he could play in the 2nd half. This injury appeared to be minor & is not something I expect him to show up on the injury report with later this week.

S Siran Neal (concussion)

Neal suffered a concussion midway through the 2nd quarter on the kickoff with 7:41 left following Hauschka’s FG. Unfortunately, the video is not available yet as there was a touchback & the camera followed the ball & not the players. It was reported he was shaken up on the play, but once All-22 comes out, we may get a clearer view of what exactly happened. Neal enters the concussion protocol with no guarantee he is cleared for next Sunday. 

OT Ty Nsekhe (right ankle)

Nsekhe suffered a rather severe right ankle injury with 9:14 left in the 3rd quarter. This was a routine run play by Singletary up the middle when Nsekhe’s foot was caught from behind by Dolphins DE Avery Moss, landing on the back on Nsekhe’s heel, forcing the ankle to roll under the big man violently before his body caught up & he falls down in obvious pain. 

He was immediately placed into in an air cast & carted off, waving to fans but in significant discomfort. The result: a likely ankle dislocation with fibula fracture. There is a concern that he suffered a tibia fracture as well, but he may have spared the more significant bone due to the ankle rolling as much as it did before he fell over. 

300px-Fibula_Fracture
Credit: physio-pedia.com

According to Monday’s press conference, more tests were being performed on Nsekhe’s ankle with no definitive answer at this time. 

This could be for several reasons: 

  • The swelling may have been so great that imaging did not show the true extent of the damage.
  • There isn’t an actual break but significant ligament damage on the lateral portion of the ankle.
  • The Bills know exactly what is going on (they likely do) & are sitting on the info because they have no reason to release it until they feel they’re ready or can sign someone to replace his roster spot. 

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Credit: physiodirectnz.com

Looking at an alternative video angle from Thad Brown, there is the possibility that Nsekhe avoided a break but dealing with quite a severe inversion ankle sprain. He would have injured the anterior talofibular & calcaneofibular ligaments when Moss landed on his ankle. There is a slight chance he avoided a fracture due to observing the heel sliding out, relieving pressure off the fibula as he went down. 

The sheer fact that he was placed into an air cast & carted off without the ability to place weight through his leg isn’t ideal. His season is possibly done, heading to IR for surgery & rehab if my original suspicions are confirmed. I am not certain but if you go on NFL Gamepass & watch the replay, it appears as though the snap of the bone is audible. I’ve played it multiple times in a row. 

This may be a similar injury to what LB Matt Milano suffered last season. if so, a recovery timeline for Nsekhe would be 6-9 months with my guess being closer to 8-9 months. There are several factors including: 

  • Nsekhe is 34 years old, Milano was 24 during his injury.
  • Nsekhe is 6’8”, 325 lbs. Milano is 6’0”, 225 lbs. 
  • Nsekhe’s bones are thicker & are required to accept more weight than Milano’s, requiring a longer healing time & associated recovery.

While 34 is still a youthful age, it is getting up there when it comes to the NFL. Nsekhe can & should make a full recovery, but considering the mileage on his body, it’ll be interesting to see whether he is able to return to full form in order to compete for a roster spot next year. He should be close to, if not fully ready for training camp & should be able to participate in OTA’s in 2020. He is clearly a talented player, the Bills have him under contract for another year, it may come down to how he looks in camp.

For the interim, OT Cody Ford slides into the starting role he has alternated with Nsekhe all season. OT Ryan Bates will likely move to back Ford up. Once Nsekhe moves to IR, the team may elect to fill his roster spot with practice squad players OT Brandon Hitner or OT Victor Salako. The other option is to find a street free agent or another player off another team’s practice squad. Either way, GM Brandon Beane already has a preliminary plan in place. 

Other observations from today’s game injury-wise include noting Nsekhe’s replacement OT Cody Ford is still wearing a hinged elbow brace with a compression sleeve on the left elbow from the injury in the Eagles game. Each week he wears this brace further confirms that he suffered some type of injury to the UCL ligament in the right elbow & the brace provides protection as the ligament heals. 

Other injury news to note is that DE Jerry Hughes was active & played his usual snap count, highest among the DL group. I had originally stated that Hughes would miss the game & I was wrong. While I did not observe every single snap, he did not appear to be compensating or limited. This also creates the thought that the team is not sold on rookie DE Darryl Johnson. While no one expects that Johnson can be an effective player such as Hughes, it shows that an injured Hughes is still better than a healthy Johnson. 

The loss is Nsekhe is going to hurt. While he is older, he showed the ability to play very well with the offensive unit. Ford is able to step in & contribute, but his play has been marred by penalties & inconsistent play. He will suffice, but the quality of play at the position will suffer. However, the Bills are 7-3 & even with a 3-3 finish to the season will give the Bills double-digit wins for the first time this millennium. The Bills are still very much in control of their destiny & can make noise in the playoffs if they played like they did Sunday.