Week 2 Bills Injury Review- Chargers

Breaking down the latest injuries following the Week 2 loss to the Los Angeles Chargers.

Different week, same result. Another loss to the Chargers sends the Buffalo Bills to 0-2 on the season and more questions remain. Fortunately, the Bills began to look like a real NFL team in the 2nd half, holding the Chargers to just 3 points while scoring 14. Regrettably, the hole they dug in the first half down 28-6 was just too much to overcome. In addition to the poor outcome, several players found their way to the injury report with varying degrees of injury. Today’s post will assess the injuries sustained in the game and what this means going forward.

First point I would like to address before the injuries is the sudden retirement of CB Vontae Davis. As everyone by now knows, Davis “retired” at halftime and left the stadium, leaving the Bills a man down and questioning his motives. He has since stated that he felt he could no longer play up to his standard and knew when it was time to be done. He has his reasons for doing that and well, it’s his decision. Personally, this is not something I would do nor do I believe it is the right decision to make in the middle of a game. However, he made his decision, he’s sticking to it, and I believe that the coaching staff, the team, and fans all want players who want to play for this team to be there 100%. I wish Vontae the best in his retirement and the Bills can move forward without him.

First injury up is CB Phillip Gaines who suffered a dislocated elbow late in the 1st quarter. He suffered the dislocation during a tackle and came up having difficulty moving his right arm. He was observed requiring support to the forearm area walking off to the medical tent to have further assessment. Upon video review, he dislocated his elbow when he attempted to tackle RB Melvin Gordon. Quick anatomy review, the elbow is made up of 3 bones: the ulna, radius, and humerus. The ulna is the bony portion of the elbow that articulates with the humerus and fits rather snugly in against the humerus acting as a hinge joint. The radius is a lesser bone of the elbow but provides forearm support and motion to the wrist during rotation.

As he began wrapping the ankles up, his elbow hit the ground while Gordon continued to run forward, creating a rotational force which caused the ulna to dislodge either posteriorly or medially from the humerus and appeared to stay dislocated. This was why the training staff needed to support the area with his inability to bend the elbow. At some point later, they were able to successfully reduce the elbow and wrap it for protection and swelling management. The picture below describes the types of elbow dislocations including the posterior and medial dislocations mentioned above.

Elbow dislocation.jpg
Credit: www.orthopaedicsone.com

While this does sound rather gruesome, it is probably one of the best joints to dislocate for quick recovery as once the joint is reduced, it can regain normal function due to the makeup of the joint being as stable as it is compared to a shoulder or ankle which has much more mobility. There is no word yet on whether there was other damage that occurred but Gaines return to the lineup seems relatively hopeful. These types of injuries require 1-3 weeks to rest and recover along with rehab to increase motion and maintain swelling. He may be ready/forced to play against the Vikings unless the Bills make roster moves to address the depth with the loss of CB Vontae Davis. It does help that CB Taron Johnson should be back next week in order to fill the gaps.

Next up is RB Taiwan Jones who suffered a very hard hit to his forehead on a play whistled dead in the end zone off of a muffed punt midway through the 3rd quarter. During the recovery, Jones lost his helmet and while attempting to keep the play alive, got struck by a Chargers defender, drawing what looked to be a gash on his head, dropping him to the ground. When he got up, there was visible blood on his head wrap and he appeared to be in pain. He was taken back to the locker room for a concussion evaluation which later reports indicated that he did not suffer a concussion. Reports also mentioned that he had a CT scan of the head to assess for skull fractures. Thankfully, it appears that he only suffered a rather large gash on his head which required stitches to close up. Depending on how the wound is healing, it may be possible that he can play next week but more likely he would miss no more than a week so that he may let the skin fully heal. Brutal injury, but positive outcome.

Finally, RB LeSean McCoy suffered what was initially reported left broken ribs late in the 3rd quarter due to C Ryan Groy falling on top of McCoy after he had been tackled. The veteran back appeared to leave the game and return only to leave again later and ruled questionable with a rib injury. Reports came out that he suffered broken cartilage in the ribs which can be more difficult to manage than a single broken rib. The chest is made up of ribs that act as a cage around the vital organs such as heart and lungs and provide structural support for the abdominal wall and upper extremities. Connecting these ribs together is cartilage, a firm but pliable tissue that allows the rib cage to move with breathing motions and adapt to movement. This is the same type of cartilage that makes up your ears and nose. In the picture below, the blue tissue is the rib cartilage that McCoy fractured on the left side near the lower portion that connect the false ribs to the sternum.

Anterior-View-with-description_1.jpg
Credit: acuteinnovations.com

Unfortunately for McCoy, rib cartilage breaks are more difficult to manage as this tissue helps attach the ribs together and to the sternum or breastbone. So instead of one isolated rib, the pain can be all over the injured area, leading to greater deficits. As with most other tissues in the body, the cartilage will heal and pain will be reduced. Rib cartilage takes between 3-4 months to heal completely as it does not have a good blood supply which means it’s slower to heal. McCoy does not have this type of time frame to work with considering the NFL season. However, with proper bracing and pain management, he can play through this injury. However, all upcoming defenses are now aware of this and may try to target that area to knock him out of games quicker. He may benefit from a week off to get more rest so that he can play with greater effectiveness in future games.

Overall, the Bills did not suffer a lot of injuries, but the ones that did occur were rather moderate. All 3 players could come back to play next week if need be, but may benefit from at least 1 week’s rest in order to heal more effectively. As always, it comes down to whether the training staff, ownership, and the player have to agree that they are able to play.

Continue to check back for the latest updates and news coming out of One Bills Drive. Continue to watch for the latest injury news on Twitter @BangedUpBills, on Facebook at Banged Up Bills, on Reddit at u/BangedUpBills, and on http://www.bangedupbills. As always, thank you for reading and GO BILLS!!

Author: Dr. Trimble

My name is Dr. Kyle Trimble and I am, first and foremost, a Buffalo Bills fan!! When I am not cheering on the Buffalo Bills, I am a Physical Therapist. To give a background on myself; I was born and raised in Erie, PA, moved to Buffalo in 2006 to begin my studies at D'Youville College towards becoming a Physical Therapist at which time I became a devoted Buffalo Bills fan.  I graduated in 2013 with my Doctorate in Physical Therapy and moved home for several years. Moving back to the Buffalo area in 2016, I have gained extensive experience in outpatient orthopedics, skilled nursing, acute care hospital, and home care. Having obtained a significant wealth of knowledge that continues to grow, along with a undying fandom of the Bills, puts me in the unique position to educate my fellow fans about our great team. 
I am currently an injury spotter working with Dr. David Chao, Orthopedic Surgeon @ProFootballDoc based out of San Diego. In this role, I provide real time updates regarding injuries during the game. I hope you enjoy what I publish and I welcome any comments or questions you may have.
Disclaimer: My opinions are my own.  Any thoughts I have on the injuries is based on media reports, my knowledge of the injury, and speculation based on the information currently available.


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