Week 9 Bills Injury Recap- Bears

Read the latest about RB Chris Ivory’s shoulder injury, TE Charles Clay hamstring, and other concerns following the loss to the Bears.

This 2018 season is really testing our patience. 2017 was a new regime and we ended The Drought! After such a high, the 2017 off season saw several key players leave and well, we thought the team would take a step back. Though we expected this, we still go crazy with the results. I think what drives most of us nuts is how bad they have lost some of these games. They have not had a loss yet that came down to the final minutes nor have they had a loss that was defined by a single play or two. These losses have come during blow outs and mind numbingly horrible offense. Though the defense continues to hold their own, not even the best players in the league can play for 60 consecutive minutes of football; essentially what the Bills defense has been forced to do due to the ineptitude of the offense. Along with the lack of production, the Bills continue to lose offensive producers to injury. Today’s post will review the injuries sustained in the soul crushing loss to the Bears.

While the Bills did not lose much on Sunday, what they did lose was still painful. First up is TE Charles Clay (right hamstring). The veteran TE suffered the injury on the last Bills offensive possession in the 1st quarter running a route to the middle of the field. He appeared to slow down, turn to his right and begin to try and run towards where the play was taking place, but appeared to take a step and began limping. He was observed on the sidelines getting assessed and stretched by the training staff but was unable to return to the game. He suffered a hamstring strain that appears to be Grade 1 but will unfortunately cause him to miss some time. He has been since listed week to week.

Hamstring strains can and do happen at any point in the season but are more frequent early in the season as players are still ramping up into game shape. As this injury was in the 1st quarter and not the 4th, fatigue does not appear to be a contributing factor. He may have decelerated too fast and felt a pull when attempting to turn direction. Unfortunately, the video available is limited and the injury is subtle in nature, limiting the ability to confirm the specific action. This may have been an unfortunate circumstance or as the result of cumulative injuries as he’s had hip, ankle, and shoulder injuries this season along with a well known knee issue. If this upcoming game meant more or he was desperately needed, it’s possible he would be able to play, but considering he’s had several injuries already, he’s a veteran, and the bye is coming up, it would not make sense to rush him back out there. I’d expect him to miss next week with him coming back after the bye.

The other injury noted was RB Chris Ivory (left shoulder). He suffered his injury on a goal line plunge that was unsuccessful halfway through the 4th quarter. He got hit hard up in the air by LB Danny Trevathan and was stopped cold in his tracks. Ivory immediately went down and began motioning to his left shoulder, requiring assistance to get off the field and eventually carted to the locker room. There was initial speculation that he may have suffered a painful contusion but reports have since come out indicating that he suffered a shoulder sprain.

The most likely sprain that Ivory suffered is an AC joint sprain. The joint that is injured is known as the acromioclavicular joint which is near the top of the shoulder. This joint is made up of the distal or far portion of the clavicle and the acromion which is the hook portion of bone that creates the bony edge of the shoulder. This joint helps connect the shoulder to the thorax via the clavicle and allows for shoulder movement throughout its range. This allows for overhead, pushing, and pulling motions required for activities in every day life.

When a AC joint sprain occurs, the ligaments holding the clavicle and acromion together are damaged due to a direct blow to the shoulder, as in the case of Ivory. These types of injuries can also occur as the result of falling on an outstretched arm, or FOOSH injury. However, most of these injuries occur as direct blows and cause immediate pain and loss of function. This will be evident by the limitation in motion to the shoulder, pain with movement, possible visual deformity as the result of the clavicle rising up higher than the shoulder, and bruising. There are specific grades that allow us to identify the severity as seen below. While MRI may be helpful to identify specific ligament damage, a physical examination and x-ray will typically tell a medical professional the grade level. While we are unable to identify the grade level on Ivory as he had his shoulder pads on, my best guess is that he suffered a Grade 1-2 AC joint sprain which would put him at 2-4 weeks for recovery.

AC-Joint-Separation-Image.jpg
Credit: sportsinjuryclinic.net

Rehab will include rest and stretching to allow for proper healing to the area. Once he is able to move the arm without causing further discomfort, he will begin strengthening and stabilization activities to challenge the joint to perform its function and ensure proper healing to the area. These are injuries that a player can play through if minor enough, however considering the hit that Ivory suffered and the fact that he had to go to the hospital due to initial concern for internal organ damage makes me believe that this is not minor. I can realistically see Ivory missing next game and then using the bye week to recover fully enough to resume playing against the Jaguars. He may be healthy enough to return to play by that time but he may also have taping to the affected area to help provide some type of additional support in order to get through the game. There is a possibility that he will be out longer if the severity is worse than I anticipate, but this is not something that the team would consider placing him on IR at this time. Had he had a Grade 3-5 injury, reports would have surfaced and he would have most likely been placed on IR by this point.

Overall, this upcoming bye will be a welcome reprieve for this team trying to get healthy for the final stretch to salvage any respectability for this season. Ideally, most of those on the injury report will be healthy enough to return and play out the rest of the season. Fortunately, one player will not be completing the final home stretch of the season with the Bills. CB Phillip Gaines has been released with CB Levi Wallace replacing him on the roster. Gaines has been a liability all season and even in his absence due to injury, his replacements demonstrated why he was expendable on this roster. As a fan, I will not miss his giant pass interference calls giving the opposing offense an easy trip down the field.

This wraps up another post for Banged Up Bills injury review. Continue to follow for the latest updates and news coming out of One Bills Drive. Follow on Facebook at Banged Up Bills, on Twitter @BangedUpBills, on Reddit at u/BangedUpBills, and online at www.bangedupbills.com. 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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