Week 14 Bills Injury Review- Jets II

Breaking down the latest Bills injuries following Sunday’s loss to the Jets.

Back to back tough losses really take the wind out of the Bills sails and drops them to 4-9. This was the 3rd loss this season where the Bills had the game in hand but were unable to secure the win. I’ve said this before and I’ll say it again, we knew that they were going to take a step back this year. However, the mark of a good team is the ability to finish games and beat the teams you should beat. This wasn’t one of those times. Hopefully the Bills can learn from this season and transition into more consistent wins next season. Sunday’s loss also marked one of the most injury riddled days in recent memory and the most since I began this site. Today’s post will review the injuries sustained and what significance they have moving forward.

Starting off with the most serious injury, LB Matt Milano (fibula) suffered an ankle dislocation and fracture late in the 4th quarter at the goal line. This was the result of QB Sam Darnold attempting to dive into the end zone, landing on the back of Milano’s heel, firmly planting the foot in the turf. As the foot is planted, Milano is hit from behind by S Jordan Poyer and Darnold’s body being in the way prevents Milano from falling naturally, instead twisting to the left and snapping his fibula which is the outer portion of the ankle. I had retweeted a rather graphic picture of Milano’s ankle twisted 180 degrees with his heel facing where his toes should be. Thankfully, the tibia, which is the shin bone, was spared due to twisting to the left instead of the right. The ankle broke on what I can only assume based on video is the lower portion of the fibula which is the outside portion of the ankle. There is fairly significant ligament damage based on the twisting but can and will heal up due to the ankle being reduced or put back into place on the field and the ankle will be immobilized for some time due to surgery. Below is a picture of a fractured fibula, though not exactly represented as how Milano’s may look on x-ray.

Ankle Fx Pre-op.jpg
Credit: ankleandfootnorthwest.com

A lot of chatter on Twitter has been discussed over the Bodine injury compared to the Milano injury. Both injured the same bone but the severity is starkly different. Bodine will be back before Milano in regards to healing and normalcy due to Bodine’s fracture was fairly simple; he suffered a break, there was no dislocation or what appeared to be associated damage to the area. He just required surgery to set the bone and stabilize it in order to heal. Milano’s injury was more severe due to the corresponding ligament damage in the area. He will be immobilized and non-weightbearing post surgery, but as a result of the immobilization with the ligament damage, the ankle will become very tight due to the scarring down of the healing ligaments. This limited range of motion this will require further stretching and rehab interventions to address the tightness coming out of the surgery to regain the mobility required for his position. However, the timelines are still similar with rehab and recovery with the difference being weeks vs months in regards to return in comparison to Bodine vs Milano. I still expect Milano to take between 6-9 months to fully recover, but I’ll take the low side of that recovery which makes him possibly ready to participate in OTA’s.

The most comparable Bills injury is that of RB Travaris Cadet who suffered a similar injury late last year but was able to return in time for training camp. The only difference between the two players is that Cadet was a fringe roster player buried on the RB depth chart and couldn’t make the team. However, he was able to return to full health as evidence in his participation in training camp.

The other significant injury is RB LeSean McCoy (hamstring). Shady suffered a hamstring strain during the first offensive series against the Jets and was initially questionable to return, later downgraded to out. He appeared to pull his hamstring on a 6 yard gain right before the first Bills TD by QB Josh Allen. There was not anything specific regarding the injury; he did cut hard to his right before taking a step forward and going down. He was observed at one point running on the sidelines and cutting to test it out, but it appeared that he was not ready to return Sunday.

Hamstrings are tricky because they range in severity and affect each position differently. With McCoy’s skill set, as poor as it’s been this year, that hamstring is still more vital to his abilities than let’s say an offensive lineman. The veteran running back has since been listed as day-to-day by the team and has had an MRI to determine severity. This tells me that this is most likely a moderate Grade 1 strain. Yes I am splitting hairs here but they performed an MRI which in my observation is only reserved if the physical assessment is not matching up with typical physical examination. Day-to-day indicates that he will be limited with the possibility of playing next Sunday. However, we have seen this wording used in the past and interpreted to eventually missing some time. Typically we are not seeing players who suffer a strain come back this quickly.  But since there is a muscle tear as all strains are classified, once he rests, the muscle does tighten up and the inflammation process begins which limits his abilities. I’m going to be conservative and say he misses next week against the Lions because it’s a game that doesn’t mean anything and Shady has been absolutely been beat up this year, so a week off will only help.

Other players sustaining injuries include RB Chris Ivory (shoulder), WR Robert Foster (right thigh) WR Isaiah McKenzie (left ankle) OL Jordan Mills (left knee), CB Levi Wallace (left ankle), CB Ryan Lewis (concussion), and K Stephen Hauschka (hip/back). Ivory suffered a left shoulder injury running through the linebackers and secondary, landing hard on his left shoulder after being taken down for an 8 yard gain, appearing to favor his left shoulder coming off. If you recall, he suffered what I believed to be a left AC joint sprain back in Week 9 during a failed goal line plunge. He may have aggravated this injury again as he was slowed down and then fell hard to the turf onto the left shoulder and potentially re-spraining the area. He may also be another guy who misses a week, but he would be more likely to play Sunday than McCoy. Overall, AC joint sprains heal on their own with rehab and rest and only require surgery in the event that there is significant trauma to the area.

Foster and McKenzie got banged up on back to back plays at the end of the first half. Upon video review, McKenzie landed awkwardly on his left foot, appearing to tweak his ankle trying to haul in a pass from QB Josh Allen; this occurred with 1:26 left in the 2nd quarter. He was able to return and finish out the game. I would suspect this is nothing more than at most a mild ankle sprain that will may end up on the injury report but should not slow him for next Sunday as he was able to return very quickly after the injury. He did come into the game questionable with a toe injury but this does not appear to be related to the injury he suffered Sunday.

As for Foster, he got hurt on the very next play after hauling in a 17 yard pass from Allen before taking a very hard shot into his right thigh area that drove him out of bounds. This injury appears to be a contusion at worst as he was able to return quickly. He may be dealing with some soreness and may be limited in practice Wednesday, but this also appears to be an injury that should not keep him out Sunday as he has become a vital piece to the limited WR corps.

OL Jordan Mills suffered a left knee injury performing what appeared to be a chop block though he was withering in pain immediately after the play which required training staff to assess his knee. He was able to return the next offensive series and finish out the game. My best assessment is that he came down on his knee hard and he suffered a mild contusion. Mills has had several injuries similar to this this past season in where he goes down, needs to come off, and then quickly returns. I can’t even classify this as an injury per se, sometimes things hurt when you hit a certain way. No concerns for next Sunday.

CB Ryan Lewis suffered a blow to the head which was later diagnosed as a concussion late in the 2nd quarter. We have seen most of the younger players return from concussions quicker than older players such as QB Derek Anderson, but each concussion continues to be unique and only time will tell how Lewis responds while in the concussion protocol. Far too early to tell whether he will be available Sunday.

CB Levi Wallace suffered an odd looking left ankle injury early in the 3rd quarter. He began to suddenly stop and planted hard on his left leg, the ankle buckled as he attempted to pivot and assisted in taking down the ball carrier. I do not believe that he suffered any major injury to the area, coming off may have been more precaution to further assess the injury after the play. He was able to return after several plays and finish out the game. With his stellar play this year, we can not afford to lose anymore players in the secondary in order to finish this season. He should be available for Sunday.

Finally, K Stephen Hauschka (low back/hip) suffered a cheapest of cheap shots by Jets DE Henry Anderson after the blocked FG on the last play in the 2nd quarter. Hauschka was blindsided when he got hit, unfortunately he was unable to react properly and came down hard on his right hip and potentially jarring his back. It was reported that he had x-rays to assess for any damage but based on the hit, it appears as though he suffered a hip pointer injury. An injury such as this is basically a bruise to the bony portion of the hip that is about where most of our pants sit at on our waist. The reason this is so painful is because there are so many muscles that attach to this area which in turn affect how the core muscles perform along with the hip musculature especially with him being a right footed kicker.

The blindside hit clearly affected his ability to kick as he missed a FG try later on in the game and appeared to be limping at times afterward. This is an injury that does not appear to be long term nor should affect him next week due to the limited need of his position. We have also not had any reports that kickers were being brought in which indicates that this is not a severe issue which should make him available for Sunday.

Overall, a very rough day from an injury standpoint. The only silver lining is that we are out of the playoff race which makes these injuries hurt less. The benefit to these injuries now is that all these won’t be long term and allow all to be ready by training camp barring any setbacks or new injuries over the next several weeks.

As a result of all these injuries, the team will have some new faces in the starting lineup. LB Julian Stanford will be starting in place of Milano, RB Marcus Murphy may get the start if Ivory can’t go and RB Keith Ford may be brought up from the practice squad to backup Murphy. This is the time of year that is great for the front office to find out who else they want to keep for next year by seeing how they do in game action now. We know this roster will have more turnover next year; might as well get familiar with some new faces with the idea that they are here next training camp.

Continue to check back 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.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s