Week 7 Bills Injury Review- Dolphins

Breaking down the severity of Williams, Coleman, & Johnson’s injuries.

I love the Buffalo Bills, I really do. But that was one hard game to watch on Sunday. The Bills, coming off a 4-1 start & a bye week, hosted the 0-5 Miami Dolphins at New Era Field. While the final score of 31-21 was not as close the game really was, the Bills nearly gave Miami a win which would have dealt a blow to their playoff chances. Fortunately, the Bills moved to 5-1 with fewer injuries than they had following the Titans win. 

Prior to the game, it was announced that both LB Corey Thompson (ankle sx) & Matt Milano (hamstring) were ruled out indicating that the Bills would be short at the position Sunday. While Milano’s presence was missed, it was still the right move to not rush him back as there is still much more football to be played.

Others coming back from injury included WR John Brown (groin), TE Tyler Kroft (ankle), RB Devin Singletary (hamstring), & CB Taron Johnson (hamstring) were all able to return and did not appear to demonstrate any restrictions, though their production in play greatly varied. Moving to the Dolphins game, reviewing the injuries below:

 

CB Kurt Coleman (hamstring)

Going in chronological order, Coleman suffered a hamstring strain late in the 2nd quarter with 2:15 left on a punt return. It was difficult to see on the broadcast, but this occurred as he ran down the field as a gunner before coming up lame before the ball was even caught. 

Like all the other hamstring injuries this season, expect the Bills to be conservative in slowly bringing Coleman back into the special teams fold. Look for a minimum of 2 games before he is able to return. Observing the hamstring injuries so far this season, most have come on full out sprinting with some change of direction or deceleration incorporated into the injury. This doesn’t mean that the Bills are doing anything wrong in preventing these injuries, it just shows that going all out on every play, even the best, most conditioned athletes can get hurt. 

 

WR Duke Williams (right shoulder)

Williams suffered a right shoulder injury on a 23-yard completion late in the 3rd quarter. After hauling in the catch, Williams fell hard onto his right shoulder before rolling out of bounds in obvious pain. Miraculously, he was able to return late in the 4th quarter in a red zone package on the WR Cole Beasley touchdown. Later, it was reported that he went in for x-rays following the game.

Looking at the actual injury itself, it appears as though Williams suffered either a contusion or AC joint sprain, also known as a separated shoulder. The mechanism of injury for this is falling directly onto a shoulder without the ability to brace against the fall. Considering that he fell more on the top of the shoulder, I believe he may have sustained an AC joint sprain. This is the area that the acromion connects with the collarbone. This allows the collarbone to connect to the scapula and create a framework for the shoulder muscles to connect in order to move freely during arm motion and overhead movement.

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Credit: http://www.dovemed.com

There is a slight chance he could have suffered a glenoid labrum tear, but that is relatively unlikely considering the shoulder was slammed into the ground versus falling on an outstretched arm. If he sustained this, then I expect to see bracing on the area which will be a dead giveaway. There was also a chance he could have sustained some type of clavicle fracture due to the hit, but if he had sustained that, he would not have been cleared to return & a public report would have been made.

The fact that he was able to return to the game even in a limited fashion indicates that this may be more of the AC sprain/contusion variety. He may be limited in practice this week as he recovers, but his availability in practice will further dictate the specifics of the injury. Looking back at past research from other articles, the average time for a player to miss is 9.8 days according to data obtained from the NFL injury surveillance system. The fact that he doesn’t have to throw a football may accelerate his return. It’s very possible he plays next week. If he does miss any time, it should be minimal one game as a precaution.

 

LB Maurice Alexander (left hip)

Alexander, filling in for the injured Matt Milano, suffered a left hip injury while tackling Dolphins TE Mike Gesicki going out of bounds. The tackle itself was clean; the injury occurred when Alexander’s left hip fell on Gesicki’s foot while going down. He attempted to walk back to the field but quickly went down for medical attention, motioning to his left hip/back region.

Thankfully, he was able to return as the Bills were only carrying four linebackers Sunday. This injury may have been a hip pointer which is a deep bruise to the iliac crest. This is the portion of the hip where the core muscles attach and give that distinctive flair out seen in the hips. Considering the muscles attach there; twisting, side-bending, & engaging the core muscles further aggravate the injury with pain being the major limitation.

This may be an injury that Alexander doesn’t miss anytime with or even show up on the injury report. If he does miss anytime, I wouldn’t expect any more than one game. But noting these minor injuries here explain why the player went down & the possibilities of the injury.

 

CB Kevin Johnson (stinger)

Johnson suffered what has now been termed a stinger following evaluation for a head injury Sunday. These injuries are subtle on film and may not be apparent, but Johnson’s last play during the game came with 3:27 left in the 4th quarter. Johnson managed to tackle Dolphins WR DeVante Parker with assistance from Bills LB Tremaine Edmunds. 

While we are not certain that this play caused the stinger injury, it’s likely due to the fact that his head bent awkwardly & was rolled over as he hit the turf. He initially appeared dazed for a moment following the play & did not return. 

A stinger occurs as the result of the neck getting forcefully sideways and down, putting pressure on the cervical nerve roots coming from the spinal cord. These can be pinched by the vertebrae stacked above & below the nerve or can be the result of a disc protruding out & pushing on the nerve root. The nerve roots can also be overstretched due to traction from the neck getting hit in the opposite direction. A direct blow is yet another way for this to occur.  The pain associated with this is what gives it the name burner or stinger. The nerve root that is compressed sends a pain signal down that nerve & gives the unwelcome sensation. 

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Credit: http://www.aafp.org

This pain would only be produced in the affected nerve roots which means if someone sustains a stinger, they could feel it down in the specific parts of the arm/hand based on which nerve has impinged. This could be felt in places such as the 4th and 5th digits on the hand with resulting grip weakness or difficulty lifting the arm up overhead, indicating the specific nerve root affected. The effects of the stinger may linger for several days or the symptoms could resolve quickly.

Most of the time, these injuries are minor & don’t cause further issues. Return to sport would be indicated when the player is pain-free, full strength and range of motion have returned, and no flare-up of symptoms occurs. If this becomes recurring or linger, then further examination is warranted. This could involve getting an MRI or nerve conduction studies to further identify the specifics of the injury. It could lead to surgical consults if there was a need for cervical fusion due to instability or if the injury was high enough in the cervical region, potentially career-ending as in the case of former Bills C Eric Wood

I do not believe this to be the case. I merely lay out the possibility of the severity of the injury & what this means regarding stingers. It is still too early to determine if he misses any games or will be limited in practice.

Fortunately, the Bills walked away from Sunday with far fewer injuries than in previous contests. The injury report will be far smaller than in past weeks & indicates that the Bills are getting healthy as a critical stretch in their season approaches. While the quality of the opponent’s vary, they still all pose a threat to the Bills playoff chances. This team is built for depth but there is a clear difference between starter & replacement level players, evident over the past few games. This week’s practice will hopefully show progress for Thompson, Milano, and Johnson as the Bills prepare to host the Eagles next Sunday. 

Top Image Credit:

http://www.predictem.com

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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