2020 FA Roundup: DE Bryan Cox Jr. injury analysis

Can Cox Jr. find a home Buffalo’s DE rotation?

Recently, the only intimidating thing about new Bills DE Bryan Cox Jr. has been his NFL lineage. Yes, the well worn old narrative that his father is former Miami Dolphin & Bills villain Bryan Cox

Besides that connection, there isn’t much to Cox Jr. that inspires a ton of fear as offensive playmakers look to prevent him from doing his job. In fact, injuries have done a better part of limiting his ability to play than talent alone. Cox Jr. has suffered a multitude of injuries that haven’t derailed his career but hasn’t exactly set him up for success dating all the way back to college.

Below are Cox Jr.’s known injuries:

2012: 

Redshirt year.

2013: 

Appeared in 8 games in the defensive line rotation, no known injuries.

2014:

Played in 11 games, starting 10. Following his sophomore year at Florida, Cox Jr. required hip surgery that was described as deteriorating. While I could not find specifics regarding the exact surgery or side affected, it appears that this was possibly a hip labral tear repair.

Due to the lateral movements and pivoting required for a defensive end, this is not unexpected due to the nature of the movements and/or congenital issues that may have been present. He missed the bowl game that year but appeared to return to full health. 

2015:

Appeared in 14 games, starting 13. Did not appear to suffer any injuries.

2016:

Cox Jr. suffered a left thumb fracture, knee tendinitis, and a high ankle sprain which severely limited his ability to be available & certainly derailed his chances to get drafted. 

Outside of the thumb fracture, details are not known as to which side the tendinitis or high ankle sprain occurred. This certainly was a strong reason why he was not selected as an NFL draft pick. 

2017: 

Signed with Carolina as a UDFA. Was limited as a rookie with regards to playing time but did not appear to suffer any known injuries. Appeared in 7 regular-season games and 1 playoff game.

2018:

Suffered an injury during June OTA’s that led to him getting carted off. There were reports that he suffered an ankle injury with others reporting knee. This was the result of getting tangled up with OG Norman Price.

Later reports indicate that he started on the PUP list with some reports indicating that he had surgery with others reporting a high ankle sprain

Based on the timeline & description of the injury from the various reports, it appears that he suffered closer to a high ankle sprain versus some of the other possible scenarios. He could have had surgery to remove bone chips in his ankle, but specifics of that are not known. 

What is also not known is whether this was the same side that he suffered his high ankle sprain on in college. He ended up playing in 11 games over the season with multiple weeks declared inactive.

2019:

Was with Carolina for one game before getting cut, signing with the Cleveland Browns. He appeared in 6 before suffering a hand injury at the end of the season. 

Bills Injury Impact:

Cox Jr. has had a rough time in the NFL, playing in his father’s shadow & not being healthy enough to really dominate. In addition to his arrest while in Carolina, he has had to fight for every opportunity, especially coming out as a UDFA. 

There is little concern regarding any of the previous injuries hampering him as he begins his stint with the Bills. Hip labral tear repairs have fairly straightforward outcomes with rates as great as 80% return to play with other reports pushing past a 90% success rate. The high ankle sprains are concerning but they have been spaced out over time, indicating that he is not returning too quickly. As stated above, it’s not known which side was injured each time which prevents identifying whether there is a risk for recurrence. 

Cox Jr. could make the team as his NFL health is far better than his college health. The high ankle sprains are somewhat concerning, but he does not have repeated back to back injuries. Considering the position he plays in where lots of bodies fall everywhere, he is simply at a higher risk of someone falling on his leg. 

He could make the Bills due to injury or simply outplaying one of the older players in the room or settling in as a depth piece. His roster spot is far from guaranteed, but due to his position, he may have a better shot than others currently on the roster. 

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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