2020 Week 5 Bills Injury Review- Titans

How beat up are the Bills?

We’re Bills fans. We’ve suffered a few losses over the years. I’m not certain that Tuesday’s loss is drastically different, but it does hurt after a 4-0 start. However, what is different is the expectations. To just make the playoffs before 2017 was a pipe dream. Now it’s not only an expectation, it’s not enough. This year needs a playoff win, an AFC title game appearance, hell, Super Bowl or bust! 

Let that sink in. In 2017, that wasn’t even fathomable to consider. Losses hurt, but the bar for success is now higher. This is why we feel this way, we now expect to win. What’s different for this season and a downside of 2020 for the Bills is the effect that injuries have had on this roster after being one of the healthiest teams over the past few years is noticeable. Below is the injury recap including those that were declared inactive & in-game injuries. 

In-game injuries:

G Quinton Spain (foot soreness)

Spain was a surprise inactive with foot soreness just prior to the release of inactives. Besides the designation, nothing is known regarding what led to the foot soreness. He was not on the injury report last week and has not dealt with foot soreness since the preseason from 2019 from my records. I do not believe they are related at this time. Sean McDermott reported Wednesday that he was improving since last night. Despite not starting anymore, to lose him as depth hurt Tuesday night.

TE Dawson Knox (calf)

Knox left early in the 2nd quarter with a calf injury that was not reported until much later in the game. He wasn’t terribly effective on Tuesday but dealing with a calf injury won’t help his availability come next Monday. It is not clear when he suffered the injury as he ran up through the line on his last play with 12:25 left in the 2nd quarter. Following that play, he then exited the field. Several plays before that, he caught a pass on the right side of the field and was tackled low, potentially hitting his calf at 13:49.  Calf injuries like groin injuries are subtle and not always clear on film. 

Credit: WebMD

According to a study from 2017, it looked at a single NFL team’s calf injuries over a 13 year period. The average time to return following a calf strain was 17.4 days. Based on film with Knox, he may have suffered a Grade 1 as he was able to exit the field on his own and the injury wasn’t apparent at the time. So if 17.4 days is the average between Grades 1-3, the standard deviation for the study was 14.6 days. So the recovery time could be as short as 3 days. 

Can’t say for certain how long Knox will take, but we have seen teammate John Brown play through a likely calf strain, its possible Knox can too. He could miss a week with what we know right now, but things can and do change. The team reports that he received imaging on the calf to determine the severity. We will have to see if Knox participates in practice this week at all. 

S Micah Hyde (possible ankle/knee)

Hyde scared the fan base when he went down with a non-contact injury, grabbing at his knee with 11 minutes left in the 3rd quarter. The initial fear was something severe, especially when a player goes down without any contact, but fears were reduced once Hyde came back out later.

In this clip from Cover 1, you can clearly see the moment Hyde went down and it appears that he injures something. I had to watch this clip multiple times before settling on what appears to be an ankle injury. He has battled low ankle sprains frequently this season and the sudden direction could have caused him to roll his ankle. However, it could be his knee; we simply need more information including body part designation.

Other injuries 

CB Tre’Davious White (back)

Prior to the inactives getting announced, CB Dane Jackson was called up from the practice squad. That was a sign that either Tre’Davious would not play or that Jackson was available in the event that he could not finish the game. Unfortunately, Tre’Davious did not suit up indicating that this back injury is real. We still don’t know the specifics of the injury and it’s not certain that the team will release that information. 

Sean McDermott did note that he had an injury that flared up in practice last week which likely indicates that his injury predates the Raiders game. Nothing on film suggests that he suffered an injury. His snap percentages going in order by week for this season: 79%, 96%, 100%, 100%. If this was a worsening injury, I would expect his snap counts to decrease as the season progresses. Hints like what McDermott said today at least help to begin to narrow down the possibilities. This will be something that will be monitored. 

Those believing that White missed the game due to COVID concerns, just think about how crazy that sounds. Many players play hurt, many players strive to give everything they can to be part of an NFL roster. For White to sit, that simply doesn’t appear to be in his DNA. If the team reports he has an injury, then he has an injury. End of story. We will get more details hopefully later. 

WR John Brown (left knee)

Brown was ruled out prior to the game with several nagging injuries already this season, adding in a knee injury sustained in practice on Thursday. While it was possible for him to play, it was best that he sat out a week to give his body a much-needed break. None of these injuries are season-threatening, but the culmination of the foot, calf, and knee injuries led to missing Week 5. Hopefully the night off allowed him to get right and he can come back for Week 6.

RB Zack Moss (toe)

Moss missed yet another game with a toe injury, his third one in a row. He practiced in full this past week towards the end and it appeared he was trending towards playing. Either Moss is being held back as he is a rookie, wanting to get him fully right or he wasn’t needed in the game plans. I still believe that he has turf toe and it does take 2-4 weeks to recover from as noted in my previous articles. I’ve learned that the literature shows the guidelines for recovery and the NFL tends to be more aggressive in returning players to play, hence my aggressive timeline as well. It’s very possible the team is simply protecting their assets.

LB Tremaine Edmunds (right shoulder)

Edmunds does not look as good as he has the past 2 seasons due to the right shoulder injury he suffered in Week 1 against the Jets. The team acknowledges that he’s battling through the injury and he continues to improve. I had been conflicted about the initial injury due to several things I was seeing following the injury, but I have settled on the fact that it is an AC joint sprain looking at the mechanism of injury. Based on what we’ve seen so far, we know this appears to be more of a grade 2-3 sprain as he missed 1 game and hasn’t looked great against the Rams with slowly improving quality of play against the Raiders & Titans.

According to Dr. Colberg at the Andrews Sports Medicine and Orthopedic Center, Grade 2 sprains can take 3-4 weeks to heal and Grade 3’s can take up to 8 weeks. This is with proper rest & rehab under these circumstances. Edmunds continues to play football, potentially re-injuring the area at times, though he has avoided contact to the right sides when tackling. He will continue to play and get better through the season, but things still may not look pretty for several weeks. If he can get right for the second half of the season and it appears he’s trending towards that, then he could be playing his best football come December & January.

LB Matt Milano (left pectoral)

Milano was the only expected injury to miss with the left pectoral injury suffered in the win over the Raiders. He was ruled out prior to the game and I am not expecting that he plays in the Chiefs game either. McDermott notes that Milano is improving, but he will need several full practices before he should even be considered to play. 

QB Josh Allen (left shoulder)

Allen was noted to be playing with the shoulder harness that he was wearing at practice last week and following the initial injury against the Raiders. I had thought that he would run less in the offense to protect the shoulder and it appeared that he did. He only had 4 rushes for 18 yards and from my observations, he was less inclined to take a hit, instead going down to avoid contact. The 4 rushes are not a career low but is something to note. It’s not known if this was game planned or to avoid injury. Allen will still continue to play this season and hopefully improve on his performance from Tuesday.

I expect that there are new injuries added to the report by this afternoon. There seems to always be an injury or two that show up that wasn’t apparent during the game. The Bills will continue battle through injuries as they prepare for Kansas City on Monday night. 

Top Photo Credit: RochesterFirst

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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