This season has been one to remember and we’re not even finished!
Less than a week after Bills S Damar Hamlin required life-saving treatment on an NFL football field, the Bills suited up to play in his honor. And honor Hamlin they did!
Two kickoff returns for touchdowns by Nyheim Hines, three touchdowns by Josh Allen, and three takeaways for the defense made the 35-23 victory over the New England Patriots extra special.
To top it off, the Bills appeared to escape the game with minimal injuries as they entered the playoffs. Below are the injuries from the game along with thoughts on Damar Hamlin and Micah Hyde.
In-game injuries
OT Spencer Brown (Left foot)
Brown briefly left the game with just over two minutes left in the second quarter when he was taken down from behind on a 10-yard run by James Cook.
Below you can see the play where Brown gets injured. He appears to grab the top of his foot and then hobbles off.
Fortunately, he was able to return without missing a play due to the two-minute warning. Considering he played the entire game, I don’t anticipate that he will be on the injury report, but this shouldn’t limit him heading into Sunday’s game.
Other observations
S Damar Hamlin
Hamlin was released by the University of Cincinnati Medical Center on Monday, getting transferred to Buffalo General Hospital/Gates Vascular Institute.
There, he will undergo further rehab along with tests and evaluations.
From a professional observation, he’s in an absolutely fantastic facility for cardiac care. He is under the care of some wonderful doctors including Dr. Ken Snyder.
He is an unaffiliated neurotrauma consultant for the NFL but is also a regularly treating physician at the hospital. I have had the fortune to hear him speak at continuing education courses, he is absolutely brilliant. If there is one person to understand what happened to Damar Hamlin on that football field, it is him if they haven’t figured it out yet.
He still has a long road ahead of him before any decisions can be made, but he is still on oxygen from recent pictures which means his lungs are still healing.
Whatever the final outcome, this continues to be excellent news.
In related news, this article from ESPN dug into the details of that night on the decision whether to resume play or not. There were certainly a lot of factors in play, but the general sense is that the league wanted to resume play. Worth the read.
S Micah Hyde
This week marks exactly four months, give or take a day, from when Micah Hyde underwent surgery with Dr. Robert Watkins for the herniated disc in his neck.
Increased chatter about Hyde returning began to surface when The Athletic’s Joe Buscaglia spoke to Hyde on the sidelines at practice just prior to Thanksgiving.
Paraphrasing, Hyde stated that it’s not up to him but the doctors, but there are other people and other situations that could spell a return.
All along, his recovery window was about 6-to-9 months considering this was very likely an anterior cervical discectomy with fusion or ACDF.
Brandon Beane has not ruled anything out either in this tweet last month.
I had said back in September that a return was possible but aggressive. The team has historically been conservative, but they have been shown to make exceptions, see: Josh Allen’s right elbow.
Looking at the research, a systematic review dug into the return to sport following ACDF. They looked at 13 studies that pooled 261 NFL players. In 10 studies involving NFL players, they had some cases that returned to play as early as 5-to-6 months. Other articles had a longer return timeline, but due to the length of the season, most did not appear to get the opportunity to return.
Of the 13 articles used, 10 involved NFL subjects. I was able to access 6 of them to fully read the findings. Most were kept in line with a longer return timeline, but there was one singular case that returned in 2.5 months.
This player was a cornerback but he, unfortunately, suffered another disc herniation two years later and retired. We don’t know the age or how long this player had been playing either to that point. It’s important to highlight that this study was published in 2002 which means this case may have played nearly 25 years ago.
The big concern to returning to play is whether enough healing has taken place. Bone fusion can be seen as early as nine weeks but on average three-to-six months.
Looking at research that Hyde’s surgeon has been part of, Robert Watkins IV, outlined in the criteria to return to play in professional athletes:
Return-to-play criteria included (1) status of at least 6 months postoperative; (2) normal examination results; (3) successful completion of the rehabilitation program; and (4) evidence of fusion and stability on radiographs, and preferably on computed tomography (CT).
All radiographic studies were analyzed by the surgeon and an independent radiologist. Stable fixation was defined by no motion on flexion/extension radiographs and no evidence of radiolucency around fixation on CT and radiographs. If the player was asymptomatic with normal examination findings and imaging showed stable fixation, he sometimes returned to sport despite the lack of bridging bone throughout the interbody space between postoperative 6 and 12 months, depending on the sport and position.
Assessing the criteria, it’s reasonable to expect that Hyde could meet some of the goals now. We don’t have the examination or imaging, but that information would be found with follow-up appointments at key benchmark dates. The one that hasn’t and can’t currently be met is the six-month timeframe. The research above shows that there is some play with the return to play and their article even shows that return to play can be as early as five months with the average return to play being 9.5 months.
Why am I digging so much into all of this? These discussions aren’t made public if there isn’t some truth behind them. Joe Buscaglia’s reporting began to fuel the fire, Micah Hyde’s comments within the article further stoked it, and finally, Brandon Beane’s comments above kept the door open keeps the fire going. We also know that exceptions can be made and it’s the NFL playoffs.
What we don’t know is if the doctor will be on board or if Hyde will even meet the criteria for healing. There is a concern for hardware failure or adjacent disc herniation as seen in multiple studies listed above. Even after the events surrounding Damar Hamlin, does this change Hyde’s outlook? We don’t know.
The purpose of this research was to show that where there is smoke, there is likely fire. It’s a possibility and there is precedent for Hyde to return. Even at four months, it’s aggressive, but it is the playoffs and Hyde is certainly in the second half of his career. How many more shots will he have at a Super Bowl?
There are a lot of variables in play, but until the team announces his return to practice, we can only guess. It’s a possibility and as a fan, it’s fun to consider. But the short and long-term health of Hyde has to be considered first and foremost before any return to football is considered. I do not know whether he will return, I just lay out the research and argument that it’s possible.
This is a big week for the Bills to face a divisional opponent, especially one that defeated them already this season. The Dolphins are dealing with a ton of injuries themselves which could be the great equalizer or give the Bills an advantage, depending on the status of several players.
Look for plenty of updates this week as we get closer and closer to 1:00 pm Sunday.
Top Photo Credit: Sports Illustrated
