Buffalo Bills vs. Miami Dolphins Week 18 Injury Review

Buffalo Bills vs. Miami Dolphins Week 18 Injury Review
MIAMI GARDENS, FLORIDA - JANUARY 07: Gabe Davis #13 of the Buffalo Bills looks on from the sideline during the first half of the game against the Miami Dolphins at Hard Rock Stadium on January 07, 2024 in Miami Gardens, Florida. (Photo by Megan Briggs/Getty Images)

The Buffalo Bills are the 2023 AFC East Champions! For the fourth consecutive year, the Bills have secured the division and the right to a home playoff game following a 21-14 win over the Miami Dolphins. After years of missing the playoffs, this is fantastic to see. This is the third instance where the Bills have won four consecutive division crowns, the others being in 1963-66 and 1988-1991. 

Securing the number two seed in the playoffs will go a long way in helping to ensure that the Bills can carve a path to the AFC Championship game. The first stop on their playoff journey is the Pittsburgh Steelers, the number seven seed. They have had an up-and-down season but are effectively coached by Mike Tomlin and should not be taken lightly.

As the Bills prepare for the Steelers, they may be without several key contributors on Super Wild Card Weekend. Below are all the injury notes from the game and other observations.

In-Game Injuries

WR Gabe Davis (Left Knee PCL Sprain)

Davis injured his left knee tripping in the end zone late in the first quarter on a play that ended up Josh Allen’s first interception of the night. The play in itself was rather benign as Davis got back up immediately and walked out of the frame.

However, on the next offensive possession, Davis tried to cut to his right and began hopping on his left leg in pain before going to the sideline. He was assessed by team doctors before going back to the locker room for further evaluation and then later ruled out for the night.

I had initially thought there was a concern for a PCL sprain or patellar subluxation by the way he fell. Unfortunately, I saw another angle which led me to believe that he simply suffered a contusion that swelled up. 

On Monday afternoon, it was reported that Davis suffered a PCL sprain that was not major with his timeline TBD. 

Here at Banged Up Bills, we always look to educate and attempt to determine a reasonable timeline for return. 

The PCL is the other ligament in the back of the knee that runs opposite direction of the ACL. This ligament helps stabilize the tibia from sliding too far backward to the femur. This ligament is thicker, has a better blood supply, and traditionally does not require surgery.

The mechanism for injury for a PCL sprain is a direct blow to the anterior tibia. This is often seen in motor vehicle accidents when the knee collides with the dashboard. This damage creates laxity when moving the tibia backward when performing the posterior drawer test.

This also explains why when Davis went to cut off his left leg to go right, he straightened out his knee and the laxity of the joint made the knee give the sensation of hyperextension.

While this is not considered a major injury, it will still have a significant impact on his availability for the playoffs. Depending on the severity of the sprain will determine how soon he returns for the playoffs. Looking at the literature, a Grade 1 sprain takes anywhere from one to two weeks to recover while a Grade 2 will take three to four weeks to recover. 

The hope is that this is a Grade 1 sprain and that Davis would only have to miss one game before returning in the divisional round should the Bills make it.

Looking at comparables for PCL sprains, the Bills have dealt with this before in former DT Harrison Phillips. He suffered a PCL sprain against the Chicago Bears in the preseason, suffering an injury to his left knee. He missed the final preseason game but was ready for Week 1, taking roughly three weeks to recover.

Other comparables include:

-Baltimore Ravens QB Lamar Jackson: 2022, missed 6 games.

-Tampa Bay Buccaneers WR Julio Jones: 2022, missed 2 games, returned and missed three more.

-New York Jets QB Zach Wilson: 2021, missed 4 games.

-Dallas Cowboys RB Ezekiel Elliott: initially played through the injury, missed 2 games later, and wore a brace

-Tampa Bay Buccaneers DT Ndamukong Suh: 2022, missed 0 games.

-New York Jets WR Eric Decker: 2015, missed 1 game.

This injury does not appear to be a worst-case scenario like we saw with Lamar Jackson or even Zach Wilson. Based on the wording of the report from Ian Rapoport, it is not major and with the comparables above from the PCL sprain, Davis is looking at likely missing one game, potentially two.

Should he try to play through the injury too soon, he will have difficulty cutting off the left side and landing on the knee when jumping. The knee won’t be as stable to push off or land on which could cause further instability or time missed.

Even when he does return and is fully healthy, there may be some residual laxity within the knee. He may be best suited to wear a brace but that could affect his mobility which may force him to try and play without one.

Considering the opponent, I would expect the team sit Davis and let him rehab the knee and be ready for the divisional round.

LB Tyrel Dodson (Left Shoulder)

Dodson had to leave the game midway through the second quarter following a late collision as seen below. 

He pops back up and continues to play the remainder of the series but appears to be bothered by it as the shoulder takes further hits. He eventually goes to the locker room where he is questionable and eventually downgraded to out. Looking at the video, there is concern for an AC joint sprain how the top of the shoulder hits as he flips over. Once the adrenaline wore off, it’s very possible that the pain began to set in and required further attention.

However, as noted by a fellow PT below, a labrum tear could also be considered.

The head of the humerus hits and pushes/shears downward, causing a tear at the bottom of the labrum, the cartilage ridge that helps deepen and support the shoulder socket. He may have had some type of subluxation where the shoulder pops out partially when he hit and then the further hits jarred an already unstable joint.

I expect Dodson to be limited in practice this week with a red non-contact jersey on and wearing a shoulder harness. I want to see how much he can do at practice but this could be an injury where they elect to keep him out a week so that he can come back after letting the shoulder heal.

CB Rasul Douglas (Left Knee)

One of the top injuries of the night, Douglas appears to suffer friendly fire when Micah Hyde’s leg hits him in the left knee midway through the second quarter.

Douglas required attention from the training staff and tried to test out the knee, never officially being ruled out. After the game, Douglas told reporters that he wanted to try and come back but Dane Jackson told him that he had it.

This looks like more of a contusion which is still very painful but depending on where on the leg he was hit, it’s possible he could play come Sunday. This will come down to how his knee responds regarding any swelling, pain, and ability to cut, backpedal, and decelerate. His practice participation will be one to watch closely this week.

RB Ty Johnson (Concussion)

Johnson’s injury appears to be the most severe and obvious injury of the night at the end of the second quarter. This injury occurred when he took a shot to his head at the goal line from LB Jerome Baker.

Johnson underwent a concussion assessment and was later ruled out. He will now have to pass through the five-stage concussion protocol before he can be cleared to return. This is Johnson’s second concussion after suffering one in 2019 but clearing within a week. 

OT Dion Dawkins (Left Ring Finger)

Dawkins suffered a left ring finger laceration late in the third quarter when he got his finger in between several bodies. By the looks of it, he noted something was wrong but continued to play through the injury until he saw that blood was leaking through and onto his pants.

He had blood all over his hand when they took the glove off to stitch up the finger and later taped up the hand before returning to the game. Joe Buscaglia later detailed the injury in the tweet below.

Matt Parrino of NYUP.com went on further to describe the injury on his podcast where he stated that the webbing between the middle and ring finger was torn. Dawkins will likely be on the injury report this week but should not have any designation for the game.

WR Khalil Shakir (Left Thigh)

Shakir took a hard shot to his left thigh late in the third quarter after catching the ball as seen below.

He briefly went off to the sideline to talk to the training staff but did not miss any time. This may not even appear on the injury report, but something to note if he does.

S Taylor Rapp (Wind Knocked Out/Ribs)

Rapp secured the game-winning interception on the play below and appeared to land on the ball, knocking the wind out of him. He did require medical attention at the end from training staff but was eventually okay following the game.

Other Observations

TE Dalton Kincaid (Left Shoulder)

Kincaid was seen with extra support sporting a left shoulder brace on Sunday. This was not on the injury report this week and it’s unclear when this injury occured. He did suffer a right AC joint sprain against the Kansas City Chiefs that was an aggravation of an earlier injury.

DT Jordan Phillips (Right Wrist Dislocation)

Phillips got his pins removed from his wrist on Monday, a step in the right direction as he continues to rehab from his right wrist dislocation suffered against the Dallas Cowboys. He is currently on injured reserve and will be eligible to return to play in the divisional round should the Bills win this weekend.

WR Justin Shorter (Hamstring)

Shorter was left on injured reserve at the end of his 21-day practice window after his hamstring strain suffered in the preseason. He is ineligible to return this season and will look towards 2024.

There is a lot of information coming out of this game but the Bills are pointed in the right direction as they prepare to face the Pittsburgh Steelers. This would be the first time the Steelers come to Orchard Park for a playoff game and the Bills are 1-2 all-time in the playoffs against them. This should be an exciting week as the Bills look to secure yet another playoff victory.

Top Photo Credit: Megan Briggs, Getty Images