How Conservative Are the Buffalo Bills in Managing Injuries? A Deep Dive into the Questionable Designation Usage from 2017-2023

How Conservative Are the Buffalo Bills in Managing Injuries? A Deep Dive into the Questionable Designation Usage from 2017-2023

In 2021, the question was posed “Are the Bills too conservative with injuries?” This was asked as part of a Locked On Bills question for Herd Mentality. As a recurring guest, I was tasked with answering that question as Banged Up Bills looks at everything injuries.

Original Question submitted following Week 11 of the 2021 NFL season.

Are the Bills too conservative with injuries? I heard a lot this week about how Darius Leonard had been playing through a high ankle sprain all season, and sure enough, he was out there again against the Bills. It got me thinking about how earlier this year, Milano was pulled out of a game late for his hamstring after the lightest of pushes from behind against the Texans, and I remember thinking there was no way he was missing time. He was held out the next week – Chiefs game, I believe. He was walking around fine all week at practice, and also on the sidelines of that game.

Then Edmunds was pulled out two weeks ago for hammy concerns, also seemingly a minor injury at the time. He’s held out against the Jets – but I was at the game, and he was horsing around in pregame warmups (impossible to miss, he’s a monster even in street clothes) and certainly didn’t look hobbled. Missing this week was unfathomable to me after watching that, but nope – inactive. Even an 80% Edmunds would’ve been better than none against Taylor today.

It’s a recurring point with Kyle how they always ebb on the side of caution with injuries – is it too much so, and possibly even to a point of detriment? This question comes to mind in a context where there’s a lot of chatter happening that questions other areas of McDermott’s conservatism on game days lately too.

In 2021, I answered that question which you can read in full here.

While the numbers were quite interesting, changes to the injured reserve rules, coaching staff, training staff, and overall league dynamics changed these numbers. This warranted a revisit to the data to see what changed. 

What you’ll find below is surprising given the Buffalo Bills and the league as a whole. How each team reports injuries, the rates at which they deem players questionable and doubtful, and the overall cumulation of the injury report numbers.

To keep things consistent, some parameters were put in place.  


  • All information was gathered from
  • The timeline for assessment was 2017-2023, this coincides with the start of the Sean McDermott era
  • Research was focused on the frequency of the questionable/doubtful designations used
  • Team records were noted
  • Coaching changes were noted
  • Injured reserve designations were excluded
  • Man games lost were excluded
  • Team Averages
  • League Averages
  • Bills injury breakdown by soft tissue, sprain, concussion, or other

The official NFL Personnel Injury Report Policy does list designations of Out, Doubtful, and Questionable, but does not list the odds or chance as to what that designation has to be. You can read the full policy here from 2017.

Pro Football Reference breaks the designations down into color codes and percentages for easy understanding.
-Questionable (Yellow): has a 50 percent chance of playing
-Doubtful (Orange): has a 25 percent chance of playing
-Out (Pink): the player did not play that week
-//////: the player did not play that week, this is seen with Questionable, Doubtful, and Out designations
*Probable (Green): this was eliminated in 2016 due to the overwhelming number of players deemed probable that ultimately played.


-Overall, the league average from 2017-2023 for questionable designations that ultimately played was 68.11%

-This was a 1.44% increase from 2017-2020 which was 66.67%. The questionable rates playing from 2021-2023 was 69.95%.

-The league average for doubtful players that ultimately played was 1.46%. This was a decrease from 1.77% from 2017-2023. The doubtful rate from 2021-2023 was only 0.9% who played. 

The three teams with the highest frequency instances of the questionable designation did not change. 


New England Patriots: 487

Baltimore Ravens: 330

Arizona Cardinals: 257


New England Patriots: 858

Baltimore Ravens: 554

Arizona Cardinals: 468

However, from 2021-2023, this did change slightly with teams who have used the questionable designation with the top five below.

New England Patriots: 371

Baltimore Ravens: 224

Miami Dolphins: 214

Arizona Cardinals: 211

Detroit Lions: 178

The three teams with the lowest frequency instances of the questionable designation did change slightly.


Atlanta Falcons: 52

Los Angeles Rams: 65

Pittsburgh Steelers: 73


Atlanta Falcons: 112

Pittsburgh Steelers: 116

Philadelphia Eagles: 156

*Note: The Los Angeles Rams were fourth with 175.


Philadelphia Eagles: 35

Pittsburgh Steelers: 43

Atlanta Falcons: 60

The three teams with the highest frequency of questionable players playing:


Tampa Bay Buccaneers: 85.17%

New York Jets: 82.49%

Indianapolis Colts: 78.78%


New York Jets: 89.5%

Tampa Bay Buccaneers: 89%

Baltimore Ravens: 77.8%


Indianapolis Colts: 85.39%

Tampa Bay Buccaneers: 81.87%

New England Patriots: 81.40%

The three teams with the lowest frequency of questionable players playing:


Philadelphia Eagles: 51.92%

Pittsburgh Steelers: 53.45%

Houston Texans: 53.82%


Houston Texans: 41.4%

Pittsburgh Steelers: 46.58%

New Orleans Saints: 46.9%


Philadelphia Eagles: 44.33%

Atlanta Falcons: 51.67%

Buffalo Bills 53.85%

The three highest and lowest single-season frequencies with questionable designations playing did not change. 


2017 Tampa Bay Buccaneers (5-11): 96.3%

2019 Tampa Bay Buccaneers (7-9): 96%

2019 New York Jets (7-9): 93.2%


2018 New York Giants (4-12): 12.5%

2020 Pittsburgh Steelers (12-4): 20%

2018 New Orleans Saints (13-3): 27.2%

Top 10 Highest All-Time 2017-2023 (224 seasons)

2017 Tampa Bay Buccaneers (5-11): 96.3%

2019 Tampa Bay Buccaneers (7-9): 96%

2019 New York Jets (7-9): 93.2%

2021 New England Patriots (10-7): 90.9%

2021 Indianapolis Colts (9-8): 90.3%

2020 New York Jets (2-14): 90.2%

2018 New York Jets (4-12): 88.5%

2020 Cleveland Browns (11-5: 87.7%

2023 Indianapolis Colts (9-8): 87.5%

2023 Carolina Panthers (2-15): 87.2%

Top 10 Lowest All-Time 2017-2023 (224 seasons)

2018 New York Giants (5-11): 12.50%

2020 Pittsburgh Steelers (12-4):  20.00%

2018 New Orleans Saints (13-3): 27.27%

2017 Pittsburgh Steelers (13-3): 32.00%

2020 Houston Texans (4-12): 32.65%

2021 Pittsburgh Steelers (9-7-1): 33.33%

2019 Philadelphia Eagles (9-7):  33.33%

2021 Atlanta Falcons (7-10): 33.33%

2017 Chicago Bears (5-11): 33.90%

2020 New Orleans Saints (12-4): 36.00%

Most Doutbful Designations from 2017-2023

New York Jets: 100

Least Doubtful Designations 2017-2023

New Orleans Saints: 1

Super Bowl Champions Questionable Rates by Year

2017 Philadelphia Eagles: 38.89%

2018 New England Patriots:  65.59%

2019 Kansas City Chiefs: 53.13%

2020 Tampa Bay Buccaneers: 70.83%

2021 Los Angeles Rams: 78.38%

2022 Kansas City Chiefs: 61.54%

2023 Kansas City Chiefs: 54.55%

Looking at how practice squad elevations impacted the questionable rates, it only went up 3.47% from 2017-2019 to 2020-2023. This indicates that extra players available did not make a team more conservative, instead, it made them go the other way in terms of playing rates.

Finally, looking at who had the biggest swings in questionable rates from 2017-2020 to 2021-2023, there were some fairly notable swings in questionable percentages. 

Minnesota Vikings -22.3%

New York Jets -18.9%

Baltimore Ravens -12.2%

Houston Texans 28.1%

Jacksonville Jaguars 22.1%

Pittsburgh Steelers 18.5%

Looking at the Bills, we can compare how each season breaks down against league averages, the types of injuries, and frequency. 

9-7 record
Total Questionable designations/Questionable played: 47/33 = 70% play
Soft tissue questionable/played: 9/5 = 55%
Back questionable/played: 6/4 = 67%
All other questionable/played: 32/24 = 75%
OUT (28 total): Soft tissue (5) 18%, Concussion (6) 21%, Sprain/Tear/Contusion (17) 61%

6-10 record
Total Questionable designations/Questionable played: 32/17 = 53%
Soft tissue questionable/played: 4/1 = 25%
Back questionable/played: 1/1 = 100%
Concussion questionable/played: 3/1 = 33%
All other questionable/played: 24/14 = 58%
Doubtful/played: 2/0 = 0%
OUT (21 total): Soft tissue (4) 19%, Concussion (6) 28.5 % Sprain/Tear/Contusion (11) 52.3%

10-6 record
Total Questionable designations/Questionable played: 38/22 = 58%
Soft tissue questionable/played: 14/5 = 36%
Back questionable/played: 2/2 = 100%
Concussion questionable/played: 3/3 = 100%
All other questionable/played: 18/12 = 66.6%
Doubtful/played: 1/0 = 0%
OUT (19 total): Soft tissue (6) 30%, Concussion (1) 5.2% Sprain/Tear/Contusion (12) 63.1%

13-3 record
Total Questionable designations/Questionable played: 40/26 = 65%
Soft tissue questionable/played: 12/8 = 67%
Back questionable/played: 0/0 = 0%
Concussion questionable/played: 1/0 = 0%
All other questionable/played: 27/18 = 66.6%
Doubtful: 0/0 = 0%
OUT (27 total): Soft tissue (12) 44%, Back/Neck (1) 3.7% Concussion (2) 7.4% Sprain/Tear/Contusion (12) 44%

11-6 record
Total Questionable designations/Questionable played: 26/16 = 61.54%
Soft tissue questionable/played: 5/2 = 40%
Back questionable/played: 0/0 = 0
Concussion questionable/played: 0/0 = 0%
All other questionable/played: 21/13 = 62%
Doubtful: 3/0 = 0%
OUT (11 total): Soft tissue (2) 18%, Back/Neck (1): 9%, Concussion (1): 9%, Sprain/Tear/Contusion (7): 63%

13-3 record
Total Questionable designations/Questionable played: 38/21 = 55.2%
Soft tissue questionable/played: 9/4 = 44.4%
Back questionable/played: 0/0 = 0
Concussion questionable/played: 0/0 = 0%
All other questionable/played: 31/17= 54.8%
Doubtful (1 Soft Tissue: 3/0 = 0%
OUT (28 total): Soft tissue (5) 17.8%, Concussion (1): 3.5%, Sprain/Tear/Contusion (7): 78.5%

11-6 record
Total Questionable designations/Questionable played: 27/12 = 44.44%
Soft tissue questionable/played: 1/1 = 100%
Back questionable/played: 0/0 = 0
Concussion questionable/played: 3/2 = 66.7%
All other questionable/played: 17/11 = 64.7%
Doubtful: 0/0 = 0%
OUT (24 total): Soft tissue (6) 25%, Back/Neck (2): 8.3%, Concussion (1): 4.1%, Sprain/Tear/Contusion (7): 62.5%

*One note, these are more accurate as they have been checked against Pro Football Reference and they have been notified of the two errors.

The Bills dropped from 62.4% to 59.2% since the last time this was addressed in 2021. Despite the drop, this only slightly changed their overall position in the league, moving to 25th from 21st. This was despite being the third most conservative team over the last three seasons at 53.8%.

The Bills have always erred on the side of caution with their players, regularly below the cumulative league average every year except 2017. 

Why this is, there could be a variety of reasons. It could be the acuity of the injuries, how they rehab their players to minimize re-injury, their philosophy, etc.

It could even be the amount of staff available as this is a complaint in the latest NFLPA player survey. The team ranked relatively low in the number of physical therapists on staff with Joe Micca and Nate Breske the only licensed PTs. They do have Denny Kellington, Marissa Figueroa, and Tabani Richards as ATs, but 5 total people to treat upwards of 90 players during training camp and 70 during the regular season. It’s a tough task for even the most talented rehab specialists. They do a great job, the players even note that, but more staff could lead to more player availability.

Maybe they don’t have the staff to keep up as much as they want which leads them to be more conservative. Maybe the players aren’t getting the full treatment available which means more time missed. This is all just thoughts thinking out loud because of one metric, the questionable designation should not reflect how an entire training staff operates. 

Injuries are random but how the teams manage the injuries is not. There has to be an insane amount of luck in winning a Super Bowl, but how they manage the injuries does not appear to be a huge factor. However, when the injuries occur in addition the volume and severity appear to be more of an issue. 


-All data is collected from Pro Football Reference. This is the most comprehensive source of information I have found to perform this assessment. I have at times found inaccuracies or incomplete information. However, using the same source does even the playing field.

-How effective were these players if they played through a questionable designation looking at snap counts or statistics?

-How do the rates of soft tissue injuries, concussions, strains in terms of playing for the Bills compare against the league when breaking their specific injuries down?

-More statistical analysis to evenly compare years against each other and the incidence of injuries as some teams either deal with a lot of injuries or report everything or teams avoid injury and don’t have a lot to report. The overall sample size must be evenly weighted.


The Buffalo Bills have been one of the best teams over the last several years despite being one of the more conservative teams in the league when it comes to playing questionable players. They have trended over the last few seasons to be one of the top-five most conservative teams when looking at questionable designations playing on game day. They are trending towards a team that is close to a 50/50 split on whether a player plays.

The only way they can improve is to potentially manage the workload of guys throughout the season or find a way to not get hit with injuries at the very end. They have the depth necessary to win games, and they are conservative, but being more aggressive doesn’t always translate into a better record either. Instead, it can have the opposite effect. 

This is always a fascinating look into how the team operates and manages injuries in comparison to teams around the league. I believe with this data, there are more conclusions to be taken from this amount of information and future analysis could take place. If you read this and have ideas, please reach out for further discussion. 

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