Buffalo Bills OT Spencer Brown Off-season Shoulder Surgery

Buffalo Bills OT Spencer Brown Off-season Shoulder Surgery

One injury that went under the radar this offseason was the surgery to OT Spencer Brown. Without teammate Dion Dawkins highlighting that Brown’s surgery derailed an offensive line trip, there wouldn’t have been anything to suggest there was an issue. 

However, as OTA’s ramped up this week, Brown was listed as a limited participation. On Tuesday, it was revealed that Brown underwent offseason shoulder surgery. 

Brown had battled injuries throughout his collegiate and professional career, this is just the latest setback. Read below for an in-depth analysis on the potential injury, the anatomy, when the injury happened, return to play timeline, and potential concerns. 

The Injury

While Brown did battle left shoulder and right knee injuries all last year, it appeared he injured his right shoulder in the playoff loss to the Kansas City Chiefs. 

During the first series, specifically on the ninth play, Brown had Dalton Kincaid line up on the outside of him as an extra blocker. Kincaid picked up George Karlaftis briefly before he got around the edge. Brown realized he was unable to keep Karlaftis outside after Kincaid disengaged, so he then went back inside to find his next block. He found Willie Gay and began to engage him with his right arm fully extended. 

 

You can see his arm extended in the All-22 video. Once Brown struck Gay, he immediately went down grabbing his right arm. On the broadcast view, Brown can be seen shrugging his shoulder and rolling it out briefly. 

Miraculously, Brown did not have to leave the game and continued to play in every offensive snap to finish the game. Based on the fact that he was able to finish the game but require surgery suggests that the shoulder subluxed, also known as partially dislocated enough to tear a portion of the labrum. This may have been presented as a SLAP lesion or Superior Labral Anterior to Posterior tear. This signifies the area that was torn as seen in the picture below. 

Credit: JointRehab.com

It’s possible that Brown would have been able to play the following week with a shoulder harness but not a guarantee. His arm would have been weak as he lifted overhead and engaged with his blocks, leading to further instability. This would be noticed when he went to engage his block with his arm extended, the force pushing back through his arm would have pushed on the shoulder joint and led to further instability or an outright dislocation. 

Since the Bills were eliminated from the playoffs, Brown’s tear was significant enough that they determined that surgery was required. It’s possible that he tore the labrum on the play above or had a previous injury that he was playing through with that final hit being enough to cause enough damage to require surgery. 

Shoulder Anatomy

The labrum is a fibrous layer of tissue in the shoulder that deepens the socket in which the head of the humerus articulates with the glenoid fossa of the scapula. This allows for stabilization to the shoulder joint and prevents the joint from separating during movement. Other structures including ligaments, muscles such as the rotator cuff, and connective tissue allow for additional support. Finally, the long head of the biceps tendon feeds into the glenoid and serves as an attachment for the biceps to contract. All these structures together help make up the shoulder joint and maintain stability through motion.

Credit. Matthew Provencher, MD

Mechanism of Injury

The labrum can be injured by a variety of mechanisms due to the makeup of the shoulder. As with all joints, with increased mobility, there is decreased stability. A shoulder can dislocate via a direct blow to the front of the shoulder or fall on an outstretched hand, also known as FOOSH, which can cause a posterior dislocation. In cases of anterior dislocation, an extreme distraction to the area such as sudden pulling or placing the shoulder in extreme end ranges in external rotation and abduction are possible mechanisms. To picture this movement, envision the cocked-back position of the arm when throwing an object.

Brown appeared to injure his shoulder similar to a FOOSH presentation when he had his arm extended to block Gay.

Surgery

Surgery is indicated when there is enough of a tear in the labrum that creates instability that conservative measures or bracing will not address. Anchors and sutures are placed to reattach the cartilage to the glenoid. 

Timelines for recovery are anywhere from four to six months though can be longer if damage is more complex. We know the surgery was sometime in late January after the playoff loss and before free agency when Dion Dawkins mentioned the surgery. Considering they have exit physicals after the season suggests he had surgery sometime in late January or early February. 

Update 6/4/24

Brown states that he dislocated the shoulder after the game when he went to activate the shoulder against the driver’s side door suggesting that this was the left shoulder he dislocated.

He did have the shoulder taped up all season suggesting he may have also had prior damage in there.

Considering the Bills are roughly four months removed from the last game, it is assumed that Brown is also roughly four months removed from surgery. According to research, timelines for return to play are roughly nine months with between 80 to 90 percent return to play.

There does not appear to be any decline in a return to performance, but there is anywhere from a 13 to 26 percent chance of re-tearing the labrum following repair. There is also a 58 percent chance of future instability within the shoulder in the future, but considering the frequency that offensive lineman suffer a torn labrum, this isn’t necessarily a concern.

The biggest issue is missed time should he suffer a new injury and future arthritis. Recurrent instability is in the mid-20 percent, but far less (50 percent) than if he didn’t have surgery. This is also an injury he could play through after some rehab and bracing if it does occur again. 

Outlook & Potential Concerns

It’s unfortunate that Brown is missing time while rehabbing, but considering he is limited in OTA’s and was pitching underhand at Micah Hyde’s charity softball game indicates he’s moving along well. This shoulder issue has the chance to have future issues, but will only be an issue if he has another mechanism of injury that leads to it being reinjured. There isn’t any concern for performance or career longevity once he returns and should be ready for training camp barring setbacks. 

I wish Spencer Brown the best of luck this season and to stay healthy. 

Top Photo Credit: BuffaloRumblings.com

Video Credit: NFL

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