The Buffalo Bills stayed put on Thursday night and at pick 30, selected Kentucky CB Maxwell Hairston. The speedy defensive back out of Lexington was seen as a Day 1-2 pick and had met with the Bills at both the NFL Combine and he was brought in for a Top 30 visit.
Hairston was named Second-Team All SEC in both 2023 and 2024 along with an honorable mention All American in 2023. He was also one of the fastest players at the Combine with a 4.28 40-yard dash, putting him in elite company. He was able to have such a great combine despite missing considerable time during the season.
Below is Maxwell Hairston’s publicly reported injury history and analysis.
Injury History
2022 Kentucky
Undisclosed injury, vs Vanderbilt, missed 1 game.
According to Hairston’s game logs, he missed the contest against Georgia in 2022. There are no reports of why he missed or what he was dealing with.
2023 Kentucky
Right wrist/thumb injury, vs Vanderbilt, missed 0 games.
Hairston was spotted with a cast on his right wrist with extra support on his thumb area. This was first spotted against Missouri but looking back, he had a cast on the area dating back to Florida of that season. This suggests he injured the area against Vanderbilt. The presence of this cast strongly suggests he broke his thumb or one of the wrist bones on the radial side.
He later had to briefly exit the Gator Bowl with a right wrist injury at the end of the season but he was not wearing a cast on the issue at that point.
2024 Kentucky
AC Joint sprain, Shoulder infection, missed 5 games.
Hairston was forced to leave the contest against Ohio with a shoulder injury. This happened at some point during the second defensive series. He left the game for further assessment but was able to return late in the third quarter and secure an interception and return it for a touchdown. He was then forced to miss the next five games and seven weeks total.
Buffalo Bills Injury Analysis
Looking at his injuries as a whole, the right wrist injury is not an issue as that appeared to be a fracture and was addressed at the time. Those are typically one-off issues.
The biggest issue that Hairston dealt with was his shoulder injury in 2024. There initially wasn’t many details as to what the exact injury was but there are several clues as to what may have happened.
Here is the clip where both of his shoulders took most contact and then he exited for the final defensive series in the first quarter.
He was able to later return to the game in the third quarter and get a pick-six. He also did not have any notable braces or harnesses on his shoulder when he returned or later in the season.
Later reports had stated that he had to go to the hospital for further evaluation ahead of the upset win over Ole Miss the following week. He also described the injury as a freak accident and downplayed any durability concerns.
Not having the exact mechanism of injury or any additional details made it incredibly difficult to clearly identify a risk. The reports also suggest he was in the hospital for several days as the Ohio game was on 9/21 and the Ole Miss game was played on 9/28 with Hairston texting his teammates to “continue to work.”
The initial thought was that he suffered a sternoclavicular joint sprain. However, he was able to return later to the Ohio game and finish the game. The video available doesn’t show much as to what could have possibly happened.
If this was a SC joint sprain that required further assessment due to an aggravation in practice, this would at least make sense to miss the extended time. In 2019, Tyreek Hill suffered a posterior SC joint sprain and missed four games before returning. In 2012, Danny Amendola suffered the same injury and missed three games. Both later required a brief hospitalization to correct the issue.
There are certainly other possibilities but without more information, we are left guessing.
Update 4/25/25
According to Aaron Gershon, Kentucky Wildcats beat reporter, Hairston had an infection that required hospitalization. This was revealed during his appearance on SHOUT! A Buffalo Football podcast. I reached out to Aaron following his appearance and he was unable to add any more info other than Hairston attempted to play through the injury during the Ohio game. This suggests he may have originally injured the shoulder against Georgia or even earlier.
Considering he had to be hospitalized prior to the Ole Miss game, this suggests that he dealt with either an infected bursa in his shoulder or he developed septic arthritis. This is a condition where an infection develops in a joint, most commonly seen in the knees, shoulders, hips, and ankles. The cause can be attributed to bacteria, virus, or fungi. If there was an open wound due to turf burn or getting cut, this could have been an entry point for the foreign material to enter the body. Staphylococcus aureus is a common bacteria that is found in these infections.
Joint trauma can also be a primary cause and combined with an open wound can bring about the infection. This isn’t a common injury or even the first line of thought when discussing injuries, but this helps explain the timeline he missed.
Hairston attempted to play through the injury according to Gershon. Hairston likely developed a fever later with decreased range of motion, increased pain and illness are common symptoms. It’s not clear what interventions he underwent once in the hospital, but he very likely underwent a course of antibiotics, joint drainage or possible debridement of the shoulder area to possibly the AC joint.
There are a few cases in the literature of septic arthritis including to a 14 year old football player. He underwent a treatment of antibiotics after having an insidious worsening of symptoms after initial onset of pain three weeks prior. He was required to take an oral antibiotic for six weeks and then cleared to return to activities. This strongly fits the timeline that Hairston had missing seven weeks total.
Another case from a case study from 1995 in a collegiate football player. This presentation showed a more acute case, requiring immediate intervention and treatment, forcing the player to miss 22 days before returning.
Finally, while this is not exhaustive, there are two notable professional cases over the last two decades. Peyton Manning underwent knee surgery to remove an infected bursa and would be out four-to-six weeks. This occured in July 2008 after he had been dealing with the issue since February 2008 managing it conservatively. While that case was drawn out, a more acute case was Raiders DE Maxx Crosby. He dealt with a bursa injury that he continued to play through where he eventually developed septic arthritis but insanely, did not miss any time.
Once the infection is addressed and function restored, there are not any long term concerns other than being vigilant for any new onset of symptoms.
Update 4/27/25
According to Ryan O’Halloran of The Buffalo News, Hairston suffered a separated shoulder or AC joint sprain in the game against Ohio but finished the game. He received an injection at some point to numb the pain in order to play through the injury. This is a very common procedure that allows players to return quickly.
Unfortunately, one of the needles “was a little messed up” which caused an infection and forced Hairston to be hospitalized. This likely caused the septic arthritis as mentioned above.
Final Thoughts
The Bills have historically shied away from picking injury risks in the first two rounds. I had initially thought Hairston was a risk due to the time missed in 2024. Due to the fact that he had a likely fracture and an infection in the shoulder, this reduces his risk for further issues considerably. Brandon Beane even confirmed the health of his shoulder on Thursday night.
This is a pretty rare issue less of an injury and more of an acute issues. His injury history is pretty clean otherwise with no lingering issues. Overall, there aren’t any major faults in the Bills selecting Maxwell Hairston.
I would like to wish Maxwell Hairston a warm welcome to the city of Buffalo and to remain healthy this season.
Top Photo Credit: SBNation.com
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