The Buffalo Bills concluded their first week of Phase 3 OTA’s, getting on the field for the first time as a team on Tuesday. Everyone has been in attendance so far other than RB James Cook who continues to stay away from voluntary practices as he seeks out a lucrative contract extension.
As with each return to the field, new injuries and updates along with observations coming out of practices. While many of the issues are rather minor now at this time, they can also somewhat predict potential issues in training camp and during the regular season.
Below are the injury updates, observations, and news coming out of the first week of Phase 3 OTA’s.
New Injuries
DE Joey Bosa (Calf)
On May 22, Bosa suffered a calf strain while working out during Phase 2 OTA’s. The team decided to shut him down for the remainder of the spring but the expectations are that he will be ready for training camp.
While the level of severity is not known, this may have been a more ill-timed injury given the remaining practice schedule.
To read more about the injury, check out the article written earlier this week, click here.
Injury News
TE Dalton Kincaid (Right Knee)
News came out about the specific injuries that Dalton Kincaid dealt with last season after a detailed interview with Jay Skurski of The Buffalo News.
In the article linked here, Kincaid discussed a variety of topics but when injuries came up, he confirmed the PCL sprain in his left knee suffered against the Indianapolis Colts. In his right knee, he suffered a Morel-Lavallee lesion.
A Morel-Lavallee lesion is the result of a direct blow to an area where the dermis shears away from the deeper tissues. This is a closed traumatic soft tissue degloving injury. This is more often seen due to falls resulting in hip fractures but can be seen in other joints.
Symptoms include ecchymosis, swelling, fluctuance and skin hypermobility in the polytrauma patient with underlying fractures. Fortunately for Kincaid, he did not have a fracture and it was more localized in his knee.
Treatment involves compression therapy to manage the swelling and allow the underlying structures to heal. Draining the area can help manage the issue but depending on the severity and location, he may have required it but placing a needle in the joint could have also led to infection. With large enough lesions (>50 cm), these require surgery, but conservative management is preferred. Kincaid stated that he did not require surgery in the offseason.
There is a 55 percent recurrence in the non-operative cases, but the risk increases with larger lesions.
Looking back, it appeared as though he suffered this injury in Week 16 against the New England Patriots when he landed on his right knee.
He was later seen wearing a compression sleeve on the area during practice in the playoffs. Even later on in the offseason, he was wearing a sleeve.
This is something I have seen clinically but as a secondary issue. I do not recall seeing the phrase “Morel-Lavallee” but I have seen countless motor vehicle accidents, hip fractures, and other traumas that likely had this. If we see Kincaid continue to battle with this knee injury in training camp or show up on the injury report again, this could be a reason why.
OTA Observations
DT Deone Walker (Back)
Not much news has been added since OTA’s started regarding the status of Deone Walker other than he’s been still participating in positional drills. They have yet to get him involved with more play on the field but that has been the plan all along to bring him along slowly to avoid overstressing his back.
The Bills have a clear game plan on how to progress him and they are sticking to the plan. I don’t expect to see him do anything notable until the second week of training camp when the players are cleared for full contact after their ramp up period.
To read more about his back condition, click here.
TE Dawson Knox (Left Knee)
Knox has been dealing with a left knee issue dating back to at least late April based on the tape on the area observed in the two pictures.
Looking at the location of the tape in both of the pictures, it’s possible he is dealing with an IT band issue in his knee. The IT band or iliotibial band is a strong band of fascia that runs on the outside portion of the leg connecting at the hip and knee as seen below.
This band assists with hip extension, hip abduction, and lateral hip rotation at the hip. At the knee, it assists with knee flexion and extension based on knee position. Considering the tape is at the knee, he’s more likely dealing with IT band irritation at the fibular head. This would present with a burning pain and inflammation. The tape can help manage inflammation during activity to prevent exacerbations. This is common due to overuse from running due to tightness of the IT band. This could also lead to patellofemoral pain syndrome which is where the patella or kneecap tracks abnormally.
Whatever the issue is, the team is managing it and we haven’t seen Knox not practicing. These things are worth noting but this is more of a maintenance issue rather than this worsening into something more severe. Surgery may be indicated to remove a bursa or cyst, but this is rarely needed.
Final Thoughts
Thankfully there are not a lot of issues right now after this first week. The team will continue to ramp up their activities and there will continue to be updates regarding observations and injury reports.
Top Photo Credit: Megan Briggs/Getty Images
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