Every year, the Buffalo Bills deal with injuries that appear to be ill-timed or significant enough to alter the course of a season. While injuries are a part of football, the way each NFL team manages those injuries varies significantly. What is deemed questionable by one team is doubtful for another and in other cases, ruled out. Even those questionable, how likely is it that they suit up? Questionable should be a 50/50 shot, but league data shows a significantly different story.
Back in 2021, the question was posed to me through a Locked On Bills Herd Mentality submission. This has spawned a deep dive into how NFL questionable rates work and how the Bills stack up.
Read below for a deep dive into NFL and Bills metrics, along with designated to return breakdowns and specific rates for Bills 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.
Updated statistics and analysis from 2021-2023 can be found here.
To keep things consistent, some parameters were put in place.
PARAMETERS OF THE ANALYSIS
- All information was gathered from Pro-Football-Reference.com
- The timeline for assessment was 2017-2024, which 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 of 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
RESULTS
-Overall, the league average from 2017-2024 for questionable designations that ultimately played was 68.26%
-This was a .15% increase from the overall average from 2017-2023. This number has fluctuated over the years, with a high of 73.89% in 2021 and a low of 64.84% in 2019.
-The league average for doubtful players that ultimately played was 1.25%. This is a .21% decrease from the overall average from 2017-2023, which was 1.44%. This continues to show a downward trend of doubtful players playing, when the number was 1.77% from 2017-2020. It’s also important to note that no NFL team had a doubtful player play last season. Finally, only 10 teams over the last eight seasons have even had one player play with a doubtful designation. The Packers have had three players over that span, while the Buccaneers have had two.
-Team Record has no notable bearing on questionable rates or injuries, for that matter.
Results
The three teams with the highest frequency of instances of the questionable designation in 2024:
New England Patriots: 96
Carolina Panthers: 67
Tampa Bay Buccaneers: 55
The three teams with the lowest frequency of instances of the questionable designation in 2024:
Pittsburgh Steelers: 4
Denver Broncos: 5
Kansas City Chiefs: 7
The three teams with the highest frequency of questionable players playing in 2024:
Tampa Bay Buccaneers: 94.83%
Indianapolis Colts: 88.24%
Los Angeles Rams: 83.33%
The three teams with the lowest frequency of questionable players playing in 2024:
Pittsburgh Steelers: 22.22%
Denver Broncos: 41.67%
Buffalo Bills: 44.9%
The wild thing about those injury rates is that five out of the six teams were all playoff teams in 2024.
Looking at specific years for use of the questionable designation players playing, Tampa Bay owns the three highest totals over the last eight years:
2017 Tampa Bay Buccaneers (5-11): 96.3%
2019 Tampa Bay Buccaneers (7-9): 96%
2024 Tampa Bay Buccaneers (10-7): 94.83%
The lowest use of the questionable designation players playing, Pittsburgh owns two of the three lowest totals over the last eight years:
2018 New York Giants (4-12): 12.5%
2020 Pittsburgh Steelers (12-4): 20%
2024 Pittsburgh Steelers (10-7): 22.22%
Looking at Super Bowl Champions, there continues to be a weak correlation between being conservative versus aggressive, with rates varying year to year.
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%
2024 Philadelphia Eagles: 62.5%
Even looking at the Kansas City Chiefs, they are the only ones that show some level of consistency, as they are the only repeat champions during this timeframe. The sweet spot appears to be between 50-60% indicating that players who are injured can play and be effective. Several teams have been more successful in having injured players contribute, but some have been more conservative and still won.
There still appears to be a certain amount of luck that goes into winning a championship despite having elite players, units, and health.
Buffalo Bills Questionable Injury Rates 2017-2024
Diving deeper, looking at the Buffalo Bills, they had questionable players play at 56.90% from 2017-2024, but notably, there is a difference between 2017-2020, when the Bills had a questionable rate of 62.42% but dropped down to 50.71% between 2021-2024. Later in the article is the yearly results of the questionable designation players suiting up.
This was likely due to continued changes in how injured reserve works, with the number of designations from injured reserve allowed. Practice squad elevations also played a part in this, which allows more starters to recover more from their injuries. The only team with a lower rate of questionable designations playing from 2021-2024 was the Minnesota Vikings, with 50.41%.
Looking league-wide, over that timeframe, the questionable rate from 2017-2020 was 66.67% and 2021-2024 was 69.32%, an increase of 2.65% over the eight years.
Why the Bills got more conservative over the years versus more aggressive compared to the league is interesting.
One additional bit of information that can be added to the data is how teams use the injured reserve designation to return spots. Each team uses eight spots during the season, and this gets expanded in the playoffs to 10, which is why you see the playoff teams have 10 versus 8.
Thank you to Chris Jahnke for curating this information. Make sure to give him a follow on X @RealChrisJahnke
Bills: 7/10
Dolphins: 7/8
Patriots: 5/8
Jets: 8/8
Ravens: 7/10
Bengals: 3/8
Browns: 7/8
Steelers: 9/10
Texans: 7/8
Colts: 8/8
Jaguars: 5/8
Titans: 3/8
Broncos: 7/10
Chiefs: 9/10
Raiders: 3/8
Chargers: 10/10
Cowboys: 6/8
Giants: 6/8
Eagles: 10/10
Commanders: 7/10
Bears: 4/8
Lions: 8/10
Packers: 3/10
Vikings: 7/10
Falcons: 5/8
Panthers: 8/8
Saints: 7/8
Buccaneers: 8/10
Cardinals: 6/8
Rams: 10/10
49ers: 7/8
Seahawks: 7/8
Many of the teams used either most of or all of their designated slots. The only conservative ones, using less than half, were the Packers, Bears, Raiders, Titans, and Bengals. Of those teams, only the Packers were a playoff team. While injuries are random, the management is more predictable. Of those teams, only the Packers and Bears had over 60% questionable players playing, whereas the other three teams were under 60%.
This analysis from Chris was also important to contextualize how teams operated with the IR list:
With my particular data collecting this year, I noticed that teams at the beginning of the year were very cautious not to use up their return from IR designations too quickly. By the end of the year, many teams were more liberal in using them up. Even if the team was eliminated from playoff competition. I found that the Bills used theirs fairly cautiously.
In addition, the only players to sit out four games and not go on IR around the league were Taron Johnson and Keon Coleman.
Finally, this is a year-by-year look at the Bills’ injury rates with a further breakdown of types of injuries.
2017
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%
2018
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%
2019
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%
2020
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%
2021
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%
2022
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%
2023
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%
2024
13-4 record
Total Questionable designations/Questionable played: 49/22 = 44.9%
Soft tissue questionable/played: 15/8 = 53.3%
Back questionable/played: 0/0 = 0%
Concussion questionable/played: 2/2 = 100%
All other questionable/played: 32/12 = 37.5%
Doubtful: 0/0 = 0%
OUT (27 total): Soft tissue (11) 40.7%, Back/Neck (1): 3.7%, Concussion (1): 3.7%, Fracture (5): 18.5%, Sprain/Tear/Contusion (9): 33.3%
LIMITATIONS OF THIS ANALYSIS
-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 information levels 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, and 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.
Conclusion
The Buffalo Bills continue to be one of the more conservative teams in the league when it comes to playing questionable players. This has not impacted their abilities to make the playoffs and succeed as they have the second-longest active playoff streak at six, only behind the Kansas City Chiefs. They have also had playoff wins every season since 2020, which is impressive, as this is tied for some of the NFL’s longest playoff win streaks.
You could make the argument that if the starters played through more injuries that the team would be more successful. The Kansas City Chiefs played questionable players at 77.78% and the Philadelphia Eagles were at 62.5%. However, the Bills have had nearly as much success as those teams, minus Super Bowl appearances, while allowing players to recover more fully.
Despite the Bills being more conservative in allowing players to rest rather than playing through injuries, this has allowed them to have more sustained success over a longer timeframe. This is also evident in how their depth performs when called upon. The one big issue that the Bills cannot shake, though, is the timing of those injuries. They have always seemed to appear at the worst possible moments, whether it be Tre’Davious White’s ACL tear, Terrel Bernard’s ankle, or Christian Benford’s concussion. No matter how aggressive or conservative a team is, the timing of injuries has been the most unfortunate.
What the training staff does week in and week out does work. They utilize every resource available to get their players healthy, including equipment, facilities, team depth, and the use of injured reserve. The players are ready to play when they come back, and if they do have to play through injuries, they are still at least serviceable. They also get players who should be missing time to suit up and play, even if they’re less than 100 percent. We will see how the new addition of Michael Micca as an AT/PT and Alyssa Lee as an Assistant AT will impact these outcomes. Hiring Will Greenberg as the Head S&C coach will have an impact on this season.
This continues to be an interesting exercise in how NFL teams manage their injuries and how successful each team is in getting their players ready every week.
Top Photo Credit: AP Photo/Adrian Kraus
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