That was an incredibly rough game. That is said regardless of the outcome but this wasn’t the outcome anyone wanted. The Bills lost a close 23-19 game to the Houston Texans to drop to 7-4 on the season. In a game that was needed to keep pace to win the AFC East, the Bills did not do it and will now have to settle for a Wild Card spot barring a New England Patriots collapse.
The Bills got beat up in every facet of the phrase “beat up”. They were picked apart defensively in both the run and passing games, constantly sacked and stopped offensively, and absolutely beat into the ground from an injury perspective.
Read below for all the injuries coming out of Thursday’s loss.
In Game Injuries
WR Khalil Shakir (Concussion Check)
Shakir was the first injury issue of the night when he was tackled near the line of scrimmage and came up shaking his head, prompting a call down from the independent spotters for a concussion check. He was quickly assessed and cleared to return.
QB Josh Allen (Left Shoulder Stinger/ Funny Bone)
Allen put a scare into everyone early on when he slammed into the turf following a tackle by Will Anderson as seen below. The initial concern that he injured his right hand after seeing his hand sandwiched between the football, the ground, and having Anderson’s brace scrape over the top.
However, an alternate angle showed the left shoulder driven into the ground and Allen confirmed that his left shoulder went numb briefly, forcing him out of the game. This was a compression of the brachial plexus in the shoulder which caused all the widespread numbness.
He did not require any further medical attention on the sidelines and returns to play the next offensive series.
Allen later got shaken up late in the game with 58 seconds left in the fourth quarter when he was sacked again, hitting his funny bone. He can be seen shaking out his hand later in the clip.
This is something he has dealt with several times before including last year. This is more of a situational thing and should not affect him moving forward though he is subject to further hits while he tries to runs out of a collapsing pocket.
Update: Team notes that Allen is “sore” but overall fine.
FB Reggie Gilliam (Undisclosed)
Gilliam briefly went into the medical tent during the first quarter around the same time Josh Allen was injured in the first quarter. Looking back at the film, his only snaps were on the kickoff return before the offensive series and on the punt to end that series. If he tweaked something then, it wasn’t available on broadcast.
This may be something we wait for on All-22.
Update: It’s not clear what Gilliam did that earned a trip to the medical tent. He does appear to block his man and then roll out his left arm a little. Whether this was a shoulder or elbow issue, he was wearing a sleeve on his elbow during the week in practice. He was in the medical tent right before the Josh Allen hit and was able to exit rather quickly.
OT Dion Dawkins (Concussion Check)
Dawkins was seen on the sidelines discussing something with Head Athletic Trainer Nate Breske with an update later reporting that he was being assessed for a concussion.
Neither angle show a clear hit to the head but if he got blocked up underneath and snapped his head back as Breske appeared to motion, this could have caused a spotter to signal down. Whatever caused the injury, he was cleared and returned to the game.
CB Christian Benford (Left Shoulder)
Benford was slow to get up after a tackle on Dalton Schultz with Schultz appearing to kick him in the shoulder as he fell down.
He was holding his left shoulder coming off the field and walked into the locker room before returning in the second half. This may have been more of a hurt than injured situation but something to monitor if he shows up on the injury report next week.
LB Terrel Bernard (Right Elbow)
One of the more significant injuries of the night was when Bernard went down trying to tackle Nick Chubb and got his right arm sandwiched when Matt Milano came in to assist with the tackle.
He was in immense pain as he laid on the ground with the athletic trainers assessing him. He was able to walk off the field and later ruled out with an elbow injury. Based on the video, he appeared to suffer an elbow hyperextension with the possibility of a subluxation as suggested by friend Dr. David Chao.
I did have a fear that there was a fracture at the forearm where Milano’s helmet hit, but the designation of elbow indicates that this was more likely the hyperextension. Whether this was a hyperextension or subluxations, there was notable trauma to the joint. We have seen several elbow hyperextension injuries including Jordan Poyer in 2022 and Dorian Williams in 2024. Poyer’s elbow injury appeared to be more serious and caused him to miss time in the preseason and regular season while Williams was limited but did not miss any games.
Further testing must be performed to determine the extent of the damage but it’s realistic that Bernard could avoid missing time with the mini bye. If he does miss, I wouldn’t expect more than one or two games while the elbow heals. When he does return, he will have to wear a hinged elbow brace and may have difficulty blocking and tackling.
I would prefer he sits out one game to give himself time to rest, but he may try to play through this like many of his other injuries.
Update: Bernard is week-to-week which means he will miss the next game and the team isn’t ruling out a possibility that IR is on the table.
CB Maxwell Hairston (Concussion)
Hairston immediately grabbed his head once his face mask made contact with Woody Marks with 7:29 in the third quarter. He was briefly assessed by the medical staff before later being whisked into the locker room. It was announced that he was being evaluated for a concussion but no further update came out and he did not return to the game, indicating that he suffered a concussion.
This is his first known concussion according to my research which means it remains to be seen how long he will be out for. With the mini bye, the hope is that he can pass through the protocol for Week 13, but we need to see what we can do in practice.
Update: Team confirmed he is in concussion protocol.
C Connor McGovern (Left Leg)
McGovern was slow to get up with 8:20 left in the third quarter when he was hit from the right and fell onto his left knee. Reports later indicated that he was having his left leg evaluated but he did not miss any time and was able to return the next series. This may have been a more hurt than injured.
OT Spencer Brown (Right Shoulder)
Another concerning injury was when Spencer Brown was eventually forced out of Thursday’s game due to a right shoulder injury. He originally went down on the same play Connor McGovern was injured, but that was the result of playing through a shoulder injury on several plays.
Looking at the video, he delivered a block with 9:03 left which forced his right arm back into a 90/90 position badly before he fell down. He struggled through the rest of the game blocking Will Anderson with one arm before the team decided to sit him in favor of Ryan Van Demark.
Looking at how the arm is forward flexed and abducted as he engages his block with his right arm, I do have concerns that he suffered a labrum tear. This is evident with the heavy shoulder harness that he put on afterward and tape to secure the brace as seen in the tweet above.
Following the game, he was seen in the locker room with a sling further supporting some type of instability. There is a possibility this is also a rotator cuff tear but I’ll put my money on the labrum tear.
If this a labrum tear, this would be an injury to the right shoulder whereas he tore his left shoulder labrum in the playoffs in 2023 and underwent surgery.
This is something he can play through and get it fixed later, but it wouldn’t surprise me if he missed one or two games for him to get right for the final stretch. There is a distinct possibility he misses no time either but once the team gathers more information, then a reasonable timeline can be established.
Update: The team confirmed that he was medically ruled out on Thursday. They are also still evaluating which means there may be second opinions or seeing how he responds to rehab before they make a determination for his status which potentially includes injured reserve.
DE AJ Epenesa (Neck)
Epenesa got his head compressed briefly on a tackle in the fourth quarter seen below.
After returning to the sidelines, he was motioning to the back of his neck and was later cleared to return with a neck designation. He potentially suffered a stinger which is why he was cleared to return. Right now, this injury does not appear that it should linger.
Other Observations
TE Dawson Knox (Right Shoulder)
Knox was spotted early in the game when he missed his first pass down the right sideline. TV cameras caught his right shoulder taped up which was new as he has barely been on the injury report this year and not with a shoulder designation.
WR Mecole Hardman (Left Calf)
Hardman was placed on injured reserve ahead of Thursday’s game after suffering the injury in Week 11 against the Tampa Bay Buccaneers. He is eligible to return in Week 16 though he may not be needed.
Final Thoughts
Frankly, I barely got to watch most of the game because I was grabbing all the injury information as it happened. I also guarantee you there are injuries that will be on the injury report next Wednesday that are mysteries to us.
This mini bye helps hit it doesn’t help with the playing on short rest following Thursday’s game. It was an ugly game and this loss hurts more because, as Bills fans, we expect them to win and when it doesn’t go our way, that’s when you see people on social media melting down.
The team is still 7-4, they’re playing a first place schedule and they’re not winning games they should be taking care of. We’ve been down the road before with the team floating around at .500 before they go on a run, but right now, who is healthy enough for this to happen?
It’s going to be a rough couple of days to digest this loss and the fallout from all of the injuries. Stay tuned for the latest information coming out of press conferences and practices.
Top Photo Credit: Mark Konezny-Imagn Images
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