Joshua Palmer’s 2025 Season: The Injuries Behind His Difficult Year

The 2025 season was simply hell for Buffalo Bills WR Joshua Palmer. Injuries started almost immediately after signing his free agency deal after coming from the Los Angeles Chargers. A heel injury during OTA’s forced him to miss time as he began to learn the offense. Once training camp started, a groin injury lingered throughout the early portion of camp, intermittently causing him to miss time. 

Once the regular season started, Palmer started hot with 14 receptions and 234 yards before a hip drop tackle by Atlanta Falcons CB Dee Alford led to a significant injury. 

Palmer missed three games and four weeks total with the bye before he returned in Week 11. He continued to attempt to play before missing another two games in Weeks 13 and 14 before struggling to Week 18 and then placed on injured reserve. Following the injury, he only had 8 receptions for 69 yards and was highly ineffective. 

For most of the offseason, Palmer was not open to discussing the injury, only revealing that he did not undergo surgery. He rehabbed all spring and finished right before mandatory minicamp. 

On Thursday during his appearance on One Bills Live, Palmer revealed that he suffered a high-ankle sprain, MCL sprain, and slight tear of his hip labrum. 

He begins discussing the injury at the 1:10 minute mark by clicking here.

There were reports that Palmer could not run his whole route tree which is why the team shut him down for the playoffs. Considering all the damage he suffered, it’s amazing that he was able to run at all gives how each major joint in his leg was injured. 

Today’s article breaks the various structures involved and explains why playing through the injury became so difficult. 

Hip Anatomy

The labrum is a ring of fibrocartilage that helps deepen the socket for the femur to stay in place during movement. Much like the labrum in the shoulder, the labrum is required in order to maintain stability in a ball-and-socket joint. The hip is composed of the head of the femur and parts of the pelvic bones of the pubis, ischium, and ilium. The three bones of the pelvis form the acetabulum, which is the socket that the head of the femur (ball) articulates with.

In order for the hip to function, numerous muscles attach to the surrounding areas that allow the hip to perform flexion, abduction, adduction, extension, internal rotation, and external rotation. 

Labral Tear

There are a number of ways that a labral tear can occur. It can be torn via trauma, particularly when the leg is forced into a shearing motion, specifically hyperextension, hyperabduction, or external rotation. In Palmer’s case, his hip went into hyper abduction and internal rotation. 

These types of motions would be seen with twisting, pivoting, or falling. This puts stress on the labrum and can tear with excessive force. Most tears occur in the anterior or front portion of the hip and can result in a radial flap tear, radial fibrillated, which is fraying, or instability which causes the labrum to become detached.

Sometimes, there is a singular event, such as trauma, that causes the labral tear. This is what happened in Palmer’s case. Other times, there is microtrauma in the area that eventually leads to the worsening and breakdown of the labrum. This could be sustained through activities such as running, weightlifting, jumping, etc. It’s common to find that the injury is present and a clear mechanism of injury is not known. He may have also had an impingement in his hip that was aggravated by the injury but that’s getting into extra unnecessary details for this topic.

Knee Anatomy

The knee acts as a hinge joint where the femur and tibia meet, connected by several ligaments including the ACL, PCL, MCL, and LCL. The meniscus is also present and acts as a shock absorber along with the patella that is the fulcrum for the knee for the quadriceps function. 

The MCL is the big thick ligament that runs on the inside portion of the knee and is the medial stabilizer of the knee. This ligament is stressed when a player cuts to the opposite side to protect the proper alignment of the knee. However, this is one of the most common injuries in football and is simply part of the game. 

MCL Sprain

The MCL is often injured when a player suddenly pivots or cuts with their foot planted or also known as a valgus force. We see this often when a player is tackled from the outside as they’re running, they make a sudden start pivot, or they twist the knee when the foot is planted. 

Ankle Anatomy

The ankle comes together as the result of the distal points of the tibia making up the medial malleolus, the fibula making up the lateral malleolus, and the talus which is the top bone in the foot. These are connected by various ligaments and the syndesmosis, a fibrous portion of tissue that connects the tibia and fibula together. This allows for weight-bearing through the legs and effective movement for all planes of movement for the ankle and activities such as walking, running, and jumping.

High-Ankle Sprain 

A high ankle sprain occurs when there is stress placed through the syndesmosis is typically external rotation along with dorsiflexion. This can be the result of a player getting rolled up on from outside the leg, the players foot can also be planted and the lower leg can be rotated outward such as a tackle coming from the opposite direction. Hyperdorsiflexion can also stress the syndesmosis if a player’s foot gets caught and sudden weight shifts the shin forward over the toes. 

Route Tree Limitations

So let’s break this down. Palmer had a high ankle sprain, an MCL sprain, and a slight tear in the hip labrum, all on the left side. Running forwards or backwards straight after some time off would have been possible, but painful. Most of the running would have been up on the balls of the feet and this would have been good enough for a go route, putting minimal stress on the knee and ankle relative to the other joints. These joints can also be braced or taped up for support. However, he may not have been able to reach top speed with the hip due to the labral tear catching every time with hip flexion or extension. The pain with that every step and the feeling of instability puts a damper on the ability to hit top end speed. 

As soon as he started working his various other routes into his tree, that’s where things got complicated. His injured ankle would have let him do post, dig, and curl routes cutting away from the ankle, but this puts increased stress on the MCL due to the valgus forces doing these same routes having to plant and explode off that leg. So even if the ankle could handle some of these routes, the knee would struggle and add the hip back in, then you add a rotational component where the hip is flexing, extending, and rotating against that tear, sending a constant dull ache or sharp pain through your groin as you cut to the right. 

Corner, out, comeback, and curl routes really stress the ankle working into that external rotation motion as he plants to go to the left to make his cut. The knee isn’t stressed as much but the twisting and pivot as he turns still affects the knee. The hip is once again affected with the same flexion, extension, and rotation going the opposite way causing pain and weakness, leading to a lack of explosiveness.

Going further, the comeback, curl, flat, and out routes can lead to a receiver to pivot, quickly turn, and sit down in the route to receive the pass, stressing the hip into flexion. Imagine doing that while the ankle just screamed at you from pivoting, you lacked explosiveness through the knee cutting, and then your hip zaps you as you sit to try to catch a pass from Josh Allen while a 250 lb linebacker is barreling down on you. 

Out of the nine routes in a route tree, Palmer could have done a Go Route and a Slant and those would have even been at less than 100 percent. That doesn’t make for a very effective wide receiver at all. 

We discuss in physical therapy the idea of a kinetic chain. This is where the body’s joints, muscles, and bones work together as a linked system. Everyone has heard the expression, “a chain is only as strong as its weakest link”. Palmer’s entire kinetic chain of his left leg was weak, literally and figuratively. We also see how if there is an injury in one area, that can lead to compensations in other areas in the forms of soft tissue or overuse injuries. Palmer was so badly injured, all he could do was further stress the already injured structures and aggravate them further. 

His situation in 2025 wasn’t about being tough enough, he physically could not do the football moves necessary to play. One or even two joints affected, alright. But all three? There’s simply nothing to push off of to be effective. I commend Palmer for even attempting to play through the injuries, but that was too much all at once. Should he have been placed on injured reserve for the season? Hindsight says yes, but if the player thinks he can play through it and they wanted to save IR spots or roster transactions, I can’t fault them for trying to rehab the injury. 

Palmer stated that he did not undergo surgery but if he had, a Tightrope procedure to stabilize the ankle could have helped and a hip arthroscopy to shave the labrum tear down would have been the likely procedures. However, the ankle was stable enough to not require surgery and hip labrums can be rehabbed without surgery, especially a slight tear. Palmer went on to say in the interview that he said when he tried to rehab one area, the others were affected. 

If any of the injuries were to affect him this season, my bet would be the hip if he has another event where he pivots or causes a shearing force through the previously injured area. The rehab team has worked him out but that would be the highest concern for injury considering he didn’t undergo surgery. The hip itself is something that he could get through and rehab more effectively in season anyway should he tweak the area.

Final Thoughts

Joshua Palmer got a lot of undue hate from the fanbase last year. 

Full stop. 

Part of that was the lack of production, part of that was being new to the team, and the final part was not knowing the full story. I really respect him for trying to play through these injuries knowing the money he was making and the duty to be out there for his teammates. 

My respect for him has drastically increased knowing how tough he is to try and play through this. I also commend the training staff for helping him to try and gut through this; this would have been an incredibly difficult rehab knowing all the structures involved. It would have been like playing whack-a-mole. You try to fix one problem, another one pops up. 

Palmer has repeatedly said how he feels better and he put the work in to get ready for 2026. We saw what he could do when he was close to 100 percent through those first six games. I don’t expect him to stay fully healthy because it’s football, but barring catastrophic injury, this is one player you could put money on to have a better 2026 season. 

Next time you see a player trying to gut it out or being less than effective, consider what they’re trying to play through or consider the person. So many people denigrate athletes or see them as a commodity. None of these players want to be injured. They know they want to contribute to winning and to have fun. They’re playing a kids game for a lot of money, most, if not all, are hyper aware of that. But to have your own fan base beat you down week after week by how bad you are when they don’t know the full story, that would be tough on anyone. 

I really admire what Joshua Palmer tried to play through in 2025 and we saw the struggles. But now that he is fully healthy, we should see a vastly improved Palmer in 2026 that can shed the negative narrative that enveloped him in 2025.

Here’s to hoping for a healthier Joshua Palmer in 2026. 

Top Photo Credit: IMAGN IMAGES via Reuters Connect