The Buffalo Bills have had back-to-back seasons where they saw a significant uptick in severe injuries that eventually cost them in the playoffs, leading to divisional-round exits. They look to rebound by getting younger and cheaper at key positions to compete in the coming years while Josh Allen is still in his prime.
The team went 11-6, winning the AFC East and a playoff game for the fourth consecutive season. This was despite several significant injuries on the defense and subpar play from others. Following the season, the front office moved on from several tenured players in Tre’Davious White, Mitch Morse, Jordan Poyer, and Siran Neal. They also traded away Stefon Diggs and lost Gabe Davis in free agency.
Below are all the notable injuries from 2023 along with the new free agents and draft picks.
Offense | Defense | Free Agency | Draft Picks
Offense
TE Zach Davidson (Undisclosed)
Davidson was placed on injured reserve back in June after suffering an undisclosed injury in late May. He missed the entire season and the only clue that we have is that he has been wearing a sleeve on his right leg, suggesting that this was a lower-body injury.
He has been practicing all offseason suggesting that he is ready for 2024, eventually, we may get clarity on the injury specifics.
OT Tommy Doyle (Left ACL)
Doyle will not play in 2024 after suffering a knee dislocation that led to a torn ACL, PCL, and nerve damage that still has him wearing an ankle-foot orthosis (AFO) on his left ankle due to drop foot. He is still recovering from the injury and was placed on the PUP list, guaranteeing his salary for 2024. It’s not impossible to think he could come back in 2025 and continue his career, but a lot has to happen for this to occur. To read more, click here.
WR Justin Shorter (Hamstring)
Shorter missed all of last year with a hamstring injury suffered in the final preseason game?? that led to his placement on injured reserve for the season. The team did activate him to return to play late in the year if they could activate him, but there were not any injuries that would have led to him being activated. To our knowledge, he did not require surgery, but his presence on IR was likely a way to stash him to let him develop and transition to the NFL.
He has no restrictions coming into this season other than his performance in training camp.
TE Dawson Knox (Wrist fracture/ligament tear)
Knox suffered a wrist fracture with ligament tearing in the Week 5 loss to the Jacksonville Jaguars. He attempted to play through the injury the following two weeks with great difficulty. Knox was also pressed into service due to injuries to Dalton Kincaid and Quintin Morris. He underwent surgery to stabilize the scaphoid fracture with a pin and allow the scapholunate ligament to heal, missing five games.
Knox was able to return for the Week 14 contest against the Kansas City Chiefs and finished the season. He should have no restrictions heading into 2024.
OT Spencer Brown (Shoulder Labrum Tear)
Brown underwent surgery to repair the labrum tear in his shoulder suffered in the playoff loss to the Kansas City Chiefs. Based on his wording, he suffered a tear to his left shoulder when he leaned on his truck door, dislocating the shoulder. He did have to have tape on the shoulder all season indicating that he was having issues all season.
He was limited all off-season as he rehabbed and let the area heal. Considering his positional demands, it’s possible that he suffered a new tear in the labrum on either shoulder but the repaired injury has minimal concerns to re-tear. For more information, click here.
QB Josh Allen (Right AC Joint Sprain/RC Contusion/Neck/Right Finger)
Allen suffered a right shoulder injury in the win over the New York Giants in Week 6 that required brief medical attention at the time. He then spent the next nine weeks on the injury report with the shoulder injury before suffering a neck injury and finger injury in the win over the New England Patriots in Week 17 securing a first down late in the game.
The neck and finger injuries are of no concern but it was later revealed that Allen battled a rotator cuff contusion all season as the result of the concurrent hits and altered mechanics resulting from the AC joint sprain. To avoid pain, Allen had to alter how he threw the ball with his arm angle. These altered arm angles due to the pain/weakness in the shoulder further led to possible rubbing of the rotator cuff against the acromion due to the funeral head migrating higher in the shoulder socket, leading to further aggravation. The shoulder was out of balance due to the muscle injuries.
Allen continues to demonstrate why he is one of the most durable quarterbacks in the league but taking injuries to his throwing arm does raise concerns as he gets older. I do not expect his style of play to drastically change as he gets older. It does help having a competent backup in Mitch Trubisky back but I do expect Allen to get dinged up once again this season.
Defense
LB Matt Milano (Left Tibial Plateau Fracture)
Countless words have been written regarding the status of Matt Milano’s season-ending knee fracture back in Week 5. He finally returned to individual drills during a mandatory minicamp in mid-June and looked remarkably well moving around. The team has been cautious in slowly bringing him along to prevent any setbacks and he appears ready to go come training camp.
I do expect him to improve as the season progresses, knocking off the rust that comes with a long-term layoff. To read more, click here.
CB Kaiir Elam (Ankle)
Elam spent time on injured reserve last year after he battled an ankle injury, specifically a deltoid ligament injury suffered during the preseason, never fully healthy. He was placed on IR to get healthy and hopefully reset his confidence. He has battled ankle/foot injuries the past two seasons and hopefully with a new secondary coach, he can move with greater confidence and reduce his injury risks.
DT DaQuan Jones (Torn Pectoral)
Jones tore his pectoral muscle in his chest in the Week 5 loss to the Jacksonville Jaguars, sending him to injured reserve for three months. He was able to return in Week 17 and contribute heavily during the Bills playoff push and into the playoffs.
There are zero concerns for re-injury to the area as he has been able to continue to rehab in the offseason and prepare for 2024. Unless he has another similar mechanism of injury, Jones should be at 100 percent heading into the season.
LB Baylon Spector (Hamstring strains/Back)
Spector dealt with an ill-timed hamstring strain in the final preseason game that saw him placed on injured reserve for the first five games of the season. When he returned, he played for two games before suffering a re-injury to the same hamstring, costing him another three games. He was able to finish the season avoiding the injury report before suffering a back injury in the Wild Card win over the Steelers.
There is concern that he will continue to suffer nagging injuries that will limit his availability and chances to make the roster again this year.
DE Greg Rousseau (Right Foot Fracture)
Rousseau was slowed by a non-displaced foot fracture suffered against the Miami Dolphins in Week 4 when Ed Oliver fell onto his foot. He missed the following week and labored through the injury as it slowly healed.
The fracture has since been healed and Rousseau has been able to train without restriction in the offseason. This injury was more unfortunate luck than anything else. There should be no restrictions heading into the season.
LB Terrel Bernard (Hamstring/Left Knee/Right Knee/Concussion/Right Ankle Sprain)
Bernard originally suffered a hamstring strain at the beginning of training camp which cost him the entirety of camp. Despite missing that time, he was still named a starter and backed up the coaching staff’s initial questionable decision. Bernard did not have any aggravation of the hamstring from what was reported but he did also suffer a left knee/quad injury following Week 2.
In Week 6, Bernard landed awkwardly and tweaked his right knee, possibly damaging his meniscus. He did not miss any time before suffering a concussion in Week 9, clearing to play in Week 10.
Finally, a right ankle sprain against the Los Angeles Chargers in Week 15 that he continued to play on. He then aggravated the injury against the Pittsburgh Steelers in the playoffs when his ankle hit the cold ground, leading to a subluxation of the joint and further damaging the ligaments in the ankle. Bernard was unable to practice all week before being listed as questionable. He ultimately was unable to suit up and missed the playoff loss to the Chiefs.
Bernard did not require off-season surgery, electing to rehab the injury instead. I do expect there to be residual laxity within the joint that he either wears some type of brace or has a strong tape job to support the area. However, if he does suffer a re-injury such as a lateral ankle sprain to the area, the added laxity will minimize new damage and should allow him to miss little time. He plays a physical game and unfortunately, I do expect him to suffer further injuries this season and make having a strong backup imperative at his position this season.
Free Agency
Click on each name for a more detailed breakdown of each player. Notable players below include Curtis Samuel, Dawuane Smoot, Deion Jones, and KJ Hamler.
Draft Picks
Click on each name below for a more detailed breakdown of each player.
Final Thoughts
While this team has the depth and training staff to weather most injuries, at some point, the losses become so great that the team simply cannot keep up. The last two years have seen the Bills decimated by injury which has led to premature playoff exits.
With many younger players on the team, the hope is that their bodies will not have the wear and tear of veterans which means they are more available. This team has the talent to make another deep playoff run, but health will be at the forefront once again in the hopes that ill-timed injuries don’t decimate position groups and lead to mismatches that even the most talented coaches can’t overcome.
This team will likely win 10-12 games this year and will once again be the favorite for the division until someone can knock them off, potentially the Dolphins. The Bills remain the team to beat until shown otherwise. If they can cut down on the injuries of the last two seasons, they can potentially break past the divisional round and potentially make a run at another Super Bowl.
Top Photo Credit: Daniel Kucin Jr./AP
