Injury Analysis: Buffalo Bills DT Deone Walker

The Buffalo Bills double dipped at defensive tackle and selected Kentucky DT Deone Walker in the fourth round. The big man out of Lexington comes to Buffalo after a solid collegiate career where he was selected second-team All SEC in 2023 and third-team All SEC in 2024. 

At 6’7” and 340 lbs, Walker possesses the size to plug up the middle of the defensive line that the Bills have been missing during the playoffs. Walker was named a preseason All-American prior to the 2024 season but Walker never lived up to it as he battled an unknown back injury.

Read about Deone Walker’s publicly reported injury history and analysis. 

Injury History

2022 Kentucky

No publicly reported injuries. 

2023 Kentucky

Left shoulder injury, vs Ball State, missed 0 games. 

Walker played through a left shoulder injury all season appearing to suffer the injury against Ball State. He was forced to wear a shoulder harness nearly all season with its first appearance against Eastern Kentucky. 

He later underwent left shoulder surgery following the season and was able to return to practice in mid-April, suggesting a labrum repair based on the timeline. 

2024 Kentucky

Lumbar stress fracture, missed 1 game. 

Walker was on and off the availability report all season dealing with a back injury according to reports before missing the game against Murray State. This came after a bye week after playing Tennessee which means he missed two weeks. He states he battled the back injury all season and considered sitting out but decided to gut through the injury. 

Following the season, he underwent a medical check at the NFL Combine and was found to have a stress fracture in his back, specifically a pars defect. 

Buffalo Bills Injury Analysis

Walker has had some notable injuries coming out of his three seasons at Kentucky with the shoulder and back injuries. Fortunately, he only missed one game over three seasons indicating his toughness and willingness to play through injury.

Shoulder Injury

Looking at the shoulder issue, it appears to be a labrum issue due to the fact that he was able to play all season with a shoulder harness. He was also able to return to practice roughly three to four months after the surgery which is a common timeline to begin to return to sport activities. 

This is a fairly common procedure in offensive and defensive lineman but can be debilitating during the season as we have seen multiple Bills players deal with this injury such as Jordan Phillips and Spencer Brown. 

Looking at performance upon return, there does not appear to be any decline in a return to performance, but there is anywhere from a 13 to 26 percent chance of re-tearing the labrum following repair. There is also a 58 percent chance of future instability within the shoulder in the future, but considering the frequency that offensive lineman suffer a torn labrum, this isn’t necessarily a concern. 

The biggest issue is missed time should he suffer a new injury and future arthritis. Recurrent instability is in the mid-20 percent, but far less (50 percent) than if he didn’t have surgery. This is also an injury he could play through after some rehab and bracing if it does occur again. To read more, click here. 

Back Injury

The more notable injury is Walker’s back stress fracture, specifically the pars defect. While back injuries and big men are historically not ideal, this also doesn’t mean a failed draft pick or extensive missed time either. To better understand what Walker played through all season, read below. 

The Anatomy

The lumbar vertebrae are composed of a vertebral body, several facets, processes, and a foreman. The vertebrae are like building blocks that stack upon each other to create the spine which protects the spinal cord and nerves that branch off which allow sensation and movement within the body. 

Mechanism of Injury

The specific injury that Walker dealt with was what is called a pars defect. This is when there is a fracture in the pars interarticularis of the vertebral arch. This can happen on one side or both sides, in the case of Walker, it’s not identified but likely bilateral. The fracture can be readily seen on an oblique plain x-ray known as a “Scottie dog” fracture.

This fracture leads to a condition known as spondylolysis. This is frequently seen at L5-S1 with occasional cases seen at L4. There are five different types that are classified based on type of injury. The stress fracture is Type IIA. This can cause localized, dull pain that worsens with activity and is relieved with rest. Pain also worsens when in a single leg stance or when the back is placed into hyperextension. Oftentimes, there is no known mechanism of injury. 

This condition is found in between 6-11 percent of the general population but found in 15-21 percent of all players. Furthermore, it’s suspected that up to 50 percent of lineman. The exact cause is unknown but hyperextension of the back due to blocking and a higher body mass index leads to increased lumbar lordosis and at greater risk for stress to the area. Weightlifting can also exacerbate these issues with activities such as squats and deadlifts. 

Pain Presentation

There also may be radiating symptoms such as pain going into the buttocks or posterior thigh or along with muscle spasms or hamstring tightness. If left untreated, this can lead to spondylolisthesis which is the anterior translation of the vertebrae which is slippage of the vertebrae over the lower vertebrae. Considering Walker’s injury was caught early enough and has since healed, he will not progress to this which could eventually require a fusion to stabilize if the slippage was severe enough.

Walker has said that he has been performing rehab and is 100 percent better now. While this may be true, he is not totally without risk moving forward. The preferred method of treatment is conservative care with upwards of 80-90 percent of people responding favorably and involves allowing the fracture to heal along with stretching and strengthening exercises to provide stability to the area. If rest is provided for 3 months and allowed to heal, the patient is 16 times more likely to return to prior level of performance without pain. Total time to return is between 5-7 months.

There is limited research showing a recurrence of the spondylosis but one study shows it at 13.2 percent in the adolescent population. Looking at the draft, players with a pre-existing lumbar issue were drafted lower than their counterparts, played fewer seasons (4.1 vs 4.4), fewer games played (46.9 vs 55.1), and games started (28.1 vs 30.6). However, there was no change in performance. 

Final Thoughts

While Deone Walker has some notable injuries, the outcomes actually are not all that bad. The shoulder injury is a pretty routine issue seen in offensive and defensive lineman with a chance of re-injury. 

His back injury is far more promising long-term than what it initially appeared to be. There is a decreased career length and games played, but the production does not suffer. What’s notable is that the average career length is over four seasons which means the Bills will potentially get the full use of his rookie contract out him before having to make a decision on his future. 

The Bills will have to be diligent in managing any complaints that Walker has moving forward. Taking care of his body by maintaining mobility through stretching, strengthening, and being proactive in pain management will be the key to his success. I do expect him to appear on the injury report here and there with a back designation but hopefully the back does not progress to another stress fracture like it did previously or worsen to require a fusion.

My assumption was that Walker dealt with the back pain, worked through it to finish the season, had it treated symptomatically, and then found the extent of the damage during the Combine. The Kentucky medical staff didn’t necessarily miss anything especially if he responded to treatment. This isn’t the first injury thought of when dealing with back injuries and is found when treatments are ineffective. 

Hopefully Walker is able to stay healthy in the defensive line rotation and harden his body to the demands of the NFL. The ideal outcome is that he returns to his 2023 playing form and the Bills get an injury discount on a talented player. Selecting him in the fourth round further confirms the research but doesn’t prevent Walker from having a successful career.

As long as he is proactive, he can successfully contribute. We will see how his career progresses in terms of career length as other injuries or performance may dictate that compared to his previous back injury. We may see the Bills slowly ease him in based on his healing timeline so as not to cause any setbacks during OTA’s. Brandon Beane later confirmed this in his post-draft press conference.

I would like to wish Deone Walker a warm welcome to the city of Buffalo and to remain healthy this season.

Top Photo Credit: Jeff Moreland/Icon Sportswire via Getty Images