Despite sitting at 7-4 in a weak AFC, the Buffalo Bills head down to Pennsylvania to take on the Pittsburgh Steelers in what is a must win game for both teams playoffs hopes. Normally, a 7-4 record could set up nicely for a postseason run, but there is much more parity this season with every division potentially having a new winner this year.
Both teams need this win to keep pace in their respective divisions to at least earn a wild card spot and earn a tiebreaker when it comes to seeding. In addition, both teams are injured in different ways which will affect how they move or defend the football.
Below is a comprehensive analysis of each injury report and projected inactives.
BUFFALO BILLS INJURY REPORT
OUT
LB Terrel Bernard (Right Elbow)
After suffering what looked to be a hyperextended elbow due to a friendly fire hit from Matt Milano, Bernard was unable to practice all week and ruled out Friday morning.
A hyperextended elbow typically has not caused players to miss extended time, but with so much inflammation due to the trauma in the area, inability to fully bend for tackling, extend the elbow for blocking and shedding would have essentially reduced Bernard to play with one arm. When he does return to play he will have to wear a hinged brace like we have seen so many wear this season including Joe Andressen, Dorian Williams, and Connor McGovern.
This game off will also allow Bernard to rest his body including his right ankle suffered in Week 6. He has had difficulty in pushing off the right side since then but he has had issues prior to this dating back to Week 1. He did have his hamstring strain in the preseason but for it to have lingered this long suggests there may be other things going on such as a low back issue causing pain and weakness down his leg. We won’t know the extent of his issues until after the season, but even this week off won’t fix all the issues we’ve seen from his play this year.
OT Spencer Brown (Right Shoulder)
Brown was ruled out after he was unable to practice all week after suffering a right shoulder injury midway through the third quarter last Thursday. By video, I have concern for a right shoulder anterior labrum tear which will increase his risk for further subluxation and dislocations to the area. This is an injury that Brown can and will play though with a shoulder harness, but will likely require a repair in the offseason.
He has had this surgery before at the end of the 2023 season and returned to form following the surgery. If he had tried to play through this injury, he would have been able to until he got his arm tweaked blocking the defensive end from bending the outside edge or trying to block across his body. Then his play would have resembled what it looked like against Houston and it would have been another long day.
Giving him a week off will allow him to regain his range of motion, let the area scar down, and get some strength back in the shoulder before he gets back out there to play.
I’d expect a combination of Ryan Van Demark, Chase Lundt, Tylan Grable, and Alec Anderson to step up for both Dawkins and Brown.
OT Dion Dawkins (Concussion)
Dawkins entering the concussion protocol was the surprise injury of the week after he was checked for a concussion during Thursday’s game. This is Dawkins’ first documented NFL concussion.
Dawkins was cleared to return but later was off according to Mike Catalana as noted below.
We have known that concussion symptoms can be delayed as we have seen over the years and more recently with AJ Epenesa. The concussion screening and protocol isn’t perfect by any means, but it’s the best we have until something better is designed.
He had a chance to play until Thursday when he did not participate for a second straight day. There has not been a Bills player that has not gotten to a limited designation by the second practice of the week and cleared protocol. Players have been questionable but none have played. We will have to see how Dawkins progresses with the possibility that he plays next week.
This is only the second game Dawkins has missed in his career, the other being a right high-ankle sprain in Week 13 of the 2022 season.
QUESTIONABLE
WR Joshua Palmer (Left Ankle)
Palmer was on the injury report yet again for an ankle injury, though I initially thought this was for his left high-ankle sprain he suffered in Week 6. He was limited during Wednesday’s practice before being downgraded to did not participate on Thursday. He returned to limited practice on Friday and Sean McDermott noted that this was a management issue of the ankle injury against Atlanta.
McDermott wouldn’t say that Palmer tweaked the ankle, but states that he is still working through the soreness from that injury noted in the Friday press conference.
Based off that information, I would expect that Palmer suits up on Sunday.
TE Dalton Kincaid (Right Hamstring)
After missing the last two games due to a right hamstring strain, Kincaid returned to practice on Thursday, getting a limited practice in, the same for Friday.
There have only been a few instances of a player not practicing the first practice of the week followed by limited practices Thursday and Friday.
The players that were initially questionable were later ruled out.
2017 RB LeSean McCoy
2019 RB Devin Singletary
2025 LB Shaq Thompson
Note: Singletary & Thompson missed the week prior.
However, there are several players who had the same practice pattern, were questionable and played.
2018 WR Robert Foster
2023 P Sam Martin
2021 ST Taiwan Jones
Note: Martin was in the playoffs, Jones was exclusively special teams, Foster is the only exception.
Based on the data, the increased snap count at his position, cold weather, and recency of the injury, I don’t expect Kincaid to play this week. He can sit out one more week and be ready for Cincinnati next week.
ACTIVE
QB Josh Allen (Right Elbow)
Anytime Josh Allen is on the injury report is concerning and worth extra scrutiny. He was beat to a pulp last Thursday with eight sacks and pressured even more against the Texans. He suffered turf burn to his left elbow/forearm area as seen in the first picture below.
He also took a shot to his right elbow ulnar nerve also known as the funny bone in the final minute of the game as seen below.
On Wednesday, he had a new product on his elbow called HEX Skin turf tape. This is meant to protect the area while allowing mobility in the elbow. I don’t suspect any damage to his UCL given how the elbow was hit previously and if there was concern about his elbow stability, we would see him wearing a hinged brace like we did before.
We know Josh will play through anything including injuries that most others wouldn’t play through. Considering Allen won’t have either starting tackle, the offensive game plan will be designed to ensure extra blocking from tight ends and running backs to give more protection in the pocket. We may also see designed runs versus ad libbed scrambles to protect Allen from getting his left shoulder and right elbow hit causing further numbness. This doesn’t mean he won’t have to improvise, but the game plan has to ensure he has adequate protection to allow routes to develop.
Fortunately, on Friday, he ditched the tape implying that he felt better or didn’t like it.
CB Maxwell Hairston (Concussion)
Hairston suffered his first NFL concussion and from what I could find, first concussion ever when he slammed face first into Woody Marks last Thursday. He was taken off the field and into the locker room where he was placed into the protocol.
Fortunately, he was able to progress through the concussion protocol with a limited practice Wednesday and full practices Thursday and Friday, cleared to play on Sunday.
DT DaQuan Jones (Illness)
Jones was unable to practice on Wednesday before returning to full designation Thursday and Friday.
DE Joey Bosa (Left Wrist)
Bosa continues to manage his left wrist injury he originally injured in Week 8 against the Carolina Panthers. He has been wearing different braces and casts to protect the area.
The injury has significantly affected his ability to rush the passer as shown below by Cover 1, outright preventing him from rushing on the right side.
At this point, there is likely some type of non-displaced fracture in the area such as an ulnar styloid fracture, scaphoid fracture, or even a TFCC tear, similar to the one that I suspect Amari Cooper dealt with last year. The hope is that this is a fracture that can heal up as time progresses. Knowing this originally happened in Week 8, the bone may be healing but still bothering him enough that he can’t effectively use his wrist. I’m anticipating him needing to use this cast or brace for another two to three weeks with the idea the bone would heal, but rushing from the left side may continue to avoid aggravating the area.
FB Reggie Gilliam (Right Knee)
Gilliam was a surprise addition to the injury report with a knee designation this week he was able to practice in full all week. It’s not clear what he did but it is Week 13 and there’s plenty of injuries that need maintenance at this point. You can see in the picture below off to the right side that Gilliam has a sleeve on his right leg.
DT Phidarian Mathis (Right Shoulder)
Mathis has missed the last two games with what was thought to be a left shoulder injury due to a picture during practice prior to the Houston Texans game.
However, he showed up at practice this week with an extensive right shoulder brace as seen below. The original thought was that this was a rotator cuff or AC joint sprain based on the video from the Dolphins game, but considering the type of brace, this suggests more of a rotator cuff issue. How much damage there isn’t clear.
INJURED RESERVE
OT Tylan Grable (Concussion)
Grable returned to practice this week after suffering a concussion originally on August 6. He did attempt to return to practice on August 19 with a red non-contact jersey but appeared to have a setback and was later placed on injured reserve at roster cut downs.
His concussion very, very likely has not lingered since then, but there has not been an opportunity to bring him back to the roster until there were injuries to both Dion Dawkins and Spencer Brown.
Despite being questionable, I expect Grable to be activated. Considering Dawkins and Brown are out, the Bills could use a fresh body available to at least play swing tackle if a combination of Ryan Van Demark, Alec Anderson, and Chase Lundt start.
WR Curtis Samuel (Elbow/Knee)
Samuel will miss his third consecutive game as he continues to deal with injuries dating back to Week 10 when he suffered elbow and neck injuries. He is still dealing with the elbow injury but picked up a knee injury at some point despite not practicing.
I’m at a loss as to what Samuel can even do at this point. This is who he was when the Bills signed him. The Bills should be looking to move on from him as soon as the season ends. He is simply not available when he needs to be.
On Friday, the Bills did the sensible thing and put Samuel on injured reserve. He is eligible to return in Week 16 which doesn’t end his season, but allows the roster flexibility not making his inactive every week.
Samuel was simply what we signed. A talented player but a high risk for injury.
PITTSBURGH STEELERS INJURY REPORT
OUT
OT Broderick Jones (Stingers/Neck)
Jones was ruled out on Tuesday after he was forced to leave Sunday’s game with what was initially called a stinger before being reclassified as a neck injury. This happened with 9:51 left in the fourth quarter when a Bears defender jumped at the end of the plan and hit Jones over the top of the head at the end of the play.
DT Derrick Harmon (Knee)
Harmon was ruled out on Tuesday after he was reported to be dealing with a knee injury.
The team did not divulge whether this was the same knee that he suffered an MCL sprain in the preseason.
ACTIVE
QB Aaron Rodgers (Left Wrist Fracture)
Rodgers is set to return to play this week after missing one game due to a left wrist fracture sustained against the Cincinnati Bengals two weeks ago.
He tried to play last week against the Chicago Bears, but was ruled out to allow the area to heal. He was spotted at practice with a soft brace on going through warm up drills but got a full practice in on Thursday.
The biggest issues Rodgers will have is protecting himself should the Bills get a lot of pressure in the pocket. He will also have difficulty in handing off to the right but he could do a backhanded handoff like we have seen with other quarterbacks including Josh Allen last year.
On Friday, he was named the starter.
WR DK Metcalf (Left Ankle)
Metcalf will be playing through a left ankle sprain that required him to exit several times throughout the game on Sunday. He appeared to suffer and aggravate a low ankle sprain throughout the game.
On Thursday, he had the left ankle heavily taped as he went through drills as seen below.
He will not be at 100 percent and have some difficulty pushing off that left side and cutting towards the left, but he isn’t a player the Bills secondary can ignore by any means. I expect him to still get his during the game and will be a huge part of the offensive plan.
LB Alex Highsmith (Pectoral)
Highsmith has missed the last two games with a pectoral injury sustained against the Los Angeles Chargers in Week 10. He was able to get limited practices last week and declared doubtful, ultimately not playing.
It’s not clear which side he injured, we’ll see a shoulder harness on the affected side on game day, but he was able to get full practices in this week. He may have some difficulty engaging blocks and tackles on the affected side especially as the game progresses.
DT Cameron Heyward (Ankle)
Heyward has been working through an ankle injury dating back to last week. He played in his regular amount of snaps indicating this is something he’s working though but won’t drastically affect his production.
CB Joey Porter Jr (Hip Flexor)
Porter suffered a hip flexor injury during Sunday’s game initially leaving just before the half and returning early in the third quarter. He later left again midway through the fourth quarter and was done for the day.
However, he was able to practice this week and has no designation heading into Sunday. He could be one to watch for re-injury should he have an early exit or begin to struggle.
WR Ben Skowronek (Shoulder)
Skowronek suffered a shoulder injury at some point during Sunday’s loss to the Bears and unable to practice Wednesday and Thursday, but got a full practice in on Friday.
Buffalo Bills Projected Inactives
OT Dion Dawkins
OT Spencer Brown
LB Terrel Bernard
CB Ja’Marcus Ingram
TE Dalton Kincaid
WR Brandin Cooks
Activated: OT Tylan Grable
Call Up: TE Keleki Latu
Pittsburgh Steelers Projected Inactives
OT Broderick Jones
DT Derrick Harmon
DL Logan Lee
LB Cole Holcomb
WR Scotty Miller
Final Thoughts
The Buffalo Bills need to win, period. A loss would drop them to 7-5, dropping them out of the playoff picture and leaving them fighting for a spot rather than seeding. The Bills have several key tiebreakers over the Ravens and Chiefs but don’t have it over the Texans who could overtake them with a win this weekend.
It’s hard to stay at the top in the NFL and this year is a prime example. The one upside is that some of the teams at the top including the Patriots, Colts, Jaguars, and even Broncos haven’t won recently which means they could falter in the playoffs. All it takes is to get to the playoffs and then go on a run, especially in this weak conference. This Bills team has lots of flaws especially on the road, but the team is battle tested in the playoffs and could make something happen. But they need this win to move towards the playoffs.
After the injury filled game that was the Texans, I’m looking for a much healthier and entertaining game Sunday.
Top Photo Credit: Sports Illustrated
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