NFL Injury Series- ACL Tears

Complete analysis of the ACL injury and associated rehab including timelines for recovery.

Today’s article begins a series that precludes the start of training camp and will review the most commonly sustained season-ending injuries in the NFL. Objectives of this series are to help educate fellow fans on the severity of each injury and timelines for recovery. Unfortunately, when these injuries occur, Banged Up Bills will have you covered. Nearly all of these injuries are season ending or become chronic if not managed properly. The first post will assess ACL injuries.

The ACL is a ligament that connects the tibia to the femur and runs medial to lateral or inside to outside, acting as a stabilizer in the knee to prevent the femur from shifting too far forward over the tibia during movement; it also assists in preventing hyperextension in the knee. When the knee is loaded during activity such as cutting and sudden stops, the ACL is designed to keeps the knee stable, but in the presence of injury, the ligament is overloaded which either stretches and partially tears or fully tears based on the activity. It is possible to live a normal lifestyle with an ACL deficient knee, but nearly impossible to resume a high level of play post ACL tear without reconstruction as an adult.

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Credit: kneesurgerysydney.com.au/acl-reconstruction/

Activities that cause the ACL to tear are direct blows such as a low block or a blow to the knee while the foot is planted. Non-contact typically happen when a player doesn’t land properly after jumping in the air, when they perform a sudden change in direction at a high speed, or when they attempt to quickly decelerate. Tears also occur with hyperflexion or hyperextension of the knee. In the event of ACL rupture, the knee buckles and there is usually immediate swelling, tenderness, loss of ROM, and pain. Risk factors include but are not limited to: sex, age, playing surface, level of play, biomechanical variances, previous injuries to the knee, equipment, and environmental conditions. Recent research has also shown that concussions can possibly increase the risk for injuries such as ACL due to slower reaction times.

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Credit: medline.gov

As with many injuries, players are not able to return to playing and require further evaluation once in the locker room. X-rays are taken to rule out fractures and special tests are performed including but not limited to: Lachman’s test, anterior drawer test, and pivot shift test. All of these tests rule assist in physically identifying that the ACL is damaged. Typically, when performing the Lachman’s or anterior drawer test, there will be increased laxity when moving the tibia in the opposite direction of the femur. There are 4 grades to determine ACL severity which grade out how much the tibia pulls out in relation to the femur. Grade 1 is <5 mm progressing in severity up to Grade 4 which is >15mm.

Another test that may be performed is a posterior drawer test. This is the opposite of anterior in that it tests for a PCL injury. The reason this is performed is due to the possibility of PCL injury instead leading the tibia to sag back which could initially mimic the laxity seen with the anterior drawer test. A pivot shift test mimics the injury mechanism of the ACL tear and will typically illicit pain and possible clunking which would signify a subluxation of the tibia. To confirm the ACL tear, MRI imaging will be performed once swelling is subsided. Otherwise, the excess fluid could occlude the view of the tear and make the imaging inconclusive.

Once the tear is confirmed and swelling has reduced, surgery is scheduled to repair the structural damage. Regrettably, the ligament cannot be repaired through simple means such as sewing it back together. The ligament has to be cleaned out and repaired through use of a graft. These grafts come from commonly the hamstring or the patellar tendon which are known as autografts or through the use of a cadaver also know as allograft. There are other options which include xenografts which come from animals and lastly, synthetic grafts made from carbon materials or Gore-Tex. While medical research has improved drastically, the preferred method still appears to be the autografts as this comes from within the patients body and have lower rates of failure. The surgery is performed by anatomically lining up the graft as the ACL would normally be in and screwed in to allow to heal to the bone.

Recovery from an ACL tear takes anywhere from 9-12 months to return to full, unrestricted activity. However, there may be concurrent damage sustained in the knee which could include meniscus tear, MCL/PCL/LCL tears, or cartilage damage which could lengthen recovery time. Once the surgery is completed, the first 2 weeks is spent allowing swelling and initial tissue healing to begin. Passive range of motion along with light strengthening of the surrounding muscles is performed. After several weeks have passed, range of motion is increased with emphasis placed on full extension or straightening of the knee which will allow the person to be able to walk fluidly through the gait cycle and fully bear weight.

As the range of motion increases, higher level strengthening activities may begin through the saggital plane which involves motion going forward/backward over the next 10 weeks. During this time, strengthening exercises are primarily composed of closed chain exercises. This means that the foot is in contact with the ground or other surface as the knee performs its movements. Open chain involved exercises that allow the lower limb to move freely which if performed too soon, may place excess torque on the repaired ligament which could cause potential failure if pushed excessively.

Once full ROM is re-established, balance exercises are incorporated to regain proprioception which allows a person to sense their joint and body in space. This awareness is crucial as if the athlete has a poor awareness where their body is at during movement, they are at a much greater risk for injury. After 3 months out, they may continue progressing to running exercises going forward, backwards, and slowly begin agility drills once fitted for an ACL brace. These braces are commonly used to prevent future ACL injuries by restricting rotary and hyperextension forces. The recovery timeline is so long due to the purpose of the ligament and its makeup. As stated before, a ligament attaches bone to bone which creates stability for the joint. Add in the stresses that the joint goes through during running, jumping, and cutting motions, proper healing is required so that the ligament can perform effectively. Lastly, ligaments unfortunately have poor blood supplies which slow down healing time unlike muscles or tendons which have a rich blood supply allowing those tissues to heal quicker.

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Credit: betterbraces.com

Once a patient has reached the 6 month plateau in recovery, they must meet certain minimum criteria to begin even considering returning to sport. They must:

  • demonstrate quadriceps and hamstring strength at least 80% that of the noninvolved leg
  • full motion
  • no recurring swelling
  • demonstrate stability both with physical testing and mobility
  • completing a running program

In higher level athletes, the running, jumping, agility set them apart from the general population and because of that, these athletes require further training in order to return to their respective sport. Athletes must be re-educated to safely land, cut and change direction, and essentially relearn how to use their reconstructed knee. Overall, 6 months is a considerable amount of time to heal properly which explains why this is a season ending injury. As the NFL season is only 6 months long, even with the best rehab, it wouldn’t be realistic to return.

However, why if a person is able to get to full recovery after 6 months, why are they out longer than that? Research has shown that the risk for re-injury decreases by over half each month up to 9 months before returning to sport. Once a player does return from an ACL repair, they are at a much higher risk to re-injure with rates up to 20-30% for up to a year after injury. These are the reasons why it takes nearly a year to return to full ability prior to the injury.

Many high level players can and do return to full abilities with proper rehab and training. It is terrible to see a player put all that hard work and training into getting ready for a season for it to all end with an injury such as this, but until medical science improves the healing process so much that players can shorten that 6 month window for healing, we are stuck with the current system. As a fan, I am praying that the Bills continue to avoid major injuries such as this as they were fortunate last season.

This wraps up the first article in the sports injury series. Continue to check back at Banged Up Bills on Facebook and on Twitter @BangedUpBills for the latest articles. As always, thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- ST

Evaluating the injuries (or lack thereof) of the 2017 Bills special team unit.

I hope everyone continues to enjoy the summer as we inch closer and closer towards training camp on July 26th! Today’s post wraps up the positional injury reviews for the 2017 season. Today’s article may be the briefest due to an overall lack of injuries, however without the special teams unit, the Bills struggle mightily! This article will review the kicker, punter, and long snapper positions.

First up is LS Reid Ferguson. The talented long snapper finished his first season after spending the 2016 season on the practice squad. Ferguson was able to take over the incumbent LS Garrison Sanborn last season who moved onto the Tampa Bay Buccaneers. While there is no official statistics for a long snapper, the body of work for a long snapper is evident with the effectiveness of the kicker and punter. Though a long snapper is only on the field for field goals and punts, they are still at risk for injury just as much as any other player. During punt returns, they still have to go block and tackle the returner. Unfortunately, special team plays like this can cause serious injury such as last year to the Bears and Jaguars. Thankfully, Ferguson avoided injury and is looking to build off a strong 2017 season. If you don’t hear his name again this season, this just means he’s doing his job very well.

Moving to the next position, P Colton Schmidt arrives on the list. The 4th year pro has been a steady presence in the backfield on 4th down after some inconsistency following the release of longtime punter and fan favorite Brian Moorman. Schmidt had 79 punts with an average of 44.7 yards/punt with a season long of 60 yards. Out of those 79 punts, he was able to place 28 inside the 20, good for a 35% rate. Along with Ferguson, Schmidt avoided injury this season and appears to continue his productive career in 2018.

Finally, we round out this article with K Steven Hauschka. The 10th year pro continues to make his mark in Buffalo after stops in Baltimore, Denver, and Seattle where he had his greatest success culminating in 2 Super Bowl appearances with one championship. Hauschka found his way to Buffalo and continued his high level of play in which he was 29/33 in FG’s made, going perfect at 20-29, 30-39, and going 7/9 at both 40-49 and 50-59. This was good for a 87.9% FG completion and was perfect on extra points. The veteran kicker was the only special teams player to suffer an injury this past season. Hauschka suffered a right hip injury following the Saints game which caused him to miss some practice that week but did not cause him to miss any games. Reading further into his injury, it did not appear to be anything more than a possible muscle strain as he was able to play through the discomfort and it did not land him on the injury report the rest of the season. As he is right footed with regards to kicking, the ability to swing his kicking leg through effectively pain free is vital to his ability to perform.

While the NFL has at times been criticized for making the game “soft” through rule changes, these changes are the reason the Bills special team players were able to remain healthy with penalties. Each position has been afforded special rules to ensure their safety. Rules for punter/kicker, and long snapper can be found here. Overall, these rules make the game safer and allow these world class athletes perform their craft avoiding serious injury.

Competing for roster spots are K Tyler Davis and P Cory Carter going into the 2018 season. While I do not believe that they will seriously threaten the above mentioned roster spots, other teams will be watching in the event they are not satisfied with their special team games. Both of these players may find their way onto the practice squad, however I believe that the front office would rather place other positional players on the practice squad for greater depth. Look for this special teams unit to be incredibly effective going into the 2018 season and help keep the Bills in games if the offense fails to move the ball.

This wraps up the 2017 season positional injury reviews. I hope you enjoyed looking back at this memorable season and reflect on how valuable healthy starters are along with effective depth is to a team. This series also demonstrated how the Bills avoided serious injuries this year which led to proper player development rather than inserting players who are not ready or are ill suited for the position/scheme.

Continue to check back at Banged Up Bills on Facebook and on Twitter @BangedUpBills. Look for the latest injury news coming out of training camp, general injury explanations, and anything else that can be reported on. As always, thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- S

Assessing the safety position injuries from the 2017 season and personnel expectations going forward.

We are 3 weeks away from the opening of the 2018 NFL season with the beginning of training camp! Here at Banged Up Bills, I have been trying to stay cool and sane despite the excessive heat and lack of football. Today’s post will finish up the injuries on the defensive side of the ball at the safety position. The secondary overall was an incredibly strong position for the Bills this past season and going into the 2018 season, this does not appear to change.

Stepping up first for review is S Jordan Poyer. The transplant from Cleveland spent the first 4 seasons mostly with Cleveland along with a cup of coffee in Philadelphia before signing a free agent deal with the Bills in 2017. He rewarded the Bills handsomely with 5 interceptions with one TD, one fumble recovery, 2 sacks along with 95 total tackles 63 solo and 32 assisted. These are fantastic stats for a player that Cleveland did not want back. In addition to his versatile abilities on the field, Poyer was able to stay relatively healthy, appearing in 15 games, missing only the Raiders game with a knee injury. He was incredibly durable this season despite the high injury risks that the position comes with. As Poyer is a veteran, he understands how to take care of his body and prepare for each game. Expect another standout year from Poyer!

Next up is S Micah Hyde who was also a castoff from the Green Bay Packers after 4 years. The dynamic play maker appeared in all 16 games producing 5 interceptions along with 82 total tackles, 65 solo and 17 assisted. The 5th year veteran has also been incredibly durable during his time in the league, rarely missing any games which demonstrate why this coaching staff values Hyde so highly. Despite Hyde not missing any time, he also dealt with several minor knee injuries that limited his play at times but did not signify any longer term issues. Similar to Poyer, expect Hyde to continue to prepare like a veteran and come ready to play every week.

Another player who saw time at the safety position this year was S Shamarko Thomas. The 5th year veteran saw action in 12 games but did not record any defensive statistics, making the most of his playing time on special teams. As he did not see many defensive snaps, he was able to avoid injury. Thomas finds himself a free agent going into the 2018 season and could be a candidate to come back at a veteran minimum but that is most likely the reason he was not retained as he became cost prohibitive.

Rounding out players who saw playing time at safety is S Colt Anderson. The oft-injured safety was used more frequently as a special teams ace in years past but his time in Buffalo was forgettable. In 2 years, he appeared in 7 games and not recording any defensive statistics. He had dealt with hand, foot, and forearm injury which cost him significant playing time. This past year, a broken forearm cost him 11 games and when he finally returned, was largely ineffective. As one may guess, he was not re-signed to the team going into the 2018 season. After the multitude of injuries over his career, he may see fit to hang it up rather than try to find another team due to his lack of availability. I do not even envision him coming back as a camp body in any fashion. My final thought on Anderson, he was a holdover from the Rex Ryan staff, I do not understand what the Bills saw in him as he was unable to stay healthy.

As for new personnel, there are many new faces coming into the secondary with the addition of S Dean Marlowe, S Kelcie McCray, S LJ McCray via the practice squad this past season. In addition, S Rafael Bush was brought in via free agency; a more detailed report can be found here. Finally, the Bills brought in S Siran Neal via a 5th round pick who could project to be a top backup with a strong training camp performance.

While this group is veteran heavy with Poyer and Hyde, they will need Bush and Neal to step up and provide effective depth as it is difficult to totally avoid injuries. With strong training camps, Marlowe, McCray & McCray can step up and add another dimension to the already strong unit. This is a position group I do not worry about due to the talent level, but could drastically change with a serious injury.

Continue to check back at Banged Up Bills for training camp content, injury reviews, and any other breaking news to come out of One Bills Drive. Follow Banged Up Bills on Facebook and on Twitter @BangedUpBills. Feel free to contact me with any questions or content you would like to see. As always, thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- CB

Assessing the injuries sustained at the cornerback position from the 2017 season.

Continuing in our off-season reporting is positional reporting at Banged Up Bills.. Today’s post addresses the cornerback position which was a bright spot this season after being outright dreadful in 2016. The cornerback position dealt with a variety of injuries that at times cost the Bills crucial games that thankfully did not cause the Bills to miss the playoffs. However, Brandon Beane realized that even though this unit was superb, there is still room for improvement going into the 2018 season.

First up is CB E.J. Gaines. The 4th year veteran came to Buffalo in a trade that included WR Sammy Watkins that worked out favorably for the Bills. Stat wise, Gaines was able to haul in one interception, 3 forced fumbles and 59 total tackles with 48 solo and 11 assisted. There was a gigantic difference between when Gaines was on the field and when he wasn’t. In games that Gaines participated in, they were 8-3, in games he missed they were 1-4 which indicated how valuable he was. However, Gaines suffered several injuries which cost him playing time during several key points during the season. He suffered a shoulder injury in the win over Atlanta that forced him to miss the Cincinnati game which was a loss. Immediately after this injury, Gaines suffered a groin injury that did not appear to be serious, but possibly led into a hamstring injury that cost him 3 games in which the Bills went 1-2. Gaines returned to health, playing in 5 straight games before injuring his knee during the first Miami game which cost him a game against New England. Prior to this season, Gaines had been fairly durable, only suffering a Lisfranc injury which cost him the 2015 season. His injuries likely stemmed from his hard-hitting reckless play. After this injury filled season, the Bills elected not to re-sign Gaines, letting him walk in free agency and taking a rather questionable one year, $4 million with the Cleveland Browns. For a player that was due a potentially big contract with limited availability, the Bills were smart to move on from Gaines despite his stellar play.

Next up is CB Leonard Johnson. The 6th year back saw time in 15 games and starting 7. Johnson managed to stay relatively healthy this season, only missing one game due to a knee injury in the loss in the first New England game. Otherwise, he suffered a quadriceps injury in the season opener and a minor hamstring injury in the loss to Cincinnati in which he did not miss any time. Johnson had been pretty healthy up to this season, only suffering a torn Achilles during his time in Carolina but was able to recover to previous form. Stat wise, he accumulated one forced fumble with one fumble recovery to go along with 51 tackles, 40 solo and 11 assisted. As with Gaines, the Bills elected not to re-sign Johnson as his veteran status most likely became cost prohibitive.

CB Shareece Wright continues the Bills exodus of cornerbacks from the 2017 season. The 7th year back saw playing time in 12 games, starting 5 with stats of one interception, one forced fumble with 2 fumble recoveries to go along with 42 tackles, 35 solo and 7 assisted. Wright suffered a minor back injury in the win over Atlanta but suffered a concussion during the second New England loss which costed him the season finale win over Miami and the playoffs. As he is no longer on this roster for what I assume are similar reasons as Johnson, I do not see him coming back unless there are several injuries which would require him to be re-signed as a depth player.

One of the true bright spots on this 2017 Buffalo Bills roster was CB Tre’Davious White. The rookie from LSU quickly became a fan favorite and helped re-establish the secondary with incredible plays that appeared to allow people to forget he was only a rookie. Numbers wise, he had 4 interceptions, one forced fumble with 2 fumble recoveries with one returned for a TD and 69 total tackles, 53 solo with 16 assists. White stayed injury free all season with the exception of a concussion from Rob Gronkowski. If you recall, Gronk gave White the People’s Elbow after a clearly dead play on the sidelines. White thankfully did not miss time, but repeated hits to the head can have a detrimental effect on a players health later in his career. As White begins his second season, look for him to hopefully stay healthy and continue to produce at a high level to establish himself as one of the best in the league at his position.

Finally, CB Lafayette Pitts rounds out players that suited up at the CB position for the Bills this season. The 2nd year pro joined Buffalo in late October after spending time with Jacksonville earlier in the season. During his time in Buffalo, Pitts only recorded one tackle and one assist on defense with most of his playing time coming on special teams. Despite the lack of stats, the Bills re-signed Pitts to a one year contract in hopes that he adds to the depth going forward.

The Bills position at cornerback appears to be solidified with CB Tre’Davious White manning one side and CB Vontae Davis manning the other. There are questions regarding Davis going into the 2018 season after he missed most of 2017 with a sports hernia that eventually required surgery. As indicated in the previous article, most players sustaining his type of injury are able to return to playing in the NFL without complications. These two players are formidable in their own right and together should really improve the quality of play at the position. Davis is an upgrade from Gaines at the position, but time will tell if the production matches.

Rounding out the rest of the cornerbacks on the roster include CB Levi Wallace, CB Phillip Gaines, CB Taron Johnson, CB Ryan Carter, and CB Breon Borders. Wallace and Carter come to the Bills via UDFA’s, Borders comes back for the 2018 season after spending the end of 2017 on the practice squad. Phillip Gaines came via free agency from the Kansas City Chiefs, and finally, CB Taron Johnson was drafted in the 4th round with the 121st pick. None of these players are guaranteed to make the roster but I expect to see Gaines and Johnson stick with the team as depth in the event a starter is unavailable. Considering the talent at the position, I could see the Bills stocking up on the position, leading one of the remaining names to sneak on to the 53 man roster with an impressive training camp.

That wraps up the cornerback review for the 2017 Buffalo Bills. Our series is nearly done, with positional reviews of safety and special teams rounding out the remaining articles. As this 6 week period between OTA’s and training camp occurs, look for remaining positional review articles along with spotlights on common injuries in the NFL. The goal at Banged Up Bills is to educate my fellow fans. I enjoy any and all feedback via Facebook at Banged Up Bills and on Twitter @BangedUpBills. As always, thank you for your time and GO BILLS!!

Buffalo Bills Season Injury Review- TE

Season injury review of the tight end position.

Today’s off season analysis focuses on the tight end position for the Buffalo Bills. This season, 4 tight ends suited up for the Bills with varying levels of success. Today’s post will break down the injuries sustained to the TE corps and impact for next season.

First assessment starts with TE Khari Lee. The 3rd year pro found his footing with the Bills for the last 8 games of the season primarily used as a blocking tight end with some occasional work on special teams. He did not see any time on the injury report and saw no targets on offense. As he was only active for half the season and has one year left on his contract, he may be an attractive option to return as he can provide depth.

Next is TE Logan Thomas. The QB turned TE turned some heads this season with his conversion to TE which appears to be working in his favor as he appeared in 12 games for the Bills. While he did not accumulate head turning stats, 7 receptions for 67 yards and 1 TD, he fit into the offense nicely and showed that he is able to play tight end at the highest levels. Thomas recently did have knee surgery which knocked him out of spring practices for the foreseeable future. It did not appear that there was any prior injury as he did not appear on the injury report for any part of the season. Thomas has one year left on his contract and is an exclusive restricted free agent which I expected the Bills to bring back to develop further as a tight end.

TE Nick O’Leary became a increased focal point in the offense and appeared to finally show flashes of what got him drafted out of Florida State. Stats for O’Leary are: 22 receptions for 322 yards and 2 TD’s which are all career high’s for him. Injury wise, the 3rd year pro dealt with late season back pain which was possibly back spasms or pulled muscles which forced him to miss only one game. As O’Leary has improved every season in Buffalo, he is an exclusive restricted free agent, and continues to grow into the offense, it would be a no-brainer to bring him back for next season.

Finally, TE Charles Clay leads the pack with his major knee injury early in the season. If you recall, he partially tore both his MCL and meniscus during the Cincinnati game during a late tackle out of bounds. Clay did have surgery to trim down the meniscus and 3 games, returning for the contest against New Orleans. While his return was remarkable, he continued to appear on the injury report for the rest of the year. His stats overall for the year: 49 receptions for 558 yards and 2 TD’s. While he was a safety valve for Tyrod Taylor, the amount of money paid to him for that production doesn’t equate.

His initial injury from a return to play perspective is unremarkable, but long term concerns remain. I had previously written on his previous knee complaints and my thoughts on how he will fare. Having knee injuries such as this add to the overall damage and may continue to cause problems. While the body has the remarkable capacity to heal and remodel based on injury, sports such as football impede the ability to heal as quickly, leading to greater difficulty to maintain a high level of play. Clay is only 28 years old and while he should have several productive years of football left, this may be limited if he continues to deal with the chronic knee complaints from earlier. I envision a scenario where the Bills let him play out his contract and move on from him as they have several younger, healthier players in the wings and will allow the team to get the salary cap under control.

Overall, the TE position is relatively healthy with the exception of Clay who can still be productive with the proper medical treatment. There are several other players that the Bills have on their radar with the previously mentioned Lee and Thomas. They also have TE Keith Towbridge who spent the year on IR with a foot injury sustained in training camp. The Bills have also recently signed TE Jason Croom to a futures/reserve deal. There will be some players that will be odd man out come training camp but many things can and will happen in the off season.

Continue to check back with me at Banged Up Bills for the latest injury news and analysis. Thank you for reading and GO BILLS!!

Zay Jones Knee Surgery Speculation

Speculating the type of knee surgery that WR Zay Jones may have had which is forcing him out of spring practices.

This new regime knows how to keep secrets! It appears nothing seems to escape the fortress that is One Bills Drive. This explains why news that WR Zay Jones underwent knee surgery last week which will force him out of the rest of spring practices. Today’s article will attempt to identify what the procedure may have been and explain the timing.

If you recall, Jones had a repair of the labrum in his shoulder which limited his production during his rookie season. Looking at a general protocol following a labral repair, Zay would be in the 3rd phase of his recovery by now according to the timeline as stated in January. By reaching this stage, he would demonstrate the strength required to adequately use crutches to assist in weight bearing following a knee surgery. This would explain why he is having knee surgery now at this time in the off-season rather than immediately such as most other players do. What this knee surgery also tells is us that his shoulder rehabilitation is progressing as expected and should be able to return to full health by the time the regular season rolls around.

As in most cases, we always want to know what type of procedure that the players have. While this is private information for both HIPPA and competitive reasons, I am still able to speculate the type of procedure. The information released is generally vague which indicates Jones escaped serious injury including ACL, MCL, severe meniscus tears, patellar fractures, etc. These types of injuries are almost always reported and would have ramifications regarding his availability for the season.

I believe this injury is related to the injury sustained during the Jets game during their 3 game slide in the middle of the season. If you recall, he hyperextended his right leg as the result of being tripped during a route run. He was later listed on the injury report with an ankle injury which may have bore the brunt of the injury acutely, but he may have suffered minor damage in the knee which may not have affected his production at the time.

Due to the hyperextension, Jones may have suffered a frayed meniscus that could have possibly caused pain, swelling, catching, occasional locking, and general discomfort. He may have also suffered from plica syndrome. This is a condition that is due to to irritated synovial membrane that may be the result of a meniscal tear, repetitive knee bending or straightening, blunt trauma or twisting, or altered knee motion. Both of these issues can be managed conservatively and addressed with physical therapy with effective results. Unfortunately, In Zay’s case, there was apparently not enough progress which warranted surgery.

There were some Twitter trolls who believe this surgery may have been related to his meltdown in Los Angeles in where he was in an altered mental state and attempted to kick through a window and jump out. I do not believe that to be the case as he would have suffered more superficial injuries to his foot, ankle, and lower leg which would have required immediate surgery compared to a scheduled surgery.

McDermott during his press conference noted that this was a procedure that he has needed, he had addressed it during rehab while addressing his shoulder, and that he miss only the spring session. According to the schedule, there are OTA’s until mandatory minicamp from June 12-14. This would give Jones about 4 weeks to recover in order to participate in some fashion, though it was made known he would likely miss minicamp. There is no timeline so in case there are any setbacks, he will not be held to any standard. The average time to recover is 4-6 weeks for both types of surgeries which fit the limited timeline that the Bills suggested missing the spring.

Either way, this is something that should not warrant any complications. It appears he is addressing his injuries, his shoulder is on track with rehabilitation, and looks as though he will be at full health come training camp. It is unfortunate that he has to deal with these issues, but sometimes, this is unavoidable.

Continue to check back for the latest updates at Banged Up Bills. Follow on Facebook at Banged Up Bills and on Twitter @BangedUpBills. As always thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- LB

Assessing the LB positional injury review from the 2017 season.

Continuing this off-season is the positional injury review’s of this past season for the Buffalo Bills. Today’s review focuses on the LB position. This was a position of weakness during the 2017 season which was horrendous against the run. Whether this is good or bad, most of the unit returns along with some new faces which allow for greater depth. There was a total of 6 players to suit up at the position with a wide variance of statistical success.

First man up is LB Lorenzo Alexander. The elder statesman of the corps managed to stay incredibly healthy during this past season. He was a frequent participant on the injury report requiring weekly rest days but never for a specific injury. The 34 year old, undrafted free agent out of California has spent 11 years in the league playing a variety of positions which may explain why he has such staying power. His ability to adapt to a variety of positions including offensive tackle, tight end, defensive tackle, linebacker, defensive end, and fullback along with special teams. This has forced him to pay close attention to his body and how it operates to adjust to the demands of the positions which I believe has allowed him to stay in the league as long as he has. Despite being one of the older players on the field, he is still able to produce with 3 sacks, 53 tackles with 12 assisted, and 3 forced fumbles. Unless there are a number of linebackers that impress the coaching staff, expect Alexander to remain on the roster in 2018 and continue to be productive.

Next up is LB Preston Brown. The 4th year LB had an incredibly productive season, leading the NFL in tackles with 144 total tackles, 84 solo and 60 assisted and adding in 3 forced fumbles. Brown also thankfully avoided the injury report which is why he was able to be so productive. Despite his availability and production, the Bills did not resign him in free agency, allowing him to sign with his hometown Cincinnati Bengals. While his production is lost, the Bills at least addressed the positional need through the draft with LB Tremaine Edmunds.

Adding the veteran presence of LB Ramon Humber brought mixed opinions from pundits as the veteran has been around the league for 10 years now playing for Indianapolis, New Orleans, and most recently Buffalo. As a 30 year old linebacker, he was able to produce 56 solo tackles, 27 assisted with 1 forced fumble while playing in 13 games and starting 9. Humber only suffered a broken thumb in the win over the Falcons in November, had surgery to stabilize the area, and then proceeded to miss 3 games. During that time, rookie LB Matt Milano stepped in and overtook his starting position, leading Humber to be a depth player, typically what he has been his entire career. The thumb won’t cause any issues coming into the 2018 season but due to his age and ability, he may find himself a camp cut unless he impresses the coaching staff.

Speaking of LB Matt Milano, the rookie 5th round pick out of Boston College impressed many this season with his ability to step up in place of the injured Humber. The rookie saw time in all 16 games and started 5. Milano was able to collect 29 tackles with 14 assists along with a forced fumble with return for a TD and added in 1 interception. While he is not the linebacker that McDermott envisions to run his defense, he has shown the ability to be aware on the field as evident by the statistics he collected this season. Injury wise, Milano stayed relatively healthy, only suffering hamstring injuries early in the season in September and then a more severe injury to the hamstring which kept him out of the playoff loss in Jacksonville. It is unknown whether this was the same side or two separate injuries. As hamstrings are soft tissue and can heal fully, he should not have any setbacks going into this season. He is still a young player and adjusting to the NFL which could put him at risk to develop further hamstring or chronic injuries, but as he sat out the last game and was able to rest, I do not believe this to be the case. Expect Milano to pick up where he left off and continue to produce in 2018.

Rounding out the linebacking corps is LB Deon Lacey and LB Tanner Vallejo. Lacy was largely ineffective, totaling only 1 tackle and spending most of his time on special teams. During his rookie season, he suffered hamstring early in the season and did not appear to re-injure it later. The coaching staff will most likely decide his fate as he was primarily special teams player. As for Vallejo, his rookie season got off to a slow start with a knee injury late in the preseason. After that, most of his playing time was in special teams with no stats recorded on defense. As he was a draft pick of this regime, I expect him to find a place on this roster for next season.

This finishes out the players who suited up at linebacker for the Bills in 2017. The LB position demonstrate significant turnover with my picks of Alexander and Milano locks to return to the roster and Humber and Vallejo competing for backup jobs. Lacey will find himself out of a job unless he impresses in camp. Add in 1st round draft pick LB Tremaine Edmunds out of VA Tech along with UDFA LB Corey Thompson out of LSU, free agent signing of LB Julian Stanford, and practice squad member LB Xavier Woodson-Luster will help reshape this position drastically.

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