That’s A Wrap!

Assessing the injuries coming out of the 4th preseason game against the Detroit Lions. Breaking down the IR, how it compares to past seasons, and upcoming posts.

The Buffalo Bills won over the Detroit Lions on Thursday night 27-17 behind a strong showing behind Nathan Peterman and company. With that win, Buffalo finishes the preseason 1-3 on a high note and ready for the home opener against the Jets in Week 1. Overall, the Bills continue this preseason by avoiding major injury, allowing them to have some depth going into the regular season. Injuries to note are Jerel Worthy’s concussion at the end of the first quarter which sent him into the concussion protocol for the foreseeable future. Michael Ola sustained an ankle injury in the first half and was unable to return. Besides the previously two mentioned, the rest of the game consisted of bubble players getting final chances at securing their roster spots.

As it was relatively a quiet preseason injury wise for the Bills, there are still some injuries to report. Right after the Lions game, the Bills had to make some hard decisions regarding their roster. As previously mentioned, TE Keith Towbridge was placed on IR with a foot injury back on 8/3/17 and TE Jason Croom was waived with an ankle injury and settlement on 8/18/17. Right now, there are no locks for IR as Michael Ola has been waived/injured, which means he may revert to IR and then released with an injury settlement in several days. I believe this to be the case as Ola had his ankle taped up after his Thursday night injury, possibly attempting to go back in. This would suggest his ankle was sprained and cost him a roster spot as the Bills had what they thought to be enough depth at the position.

Those released with injury settlement were as follows: WR Rod Streater (Toe), S Shamiel Gary (Unknown), WR Jeremy Butler (Concussion), and LB Sam Barrington (Unknown). As previously mentioned, Streater sustained what I believed to be a turf toe injury back against the Eagles. While I still believe it was a Grade II sprain, it may have been too injured to warrant holding a roster spot. Up to that point, Streater was having a solid preseason. He could be eligible to come back later in the season if the Bills run into depth issues, but it is too early to tell.

Butler was a long shot to make the roster, but he sustained what now appears to be a fairly serious concussion back on 8/8/17 and hasn’t fully recovered. Losing reps while recovering most likely cost him a roster spot. It is unknown what stage he is at in the league concussion protocol, but considering he has not been medically cleared yet, he may be still in Phase 1-2. There was little to no information on the nature of Barrington’s or Gary’s injury or when they sustained the injury. I have only been able to find that Gary came out of the Eagles game early but no description of the issue.

As the Bills are still dealing with injuries such as Taylor, Yates, and Worthy in the concussion protocol, along with Dareus’ hip and Glenn’s foot, these should not prevent these players from missing extended time. As the front office continues to shake things up releasing RB Jonathan Williams, LB Gerald Hodges, and WR Philly Brown yesterday, I am pleased to see that they are not having to replace players out of desperation.

These injuries this preseason are a stark contrast to the past several years in which multiple, big name players found their way onto IR or had significant injuries coming into the season. Going back the past several training camps, 2016 saw 10 players start the season on IR with Shaq Lawson designated to return. 2015 saw 3 players on IR and Marquis Goodwin missing most of the season with significant issues. 2014 saw 4 players out including Kiko Alonso already out due to an off season ACL tear. Looking back further, most seasons start off with 3-4 players on IR or missing large chunks of time. I had to go back to 2011 in where only one player started on IR and the noteworthy IR placements came with Kyle Williams and Eric Wood later in the season. That team if you remember, finished 6-10.

This wraps up the preseason for the Buffalo Bills with depth appearing to finally be where it needs to be at to have a realistic shot at staying in games when a starter goes down. In the next several posts, look for a final analysis of all the preseason injuries in the NFL, dissecting the severity of injury, trends, and what this means for the upcoming season. For the dedicated Bills fan, I will be doing a post on the 10 year anniversary of TE Kevin Everett’s neck injury with a retrospective look at what occurred and the outcomes afterward. I look forward to further educating my fellow Bills fans, other football fans, and growing this endeavor! Go Bills!

Bills Concussion Woes

Reviewing the NFL concussion protocol including return to play criteria and how this affects the Bills QB situation.

It’s been well known that being a Bills fan is hard. Losing Super Bowls, long extended playoff droughts, ill-timed injuries, the list goes on and on. Right now, that trend appears to be continuing with the 2017 preseason. After the loss to the Ravens by a score of 13-9, the Bills are now 0-3, heading into a show down at New Era Field tonight against the Lions. As mentioned last post, the Bills continue to demonstrate some luck by missing all the ACL tears, sprains, and injuries that can derail a season even before it starts. Unfortunately, the Bills don’t escape totally free. Tyrod Taylor and T.J. Yates both went down with concussions, leading Nathan Peterman to play most of the game. After Taylor and Yates entered the concussion protocol, the Bills signed Keith Wenning to fill in until both QB’s are medically cleared.

After a player sustains a concussion, the player enters the NFL concussion protocol. Most of the time, that’s all we hear until the player is cleared to return to play and contribute. But what does the NFL concussion protocol consist of? What is classified as a concussion? I will break down what classifies a concussion, what the protocol looks like, and the general timeline to return. Hopefully, this will give a clearer indication of what to expect.

A concussion is defined as a violent blow to the head which can disrupt brain function temporarily. Some concussions cause loss of consciousness, but not always necessary for a official concussion diagnosis. The brain is surrounded by cerebrospinal fluid which helps bring nutrients to the brain along with providing some protection during light trauma. However, the brain does not have air bags to protect from larger impacts. In the case of a more significant blow, the brain will strike against the inside of the skull, and then possibly strike the other side of the skull. This is known as a coup-contrecoup injury. This does not always happen in every concussion, but may intensify the symptoms if more areas of the brain are affected.

Upon striking the brain, immediate changes occur with physical symptoms including headaches, confusion, amnesia, dizziness, nausea, vomiting, fatigue, and delayed response time. Further symptoms include sleep disturbances, light and noise sensitivities, irritability, and difficulty with concentration, among other symptoms.

The NFL Head, Neck, and Spine Committee came up with a comprehensive protocol to identify and effectively treat a concussion. To keep it brief, the criteria are: a direct blow to the head or a force that translates towards impact to the head; rapid onset of transient impairment of neurological function, changes in neuropathological changes, and clinical symptoms that may or may not involve a loss of consciousness.

Down on the field, the NFL uses the SCAT2 which is the Standardized Concussion Assessment Tool to assess the player. This protocol has been modified for the NFL and is consistent with the SCAT3 released in 2013. The advantage is that this test can be administered multiple times with valid results to determine a concussion immediately or if symptoms are delayed. This is a test to assess for a concussion but a more formal screening process is done during the preseason and after suspected concussion to fully diagnose.

Each NFL team has a plan in place consisting of an unaffiliated neurotrauma consultant and ATC spotter to indicate whether the player may have a concussion. The player must have been removed from the field, video replay must have occurred of the injury, and an assessment must be performed. If there is any doubt of whether a concussion has been sustained, then the full evaluation must be performed. No more will there be a player being waved back into games or being rushed back in. Numerous players have stated they went back into games and they don’t remember being a part of those games when asked later.

Players will continue to be checked periodically to ensure they do not develop symptoms later and incur further damage. These results will be checked against their baseline assessment to determine the severity. Players could exceed the baseline score but still have a diagnosis of a concussion. This prevents a physician from looking at the diagnosis of a yes/no and look at the entire situation rather than a score.

If the player has sustained a concussion, there are 5 levels of recovery that must be performed in order to return to the game. These must be achieved in order to be medically cleared to return to playing. They are as follows:

  1. Rest and recovery: Players should avoid or limit meetings, social media, electronics to allow the brain to rest and minimize symptoms until player returns to baseline function. The player may engage in stretching and balance activities that allow them to lightly stress the body and being the process to improve. During this time, neurocognitive testing will be performed to assess for clearance towards normal activities.
  2. Light Aerobic Activity: A graduated exercise program consisting of cardiovascular exercise which may include a stationary bicycle or treadmill along with stretching and balance activities. This will be gradually increased as the player remains symptom free and begin to return to team meetings, film study, etc.
  3. Continued Aerobic Exercise and Introducing Strength Training: Cardiovascular exercise will continued to increase intensity and simulate the sport specific activities, progressing to supervised strength training. Once again, if the player is symptom free, they can proceed.
  4. Football specific activity: All activities continue to increase in intensity and duration and resume football activities. These activities must remain non-contact to ensure no recurrence of symptoms.
  5. Full football activity/clearance: Once the player has achieved the first 4 steps, contact may be re-initiated and determine that they have no recurrence of symptoms. The player will be reevaluated by a team physician and if cleared, resume normal activity. If at anytime the player experiences symptoms, they are placed back in the concussion protocol and restart the process until they are symptom free.

If you would like to review the actual documents in greater detail, please click here & here.

While this is a fairly comprehensive protocol, this should continue to improve as we learn more about concussions. Unfortunately, this protocol does not give a specific timeline for return as each concussion is different. Observing the hit on Taylor showed him getting his bell rung may keep him out for an extended period of time. Yates concussion was not as clear as when it occurred which may indicate a better prognosis. While it is not guaranteed that Taylor will be ready to start, CBS Sports reports that Taylor should be ready by Week 1 and has not had any setbacks. Recent reports on Twitter that he is out signing autographs before tonight’s game, tolerating lights and music which could signify he is already on Level 2-3. I believe Taylor will be cleared to start Week 1 and lead the offense to several touchdowns. Continue to follow for updates following cut down day, full recap of preseason injuries, and analysis of the Bills going into Week 1.

Preseason Injury Breakdown Part III

Highlighting the injuries around the NFL following Preseason Week 3.

Another week of preseason football down, another week of major injuries to report! These injuries are not bumps, bruises, scrapes that an athlete would sustain over the course of playing football. These injuries continue to be severe, career altering, and out of control. If you would like to review the injuries from this preseason, please read Part I and Part II. Right now, there are 170 significant injuries that have forced players to either be injured enough to be injured/waived, miss extended time, or season ending.

Digging into this week’s preseason injuries, 23 players have been added to the IR or expected to miss extended time. Most of the injuries reported this week occurred during preseason games. ACL tears this preseason alone continue to skyrocket at an alarming rate, currently at 26 players. WR Julian Edelman (Patriots), LS Patrick Scales (Bears), WR Cameron Meredith (Bears), DE Matthew Godin (Texans) and LB Albert McClellan (Ravens) all ended their respective seasons in preseason Week 3 contest with the exception of McClellan going down in practice on Friday. McClellan and Edelman’s injuries were non-contact tears and Meredith, Scales, and Godin tore during contact plays. Special note, there have now been 2 long snappers that have gone down for the season due to ACL tears. This is concerning as long snapper is a lesser known, but vital position to every NFL club.

Other significant injuries to note are LCL/PCL tears, fibula and foot fractures, quadriceps tears, and tibial plateau fractures. The other 13 injuries consisted of undisclosed/unknown or various sprains. Once again, injuries are expected to occur, but the severity is what is most concerning. There have been studies that analyze adjusted games lost compared to win totals. Some of the least injured teams still missed the playoffs, yet teams that lose more players to injury still make the post season often and go deep frequently. Football Outsiders did a fantastic job analyzing these trends with reports going back several years. I would like to note that the adjusted games lost does not equate to specific win totals, but may indicate how crucial depth is towards overall success.

Breaking down which teams got hit the hardest by injury include: Bears & Cowboys with 3 each followed by Giants, Jets, and Patriots with 2 each. It appears the Bears have been hit the hardest, sustaining 2 ACL tears along with another player requiring wrist surgery, missing extended time. The Patriots continue to be hit hard, losing players in back to back weeks with season ending injuries. No team is immune to this, but some are clearly more fortunate than others.

Once again, the Bills for the most part escape without any season ending injuries. It was reported that both Tyrod Taylor and T.J. Yates both sustained concussions and are currently in the league’s concussion protocol. This leaves Nathan Peterman as the only healthy QB on the roster at the moment. The Bills did sign QB Keith Wenning who is familiar with OC Rick Dennison’s offense, but don’t expect him to stick around once Taylor and Yates are cleared to play. Besides the two concussions which hopefully won’t keep either out for long, the Bills continue to maintain a relatively injury free preseason. How this will translate to regular season games is anybody’s guess, but having a healthy team with depth is one step towards long term improvement.

Finally, the preseason end is near! The Bills wrap up the preseason with the Lions coming to New Era Field in a Thursday night match up. This will allow the coaching staff to address some of the problems including O-line play, penalties, and scoring. As a fan, therapist, and writer; I pray that the Bills get through this game without major injury going into the Jets game with the best roster possible. As the Jets have been touted as one of the worst teams this season, I do not expect them to roll over, especially Week 1. Expect a tough, grind it out game for the early part, with the expectation that the Bills pull away due to the increased talent on their roster. Look for Preseason Injury Breakdown Part IV coming up after the Lions game. If there are any specific injuries or players you have questions about, feel free to contact me.

Big Problem with Streater’s Big Toe

Analyzing Rod Streater’s Toe injury sustained during Preseason game 2.

As the preseason drags on, injuries continue to occur and further shape rosters ahead of cut down day on September 2nd. Some players are already assured roster spots, but others that need to still prove it or that are fringe players, every snap counts. One of these players that may still need to prove it is Rod Streater. Until last week’s game against the Eagles, Streater has had a solid camp, rebounding from a pair of foot injuries with Oakland that cost him sizable chunks of two seasons before regaining his footing with the 49ers last season. As Streater went undrafted coming out of Temple in 2012, he has had to fight every year for a roster spot. Seeing Streater go down with a toe injury in the 4th quarter certainly strikes a blow to his chances for a roster spot.

Today’s post will evaluate the possible injury Streater sustained in the Eagles game. I will also briefly assess any other injuries that occurred during the game, which was largely injury free Bills wise. Streater’s injury was by far the most notable injury to come out post game. Considering that later reports narrowed down the injury to a toe helped reduce the number of possible injuries significantly. Reports have indicated that he is not in a walking boot, not expected to miss any significant time, and is week-to-week.

Knowing the previously mentioned information, we can eliminate any fractures, dislocations, or any other possible areas of injury. While there are not any specific reports of the exact diagnosis, I can safely assume that Streater sustained a turf toe injury. A turf toe injury occurs when the big toe becomes injured, specifically hyperextended or bent back abruptly. This could occur during landing on the big toe, causing it to bend backwards and cause immediate pain. It was reported that he was dragged down to the turf following a catch in which the toe could have been caught, leading to the injury. As every other part of the body, each bone is connected to another bone via ligaments. An injury such as this could stretch out the ligaments supporting the big toe and create instability.

As a toe may seem insignificant when there are much greater injuries such as ACL tears, broken ribs, concussions; it is still vital to the overall function of the athlete. The big toe is vital to running due to this being the area that is pushing off the ground. If humans did not have a big toe, the running stance would be greatly altered. Try to walk without pushing off the big toe, very awkward in walking, nearly impossible in running. The toe also assists in balance stability during walking and standing, allowing us to stay upright compared to our four legged friends.

Having an unstable area that prevents pushing off limits the ability to run routes and sprint. Turf toe injuries can become a chronic problem if not managed correctly or if forced to return sooner than possible. Thankfully, Streater’s injury does force him to sit out, he will not miss any vital games. At this time, he would not be a candidate to be sent to IR, but would most likely be placed on the roster until he is fully ready to play. Considering he is week-to-week with a toe injury indicates that it may be a Grade II injury marked by moderate swelling, partial tearing of the structures around the toe, along with range of motion limitation and pain. To further differentiate between the severity of the injury, Grade I would be minimal swelling and bruising with some pain. Grade III would be significant swelling, total disruption of the surrounding structures of the toe, noted weakness during toe bending, and concurrent instability of the toe.

Surgery would only be indicated if there was an avulsion of the bone, any concurrent fractures, significant deformity, or failed conservative treatment, among other complications. As there are not reports that he is immediately having surgery, Streater will require rehab focusing on restoring range of motion to the toe, allowing pain and swelling to reduce. Once this has taken place, strengthening exercises will be performed, slowly loading the toe to build up strength and not cause further injury to the area. Once Streater is able to walk without any difficulty and report no exacerbation of symptoms, then he would be progressed to running, jumping, etc, eventually being cleared to return. Streater may also be fitted with a stiff soled shoe to limit extra stress on the toe during push off to reduce re-injury.

Expect Streater to miss the next 2 preseason games, at worst missing the first game in order to return to full health. As he is not considered to be more than a 3rd to 5th receiver, there are other players that can step up in the interim until Streater is ready to return. According to mock 53 man rosters, he is not on the bubble as some other players, but would benefit being healthy to ensure his spot and adequate playing time.

Other injuries to note coming out of the Eagles game, TE Jason Croom injured his ankle during the game and has since been placed on injured reserve. Also, S Trae Elston injured his hamstring, leaving towards the end of the game. There have not been any additional reports regarding Elston indicating that it is not serious. The Bills are halfway through the preseason with no major injuries. As a fan and professional, I do not recall a time when they did not suffer some type of major injury in the preseason. Looking at the past 2 preseasons under the Ryan/Whaley era, there had been 4 ACL tears in 2016, 1 in 2015 along with various other injuries including Sammy Watkins foot injury. This is a nice change of pace for the Bills and hopefully this trend continues. Most of the big name players will be out against the Ravens this Saturday, allowing those injured to continue resting and prevent new injuries from occurring. Continue to check back with new updates following the Ravens game.

Preseason Injury Breakdown Part II

Highlighting the injuries around the NFL following Preseason Week 2.

The NFL has finished preseason week 2 and the only constants are that rather meaningless games are being played and players continued to be injured. Since Part I of my preseason injury analysis, 29 players have gone down with some type of significant injury. While it is difficult to gauge the exact players due to dates and delayed reporting by teams, there is still a sizable amount of players placed on injured reserve or expected to miss significant time. Please be aware, there are some players that have been waived with injury settlements that have either signed with a new team or they are in the process and will alter the numbers when final count is made at the end of preseason.

Once again, the Bills escape the injury bug with major role players. The only player to note is rookie TE Jason Croom was placed on IR with an ankle injury. Reports are scarce on the severity of injury, leading to the possibility that he may get an injury settlement at a later date. Previously, I had highlighted the fact that the New England Patriots missed the injury bug up to that point. Within a day of publication, rookie DE Derek Rivers went down for the season with an ACL tear and sprained LCL. This occurred during a joint practice with the Texans on kickoff coverage. Rivers was the Patriots top pick of this most recent draft in the 3rd round.

To add to the ever increasing ACL tear total, the current number is 21, adding 3 from last time. With the previously mentioned Rivers; also suffering torn ACL’s were LB Tank Carder of the Browns, and LT George Fant of the Seahawks. All of these tears occurred during the 2nd preseason game with the exception of Rivers who was injured during a full speed drill during practice. According to the ACL Recovery Club on Twitter, there are on average of 50 ACL tears/season. Already through 2 preseason games, the NFL is rapidly approaching the halfway mark.

While there is a smaller sample size with this article compared to the previous article, there still have been several other serious injuries. Shawn Williams of the Bengals dislocated his elbow and is expected to be out 4-6 weeks. Danny Shelton of the Browns sprained his knee and is expected to be out 3-6 weeks. Keeon Johnson of the Giants fractured his foot, requiring surgery, landing on IR. The rest of the injuries consisted of generalized ankle, hamstring, and unknown injuries. Depending on the value the team has placed on that particular player will determine whether he gets released or spends the season on IR. To make special note, I am not including Odell Beckham in this due the minor ankle injury he sustained in Monday nights game against the Browns. He is on track to possibly return Week 1 and has not reported any significant damage.

Thankfully, there are not any superstars on this most recent list. Unfortunately, there are some significant role players that did dent that particular’s team depth. I expect that several role players to go down, continue to see major injuries occur, and several teams fortunes change based on these outcomes. Of the teams hurt the most of the past week, the Browns and Giants lead the way with 4 players followed by the Seahawks, Colts, Buccaneers, and Bengals with 2. Continue to follow this blog for updates and new articles. If you have any specific injuries or players you would like me to analyze, please leave a comment, message me via Twitter at @kyletrimble88 or e-mail me at kyletrimble88@gmail.com.

Charles Clay’s Longstanding Knee Problem

Assessing Charles Clay longstanding knee complaints and identifying the root cause of the problem

Injury wise, things are slow right now at One Bills Drive and I couldn’t be happier!! If you read my last post, you were able to see that the Buffalo Bills have so far been very fortunate keeping the injuries to a minimum. Jury is still out on whether it is the practice habits of Sean McDermott and company or if the football gods have mercy on all that is Buffalo. If the fans have to suffer through 2 preseason losses with 10+ penalties a game or a star player going down with a season ending injury, I’ll gladly take the former. As there have been no serious injuries to report, I have been able to look at nagging injuries such as Cordy Glenn and recoveries such as Reggie Ragland. Today’s post will evaluate TE Charles Clay knee complaints.

Charles Clay was drafted by the Miami Dolphins in the 6th round of the 2011 NFL draft out of Tulsa. Clay spent four productive years in Miami, after which time, during the 2015 off season, signed a five-year, $38 million contract with the Bills to add a new dimension to the passing game. Going into his 3rd year with the Bills, Clay has managed to play 27 of a 32 possible games for the Bills, bringing in 105 receptions for 1,060 yards and 7 TD’s. However, since Clay has come to Buffalo, the games and practices that he has missed have been due to knee complaints.

The fact that Clay only misses practice and occasional games immediately eliminates the possible serious injuries such as fractures and ligament tears. This allows creates the possibility of chronic conditions leaving several to consider. Sports Injury Predictor lists all of Clay’s significant injury history and Fox Sports lists when he has been on the weekly injury report. Most of his injury history consists of his knee along with occasional back, hamstring, and calf injuries. Knowing what is published from media reports, this is a chronic condition. Reports from various sources that can be found from ESPN, The Phins Insider, and Palm Beach Post all indicate that this has been an ongoing issue, that there have been complications, but never identify the exact injury.

Diving into the differential diagnosis of the possible complaint, there are several options. I have already ruled out serious ligament damage or fractures. There are other possible diagnosis that do not warrant consideration at this time due to unlikelihood or rarity. This leaves 3 potential diagnosis to consider: Osteoarthritis, meniscal injury, or knee bursitis. Osteoarthritis, known generally as arthritis, is a degenerative condition in where the ends of the joint are covered in a smooth material called articular cartilage. This material is found on the ends of every freely moving joint surface in the body. Over time, this cartilage can wear down due to injury and poor management/healing. Studies have been performed demonstrating that consistent exercise and proper injury recovery over time can help keep these joint surfaces healthy. This supports why not everyone requires knee replacements once they hit a certain age. In addition, my clinical experiences have shown that arthritic knees do not swell up rapidly and often, especially at Clay’s young age. Unfortunately, this may be an expected outcome once Clay’s playing days are completed. He may already have some degenerative changes, but I can say with strong certainty that this is not the source of Clay’s complaints.

Another diagnosis that is a strong consideration is meniscal injury. This diagnosis is possible due to his known surgical history from 2012 to repair a torn meniscus which sent him to the IR while with the Dolphins. The meniscus acts as a shock absorber in the knee, helps disperse weight between the femur and tibia, and maintain structural integrity during movement. However, a repaired meniscus typically would not cause chronic issues for 4+ years in my professional experience. Clay did have an arthroscopic surgery during the 2014 off season to clean out his knee which most likely cleaned out any loose bodies or shaving down the meniscus due to fraying. He was cleared to practice shortly after, but then began experiencing further complications limiting his practice during the preseason. However, if he were to have a meniscal tear or fraying, the surgery would have corrected it and would not continue to have chronic issues.

This leaves knee bursitis as the reasonable diagnosis. Bursitis is a condition in where the bursa in the joint becomes inflamed. Bursa are fluid filled pockets in the joint that secrete a fluid known as synovial fluid which helps keep the joint lubricated and reduce the friction between joints. Think of the effects of motor oil in an engine. Sometimes, when a separate injury occurs, the bursa in the injured joint can become inflamed as a result. Returning back to practice sooner than expected could add extra stress to the joint and cause swelling. Direct blows to the knee can also cause the bursa to become inflamed, such as falling directly on the knee or striking it against a helmet/body part. There are multiple bursa around the knee resides that could be damaged. Surgery could be performed to remove the offending bursa, but this may cause the player to miss more time than expected and is rarely performed. This can be a chronic condition that takes some time to resolve.

I believe this is the appropriate diagnosis due to this supporting articles from ESPN and The Buffalo News. This indicates that it is knee bursitis due to repeated swelling and drainage, the lack of immediate concern, and his ability to play most games despite the current complaints. At worst, it is an annoyance which can cause pain, swelling, and keep Clay from producing on the field. If you would like additional information on knee bursitis, you can find them here, here, and here.

Having been to Bills preseason practice along with observing game film and pictures, Clay has not been seen wearing a bulky brace, indicating possible joint instability. Instead, he is seen wearing a neoprene sleeve, allowing for compression of the joint and reducing the possible incidence of recurring swelling during strenuous activity. Clay’s production has not been significantly slowed compared to others at his position. Considering the amount of money that Clay is paid, it is the public expectations that he produces at a greater output. It would also be beneficial if Tyrod Taylor were able to improve his passing abilities, but that’s a discussion better left to my friends at The Rockpile Report.

Considering that Clay hasn’t missed any games yet this preseason and has only been slowed at practice, this is not a cause for concern. However, the team must continue to effectively manage the knee so as not to exacerbate it and cause further complications. He may be dealing with something that is not aware to anyone but him, the coaches, and his doctors which if known, could drastically alter my thought process and discussion. I believe that Clay will be able to perform at a consistent level this season, occasionally requiring down time to ensure that he does not create further damage to the knee.

Preseason Injury Breakdown- Part I

In depth analysis of the injuries occurring around the league. This article highlights areas of concern and injuries through the 1st preseason games.

Since Sunday’s post, every NFL team has played one preseason game. Depending on which fan base you speak to, it has either been a fantastic or horrible preseason. I’m willing to wager that those that rate their team’s preseason as horrible may be due to injury. If you’ve been following Twitter, ESPN, or local news, there’s been numerous reports about the significant injuries that have possibly derailed the regular season before it has even begun.

I have previously mentioned that I am focusing this blog on Buffalo Bills injuries. However, as I am a Physical Therapist, this allows me to expand as I wish into other areas of interest. Since the beginning of the preseason, I have been tracking nearly every injury that has occurred in camps around the NFL. Injuries that I deem worth tracking are ones that force a player to miss extended time, season ending, or placed on injured reserve. For my analysis, these injuries must have occurred during the preseason. Those that had off season injuries/surgeries or injuries from last year that are still recovering are not included in this analysis. This allows for a more specific time frame to be assessed. As of publication, I fully expect these numbers will change. Players will continue to get injured, waived, and reach injury settlements. My goal with this article is to highlight areas of interest and concern.

Of what has been publicly reported so far, there has been 119 players that have been either placed on injury reserve or expected to miss significant time. Of those 119 players, 26 have been released with injury settlements, allowing them to heal on their own time, get compensated, and seek out opportunities with other teams once they are cleared. If you would like additional information about the waived/injured status and process of injury settlements, please check out this article. Most of these injuries consist of hamstring pulls, ankle sprains, and unknown/undisclosed injuries. The most unique injuries of this group are a bruised lung and a Jones fracture, the same type of foot injury that sent Sammy Watkins packing to the Rams.

Of the 93 remaining players, 16 of these players have not been placed on injured reserve. These injuries consist of rather significant injuries consisting of various fractures and surgeries. These are injuries that the teams has deemed not appropriate to use the designated to return tag on injury reserve. If they used this tag, this would prevent the player from being cleared to play until at least Week 8. Considering that all NFL teams do not have to cut down rosters to 53 until September 2nd, there is incentive to allow these players to rehab and have them ready by Week 1.

This leaves 77 players whose seasons have ended before they even began. Think about that for a second, you have nearly a full roster and a half of NFL caliber players sitting on the sidelines recovering from injuries. Remember, the NFL has only played one preseason game so far. There are 32 teams in the NFL of 53 players on each active roster equating to 1,696 players. With the already injured players, you could add a 33rd team without difficulty if these players were healthy. Most of these teams have been in camp for only 3 weeks. While that is sinking in, I will continue to break down the injuries.

One of the highlighted injuries we see too often is ACL tears. Highlights of the mechanism of injury have been previously highlighted in my Reggie Ragland post. Already, we have seen 18 ACL tears and this is not stopping. Of all of the tears, 16 have been reported as ACL only, 1 reported as ACL, MCL, and 1 reported as ACL, MCL, PCL. Looking back at the past two years of training camp, 2016 training camp totals saw 16 ACL tears and 2015 training camp totals saw 15 ACL tears. At this rate, it would realistic to see the final number for this preseason reach the mid 20’s, possibly even equal the past two years combined. Of the 18 tears, 11 are defensive players, 5 are offensive players, and 1 special teams player.

One area that has improved so far is Achilles’ tears. To date, there have been 3 Achilles’ tears, compared to 6 in 2016 and 7 in 2015. Of the Achilles’ tears, 2 are defensive players, 1 is offensive. Breaking down the rest of the injuries briefly, several injuries of concern consist of spinal injuries which include lumbar and cervical complaints. Other injuries include torn hamstrings, pectoral tears, sports hernias, wrist dislocation/fractures, concussion, or undisclosed.

This is just a small sample size of what we as fans are seeing. There may be even more that have not been publicly disclosed yet or details still emerging. The NFL still has just over 3 weeks until Week 1 kickoff. I can tell you with the utmost certainty that these types of injuries will continue to occur. I expect some types of these injuries to decline as players continue to improve their conditioning and skills required for their position. I also expect these injuries to occur occasionally at practice and but with a higher frequency in preseason games. We have already seen stars such as Ryan Tannehill go down for the season during practice. I expect to see several other bigger name players go down for some time. Assume that players on the roster bubble to be the bulk of the serious injuries that remain. Several veterans have been injured, but of the 119 players injured so far, 98 of these players have 3 years or less NFL experience, which is the typical length of an NFL career.

Finally, I will take a brief look at teams who have been hit hard by the injury bug versus those that have mostly escaped major injury. Of the 32 teams, several have been hit quite hard. Leading the count with 8 players significantly injured or on IR are the 49ers, Dolphins, and Ravens. Following behind with 7 players are the Colts, Jets and Jaguars. Next with 5 players are the Chargers, Chiefs, Lions, and Redskins. The rest of the teams have 4 or less on IR. Two teams that I want to specifically highlight are the Buffalo Bills and the New England Patriots. The Buffalo Bills have only had 1 player be placed on injury reserve so far; Keith Towbridge with a foot injury. As much as I hate to state this, the New England Patriots are the only team that I have found to not have anyone seriously injured during this year’s training camp.

While I am a Physical Therapist and could continue to go down the rabbit hole with these injuries, I will save my commentary for future blog posts. Take these numbers for what they’re worth. Football is a rough sport, these statistics prove it. I would like to give credit to NFL Trade Rumors, Spotrac, and ESPN for providing the raw data and updates necessary for this post. As a fan and professional, I hope that the injuries for the Bills continue to occur at a minimum, allowing them to go into the season with the depth required to be successful. Continue to check back for future posts updating these stats along with further analysis of specific injuries.