Football Is Back!

Football is back! The Buffalo Bills played the Minnesota Vikings last night in a 7 pm tilt at New Era Field to a 17-10 loss where we were able to finally see the McDermott era begin. While this is preseason and there isn’t much to take away from this first game, we do get to see who is ready for game time action and how some of the new acquired pieces are fitting together. While I did not watch the entire game, I was impressed with what the first team units were able to produce. Eddie Yarbrough was solid in his debut in a Bills uniform, constantly pressuring the QB and recording a solid sack filling in for the injured Shaq Lawson, out with a groin injury. Nathan Peterman moved the offense along and got the team back into contention with his first passing TD to Dez Lewis towards the end, though came up short. The running game continues to remain a strong focus of the offense, looking especially effective with Jonathan Williams and Mike Tolbert barreling through the line picking up solid yardage. Tyrod Taylor looked excellent getting the ball to Sammy Watkins, who showed no hitch in his step hauling in several catches before his day was done.

But Dr. Trimble, you stated this would be a blog about Buffalo Bills football injuries? Indeed it is reader! I would like to note that the Bills got through this game without any significant injuries. Prior to the game, it was reported that Shaq Lawson, Cordy Glenn, Kevon Seymour, Jeremy Butler, and Ryan Davis would be held out due to a variety of ailments, none that I expect are long term issues. Lawson, Glenn, and Seymour held out as a precaution; Butler and Davis still currently in the concussion protocol.

Thankfully, no serious injuries or concerns were noted for the Bills during the post game. Injuries to note were Tyrod Taylor exiting the game early to be evaluated by the training staff and quickly returning to the game. Also reported was Jonathan Williams exiting the game with a hamstring injury which was described as “very minor”. Expect Williams to either sit out a practice or two at most, but not to miss any extended time or even the next game based on current analysis.

The final player to leave the game for the Bills was LB Tanner Vallejo, the team’s 2017 6th round draft pick, with a shoulder injury. It is currently unknown which play injured Vallejo. As he was deemed questionable and then downgraded to out signifies that it is not a serious injury. Quite possibly, Vallejo landed hard on his shoulder during a play, leading to a slight AC sprain, which if not addressed right away, can worsen with continued play. With it being a preseason game, there wasn’t any incentive to put him back in and cause further injury. I expect Vallejo to possibly sit out several practices and restrict direct contact for the time being. At worst, he will miss a game as a precaution, but I do not expect this injury to keep him sidelined for long.

Unlike the Dolphins and Jets, who have sustained significant and long term injuries to key players, the Bills have not been bitten by the injury bug so far this training camp. As a Bills fan, I find that I am an eternal optimist with the team expectations at the beginning of each season. However, I do expect some guys to get banged up or miss some time. The NFL is a rough sport, players will get hurt. If this first game was any indication, things are looking good. Performances like this will allow the Bills to minimize injuries going into the season opener with the starters healthy and finally having the depth they’ve lacked on the roster for several years.

Cordy Glenn-Perpetually injured

Cordy Glenn injured his ankle in the preseason of 2016 and has been dealing with the injury ever since. Due to the rigors of the NFL schedule, it is common to deal with nagging injuries that never fully heal during the season. However, due to the Bills ongoing playoff drought, Glenn has not seen the post season since joining the team which means that Glenn has extra time to rehab his ankle. It has been nearly a year since his original injury and yet he still has not returned to full health according to reports. High ankle sprains can fully heal without complication typically, but in Glenn’s case, it continues to be an ongoing issue.

Usually, high ankle sprains require 6 weeks to heal, but can take longer depending on the severity of the sprain. A sprain occurs when the ligaments that stabilizes the connections between the bones becomes damaged which results in instability and an inability of the joint to function properly. In the case of a high ankle sprain, the top of the fibula, the bone that connects on the outside part of the leg near the knee to the tibia via the syndesmotic ligaments, becomes damaged. This is due to stress being placed on the outside part of the ankle, higher than where an individual would roll the foot under during a true ankle sprain. Stresses at a higher level either forces the higher portion of the fibula to pull away from the tibia, causing a sprain. If the foot is fixed into place and the force is great enough, the fibula can break. These forces during the injury are typically seen as external rotation, also known as outward twisting of the foot. Considering the movement of the guard position, plus the 300 lb. bodies falling on top of each other into a massive heap explains why he injured the ankle in the first place. Glenn was placed in a walking boot to stabilize the initial injury and appeared to heal enough to start Week 1 of the NFL season. Glenn then re-injured it during the season opener which caused him to miss the next 3 games. Most likely Glenn originally sustained a Grade 2 injury leading him to sit out the preseason, re-aggravating the injury to a possible Grade 3 later on. Glenn was able to play the rest of the season, missing several games, but clearly not at 100%.

With Grade 3 sprains, the presentation is where the ligament has ruptured, in which the attachment has completely torn or has become so damaged that it can no longer provide effective support. If Glenn did sustain a Grade 3 sprain, surgery is usually recommended, though not always a given. There has been no reports out stating that Glenn had surgery to stabilize the ankle, but considering he is still dealing with the injury, it is quite possible it was not publicly disclosed. The healing time can be anywhere from 3 to 6 months depending on severity of injury. Considering that the Bills season ended at the end of December and that he was not a full participant for OTA’s, the timeline would fit as to why he is not at full health.

Another possibility is that Glenn may also be dealing with chronic ankle instability. This is the result of a recurrent injury leading to deficits in posture control, proprioception, muscle reaction time, and strength leading to a delayed recovery time. This is also more likely due to the demands of the offensive lineman position. Most actions require strategic blocking performing lateral shifting, re-positioning his stance, and driving forward to maintain balance and power required for the position. Rehab for this involves significant focus on balance retraining on the involved foot, progressive loading, and bracing.

Based on the available reports published, it is possible that it is either one of the two scenarios. Both have positive outcomes, but does explain why Glenn is not at 100%. As of August 4th, Glenn is still continuing to deal with potentially the same issues. He has been held out of practice, citing “foot soreness”. It was reported that he went to Charlotte, NC to see Dr. Robert Anderson, a nationally known physician specializing in foot and ankle injuries. Glenn has since returned to practice since the evaluation. While this is continually frustrating being a Bills fan; as a professional, I would rather have the athlete ensure that they are at 100%. At this level, it is not wise to ignore nagging pain, soreness, or small injuries that can lead to further complications down the line. Expect him to be limited in the preseason so as not to aggravate the healing injury. Ideally, Glenn returns to full health for Week 1 and stay healthy to provide effective blocking for the offense to perform at its best.


My name is Dr. Kyle Trimble and I am, first and foremost, a Buffalo Bills fan!!  I am proud to call myself a Bills fan; a group of fans that commonly refer to themselves as the Bills Mafia, individuals who are passionate, devoted, and yearning for a winner after far too many years of bad to at best, mediocre football.  When I am not reading, watching, or listening about the Bills, I work as a Physical Therapist.  Being a Buffalo Bills fan for the better part of 10 years; I have experienced some highs, many lows, and a lot of what ifs.  Most commonly I hear, what if (insert player name) didn’t get hurt?  Or, too bad (insert player name) got hurt, now we have to rely on (insert horrible backup), our season is done!

My purpose of this blog is to report on the goings on of the Buffalo Bills injuries.  I will analyze different aspects such as why the player got injured, how the injury typically occurs, speculate on the extent of the injury, timeline the player may be out, and the impact it has on the team.

While I could keep busy with injuries from the Buffalo Bills, this blog will not be limited to solely the Buffalo Bills.  Based on significant player injuries around the NFL, trends, research, and questions; I will write on whatever is on my mind, and whatever questions, you, the reader may have.  I write because I enjoy it, I write because I like to educate, and I believe that a fan that is educated on how injuries affect their favorite team can have a more realistic view on the NFL season.

To give a background on myself; I was born and raised in Erie, PA, moved to Buffalo in 2006 to begin my studies at D’Youville College towards becoming a Physical Therapist at which time I became a devoted Buffalo Bills fan.  I graduate in 2013 with my Doctorate in Physical Therapy and moved home for several years.  Moving back to the Buffalo area in 2016, I have gained extensive experience in outpatient orthopedics, skilled nursing, acute care hospital, and home care.  Having obtained a significant wealth of knowledge that continues to grow, along with a undying fandom of the Bills, puts me in the unique position to educate my fellow fans about our great team. To add, I am an contributor and occasional guest on the Buffalo Bills podcast, The Rockpile Report.  I have many ideas to write about, many which I expect you will enjoy.  I welcome any comments or questions you may have.



Reggie Ragland- Return to form

It’s been just over a year since Reggie Ragland ran down Reggie Bush towards the sideline, pulled up and fell to the field, ending his 2016 season with a partially torn ACL. Going into the 2017 season, the big question is whether Ragland will be ready to suit up and become the heart and soul of the Bills defense. To understand why there is so much uncertainty going into this season, we must understand why the injury is so severe.

The ACL is a ligament that connects the tibia to the femur and acts as a stabilizer in the knee to prevent the femur from shifting too far forward over the tibia; it also assists in preventing hyperextension in the knee. When the knee is placed into unnatural positions such as cutting and sudden stops, the ACL typically keeps the knee intact, but in the instance of injury, the ligament either stretches out, partially, or fully tears based on the activity. Along with the ACL tear, meniscus and MCL tears occur, referred to as the “Terrible Triad”. This does not occur in every case, such as Ragland’s, but is certainly a cause for concern for long term rehab potential.

There are two types of ACL tears, direct contact and non contact. Direct contact being a direct blow to the knee, such as a chop block. Non contact is when the player changes direction suddenly and the knee gives way, which is what occurred during Ragland’s injury. In Ragland’s case, he partially tore the ACL, leading to instability, similar to what occurred last week with Ryan Tannehill of the Dolphins. Without the ACL providing stability, the individual is unable to stop suddenly or pivot to change direction without the knee giving out, resulting in further damage to the surrounding structures in the knee. These movements are vital for any football player, regardless of position. This would increase missed playing time and significantly reduce the length of careers. 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.

In May 2017, Ragland reported that he has been cleared to return to full contact participation, which is 9 months after his surgery, indicating that rehab went well and that he has passed all the initial conditioning tests. This includes, but not limited to: demonstrating that his left knee is at least 90% strength wise in his quadriceps, and 80% in his hamstrings that of the right knee. He must demonstrate no pain/swelling in the right knee during activity, exhibit full range of motion, demonstrate basic agility activities and resume a running program that is pain free. A general, comprehensive ACL reconstruction protocol can be found here. (Note: this is unlikely the exact rehab protocol used with Ragland, most orthopedic surgeons vary based on personal preferences and training.) Once this has all taken place, he is cleared and able to resume football related activities. A non professional athlete would be able to resume normal activities without restriction, save a stabilizing knee brace for extra protection. In Ragland’s case, he is a multi million dollar athlete that extra precautions will be taken to ensure the surgery success. He will most likely be required to wear a knee brace, but will reduce the incidence of another non-contact ACL tear.

As of now, Ragland appears on track to return to participating in training as a full participant. This has been evident through the first week of training camp, easing back in with the 2nd team to limit reps, according to McDermott. This will allow Ragland to step on the field to knock off the rust, but between rehab and an extended look during training camp will really allow him to round back into football form. Professional opinion, I fully expect to see Ragland return to full form, easing back into game play on a snap count as the preseason begins. Currently, he’s listed as 2nd on the depth chart at MLB behind Preston Brown. This is a great spot for him as this indicates that he will see significant playing time, but not expected to contribute right away while still learning the defense. While there is a risk of retearing the ACL, as seen with RGIII, Casey Hampton, and Thomas Davis, the risks remain low. Expect to see Ragland fine tune his game in the preseason, get back up to game speed, and then released to pick up where he left off in college, shoring up the LB corps and fitting into McDermott’s defense.