Studying the Strain

Educating and understanding the general muscle strain, grade severity, and complications.

Today’s post will consist of identifying several terms used to describe injuries and educate on how to differentiate on what is being reported. I have used many of these terms before and have done my best to describe them, but I believe they are worthy of their own article. Today’s overviews will consist of the common muscle strain.

A muscle strain can occur in virtually any muscle within the body if the muscle is suddenly overworked, stretched, or fatigued to the point where the muscle becomes injured. A strain is classified as a strain due to an injury to the muscle itself or the muscle bone attachment which is called the tendon. There are varying grades of muscle strains which can progress up to a muscle tear, avulsion fracture, or rupture.

Grade 1 muscle strains are relatively minor and is when a portion of the muscle is torn; function may be limited, but is typically not serious and can heal up relatively quickly with proper management. This usually consists of stretching, icing, anti-inflammatory medications, and light strengthening exercises to restore proper movement. With effective management, this can be a week-to-week injury.

Grade 2 muscle strain is where a moderate portion of the muscle is torn which is typically associated with bruising, swelling, and partial loss of function which is demonstrated as difficulty performing the muscle movement and is typically limited secondary to pain. Rehab management will consist of generally the same procedures as Grade 1, but will take longer to heal up. I can not make a blanket statement and state that a Grade 2 muscle strain will take “X” number of weeks to heal up. It is typically more than week-to-week, but based on location and job duties of the position may dictate how long the player is out.

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Credit: eorthopod.com

With an injury such as this close to the tendon occurs, if not healed up correctly or chronically injured/overused, the muscle or tendon may develop into a tendinitis based on healing. The suffix “-itis” is Latin for inflammation, which indicates that the tendon is irritated and may become painful over time. Most muscle/tendon fibers have consistent, linear striations, such as in a nice cut of beef or in the picture above. When the tendon does not heal correctly, the connective tissue heals in an uneven pattern as seen in the picture below. This does not allow for ideal effectiveness of the tendon, leading to increased pain, weakness, and loss of function. This could lead to tendonosis which is the chronic form of tendinitis and becomes even tougher to treat. Eventually, this can lead to a higher risk of rupture in the tendon later but is not a requirement for a rupture to occur.

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Credit: mendmeshop.com

Grade 3 is where most of the muscle is torn, there is typically significant damage and surgery is possibly required to repair the structural damage. There is significant swelling, bruising, and pain to the area due to the sudden and forceful nature of the injury. The muscle no longer is able to function as intended and pain limits the possibility to attempt. At this point, several other injuries may have occurred including avulsion fracture or ruptures. If an avulsion fracture or rupture has not occurred, surgery still many be indicated to assist the muscle in healing correctly.

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Credit: physicaltherapyct.com

In the case of an avulsion fracture, the tendon that attaches the muscle to the bone and acts as the anchor pulls away from the attachment point and takes a chunk of the bone with it. While this injury is uncommon, it still does happen. Surgery is sometimes indicated to reattach the bone to the original area and requires extended time missed, requiring the body to build up toleration to the muscle pulling on the attachment point without re-injuring the area.

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Credit: tylerfootclinic.com

Finally, a tendon rupture is when the tendon tears away from the attachment point but does not take a piece of bone with it. This is commonly seen in biceps and Achilles’ injuries, among other areas. If this injury occurs, the player may feel a pop with immediate loss of function. The muscle may act like a bungee cord and rebound violently and become balled up, leading to a deformity. These types of injuries also require surgery and cause a player to miss extended time due to the requirements of the muscle contraction and the actions of the muscle.

This is just a brief overview of the muscle strain and how to understand the various nuances of the wording and injury. Sometimes injuries such as calf and hamstring strains can follow a player for their career or never fully heal for sometime. The best thing that a player can do is hydrate well, stretch effectively, strengthen properly, and listen to their bodies. While the NFL is a tough sport, pain is expected, but trying to play through an injury may only worsen it and cause further complications down the line. Continue to check back for posts regarding other general injuries and broaden your knowledge base. GO BILLS!

Time to Learn

Updating Bills injury news and previewing posts for later this week.

At this point in time, the Bills are hopefully enjoying their time off and getting the much needed rest and rehab required to go into their match up against the Buccaneers next Sunday. This week was wild enough without the Bills playing and driving us insane. The Jets looked very competitive, losing to the Patriots 24-17 with a controversial TD overturned that could have changed the outcome of the game. The Dolphins upset the Falcons in their home 20-17, possibly exposing their Super Bowl hangover. With the way the AFC East games played out today, I expect each game to be a dog fight with no one lying down to wait for 2018.

As the Bills are on the bye, news has been lacking coming out of One Bills Drive. The team has been silent with injuries since last week, offering no updates or return to play expectations regarding Charles Clay, Ramon Humber, or Nick O’Leary. At time of publication of the game recap against the Bengals, it wasn’t known that Nick O’Leary suffered an injury against the Bengals. It was listed as undisclosed and as of today, still is not known what he is dealing with.

In other news, it is also worth noting that Charles Clay has not been moved to IR with designation to return. This tells me several things. This tells me that his injury may not be as severe as originally thought and may be back sooner than 8 weeks. This tells me that the team has faith in their training and medical staff, in that they keep a roster spot for him despite lacking depth at the position. Finally, the team has not gone out and found a big name free agent TE, indicating that they will rely on what they have. I have also stated before that I have no insider knowledge; just knowledge of the injuries and recovery process. With that said, I want Charles Clay to prove me wrong. I want him to return faster than expected. I want him to return healthy and contribute to the team as he was prior to his injury. Time will tell how this one plays out.

As there is little Bills information regarding injuries to report this week, I will go in a different direction. While there are a multitude of injuries that can be covered, I will look to outline general injuries so that you may understand the differences between each issue. My goal this week is to allow you to decipher what is going on when an injury occurs, how severe it may be, and generally, what to expect even before more information is publicly known. Continue to check back daily for new posts regarding these injuries and learn a thing or two! GO BILLS!!

Handling the Hamstrings

Educating on the all too common hamstring strain, levels of severity, and prevention.

As the Bills are on a bye this upcoming Sunday, this allows some deviation away from Bills injury talks to discuss general matters, my thoughts and opinions, and review ideas/thoughts that may get lost in the shuffle of the busy season filled with injuries. Already this season, we have seen Pro Bowl, All-Pro, and HOF caliber players go down with injuries that are potentially career ending, career altering, and just plain unfortunate. Over the next week, I will look to identify and explain general injuries that regularly occur and how to differentiate between injuries and their severity.

Today’s post will look at the all too common hamstring strain. This is an injury even the best conditioned athlete can sustain. This article will not focus on one specific player, but rather educate and inform what the hamstrings are, how they operate, why they’re injured, and prevention.

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Credit: myprotein.com

The hamstrings are made up of 3 muscles in the back of the thigh consisting of the biceps femoris on the outside and the semimembranosis and semitendonosis on the inside. Together these three muscles attach to parts of the upper femur and bottom of the hip which is called the ischial tuberosity . This is the bony part that everyone sits on when they are in a chair. At the other end, they connect to the top of the tibia and fibula, which is the lower leg bones. Due to the muscles crossing over two joints, they have different functions. Together, these muscles allow the leg to extend and drive the body forward, along with bending the knee. During running and blocking, these muscles cycle through the process of shortening and lengthening at regular intervals depending on the position of the leg.

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Credit: livestrong.com

To help you envision the hamstring functioning, picture a sprinting athlete. Typically, one foot is in contact with the ground, the other in the air. During the foot that is in contact with the ground, the hamstrings with other muscles assist in extending the thigh to assist in moving the body forward. As the body moves forward and begins to push off, the other leg begins the process towards beginning to make contact with the ground. Once the original leg finishes pushing off, the knee begins to bend to assist in clearing the foot to bring the leg forward. Even during the portion where the leg makes contact with the ground, the hamstring is loading back up and eccentrically contracting which means that it is accepting a load while lengthening, which is the most taxing type of muscle contraction. While the hamstring does sound confusing, it can be, but know that without them, you’re not doing much walking without them

During times of injury, the muscle can be overworked, overstretched, or fatigued, leading to part of the muscle to become injured. Depending on the severity and location can dictate the recovery time. A strain is due to the injury to the muscle or the muscle bone attachment. Grade 1 tears are the least severe in which a small portion of the muscle tears during excessive activity. This can heal up rather quickly but several days of rest, stretching, and light exercise can remedy the muscle.

Grade 2 hamstring tear is where at a moderate portion of the muscle tears with a greater force, leading the player to limp and be unable to properly use the affected leg as intended. Typically, there is greater bruising and swelling with initial difficulty placing weight, keeping the player off it for some time. Bruising, poor functional control, and tenderness may occur during this time.

Grade 3 hamstring tear is where the muscle nearly or completely tears. It can also pull a chunk of the bone away from the bony attachment, most likely at the ischial tuberosity, known as an avulsion. This is due to this area being the anchor point, meaning the harder the muscle contracts, the harder it pulls on the anchor point, leading to eventual overload. At this level of injury, the muscle is quite weak and function is no longer normal.

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Credit: physioprescription.com

These types of injuries occur when an athlete suddenly tries to decelerate and change direction, hurdling a player, or trying to push their body faster and faster. This can also occur during blocking, trying to maintain their ground as their being pushed forward and backwards, eventually the muscle gives out and the player becomes injured as a result. There are countless ways for the hamstring to be injured, these are just several of the more common mechanisms of injury.

While the injury is not fully preventable, there are certain steps that can be taken to reduce the incidence. Some preventable measures that can be taken is ensuring proper hydration, conditioning, stretching, and strengthening. Some things that can’t be controlled is previous hamstring injury and increased age. The best method to treat an injury is to prevent. However, I would be hard pressed to find an athlete that has not sustained some sort of hamstring injury during the course of their athletic endeavors.

As Bills fan, we have already seen several players deal with hamstring injuries this season with varying degrees of severity. As a PT, I am not concerned about the long term management of the injuries. I know these players need time to rest, recover, and not to rush back. I would expect to see these injuries increase as the season wears on and the bodies begin to break down. So far, several players on the Bills such as Marcell Dareus, E.J. Gaines, Matt Milano, Nick O’Leary, and Deon Lacey have all spent some time on the injury report this season due to this malady.

I hope this helped educate your understanding on the purpose of the hamstring, why it gets injured, and what it means when a Bills player or another player you follow goes down with the injury. Over the next week, I will continue to outline other common injuries or any specific injuries that occur. Thank you for your time; just doing my job one post at a time to help educate the fellow Bills fan and realize that not every injury is season ending or dashing the team’s success each year.

Charles Clay Clunky Knee

Reviewing Week 5 loss against the Bengals and impact of Charles Clay knee injury including long term outlook.

The Bills, well, the Bills lost. They lost a very winnable game by a score of 20-16 in Cincinnati. The offense never got going, the run game doesn’t look anything like it has the past 2 seasons, and this Bills team continues to make this fan base crazy. That’s the nice, politically correct way of saying that. Two years from now, this will be a game that won’t be marked as a trap game, the kind of game that is an expected win. However, we all have to “Trust the Process” and trust I will!

Sunday was one of those games that while the depth that has been lacking in past seasons was there, the talent and cohesiveness was not. The team continues to stay relatively healthy, not losing anyone to season ending injuries. Notable injuries to the Bills are CB Leonard Johnson who left with a hamstring injury in the first half and did not return. However, the focus of today’s article is TE Charles Clay’s left knee injury sustained after catching a pass and getting hit in the knee going out of bounds towards the end of the first quarter. This resulted in Clay ending his day early and getting carted off the field.

Anytime someone sees an elite player go down with a knee or leg injury, they automatically think ACL tear. Why do we think that? Because the ACL is the sexy injury that the media loves to talk about. Everyone knows its serious, everyone knows its season ending, and it’s all over the news constantly. As you begin to hyperventilate or start cursing the Bills, R-E-L-A-X. Clay did get injured, it didn’t look pretty, and the results aren’t great. If you care to continue reading, I will help you step back from the edge and explain what really happened.

Based on reports, Charles Clay sprained his MCL, tore his meniscus, and will be out for an extended time with surgery to fix the meniscus. Most people know that if the ACL is bad, then the MCL must be bad as well. It is but it isn’t. The knee is comprised of many different structures including but not limited to: bones of the knee: femur, tibia, patella; ligaments including: medial collateral ligament, anterior cruciate ligament, posterior cruciate ligament, and lateral collateral ligament; soft tissue includes cartilage and medial/lateral meniscus.

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Credit: webmd.com

The MCL runs on the inside portion of the knee connecting the femur to the tibia. The MCL allows for stabilization medially and along with the LCL, prevents the knee from going east/west and ensures that knee works as a hinge joint. When the MCL is sprained, the ligament is stretched and partially torn as with any other sprain. However, the MCL is more dynamic in that it connects into several muscles in the knee including the vastus medialis, sartorius, semimembranosus, semitendiosus, and gracillis. The MCL also attacks to the posteromedial portion of the medial meniscus. To simplify it, at various points, the MCL connects to parts of the quadriceps, hamstrings, adductor muscles, and part of the meniscus. Without these many connections, the knee would be far less stable and would not be able to change direction suddenly.

Despite a fantastic design by nature, design only allows for so much prevention. The MCL typically gets injured during sudden changes in movement such as cutting and pivoting. The MCL also becomes damaged during direct blows to the outside part of the knee during knee flexion, which is what occurred with Clay when a low tackle hit him out of bounds.

The MCL severity grades are broken down into 3 grades with the increasing grade indicate level of severity. Level 1 consists of some fibers torn with tenderness and no instability. There is some pain during application of force to the outside of the bent knee, but nothing else significant.

Grade 2 consists of increased pain and more noted swelling. There is moderate tenderness and laxity in the joint. Most of the pain is on the inside of the knee and patients typically poorly tolerate laxity testing to the MCL. There are varying degrees of a grade 2 sprain including 2- and 2+ depending on amount of damage.

Grade 3 is a complete rupture of the MCL, leading to instability along with extreme pain and swelling, resulting in difficulty with bending the knee. The knee also gives away during a valgus force which is when pressure is applied to the outside of the knee. Surgery is usually indicated as the ligament has been totally torn from the bone.

Credit: http://kingbrand.com/MCL-Injury-Information.php

Based on video of the play and difficulty with placing weight through the leg afterward, this indicates that he may have suffered a partial tear, possibly a Grade 2+. This is supported by the fact that he did not have surgery to repair the MCL itself.

To add insult to injury, Clay also tore his lateral meniscus. The meniscus acts as the shock absorber in the knee and helps with keeping the knee healthy during movement. Unfortunately, part of the lateral meniscus became torn during the hit. This likely occurred due to the direct blow along with the knee bent and planted on the ground, leading to twisting of the knee, resulting in a partial tear. Presentation of a partial tear involves pain, catching, and clicking during knee movement. While research has been proven that a nonsurgical approach can be just as effective as surgery to trim down the meniscus, this is the NFL and there is no wait and see approach. The procedure that Clay had today is called a meniscectomy which involved cutting out the frayed piece of meniscus and shaving down the area to smooth it over to ensure that more pieces do not fray off.

Reports indicate that Clay will be out at least a month, possibly indefinitely. I believe that he will be out closer to 6-8 weeks. The meniscus is something that could keep him out 2-3 weeks; the problem is the MCL. The body will need to heal and restore proper range of motion to the knee while regaining strength. There are therapeutic interventions that can encourage healing, but the body still has to do its job. Professionally, I would say place him on IR with designation to return. This gives him a guaranteed 8 weeks to heal up and return to full form. This would also allow the team to bring in another TE and not use up a valuable roster spot. This would place him on track for the Colts game in December. Considering the Bills have two games against Miami and one against New England after that, it would be an excellent time to come back healthy.

My final thoughts on Clay is that he has had several years of reported knee issues, of which I wrote about during the preseason. From observation during practice, I believe he had most of the issues on the left knee, of which he injured Sunday. However, this injury is independent from his previous issues. He was not at a higher risk for this injury as the result of the previous problems. If anything, this may help take care of the other issues by giving him time to rest.

The Bills are certainly hurting from this one. Clay has been a consistent producer and a favorite target of Tyrod Taylor. Clay should be back later this season, but whether his return will make a difference remains to be seen. I still believe that this season we have more depth than in previous years, but having depth just is not the same as the starters. That was evident in the secondary and linebackers on Sunday. Thankfully, the bye week could have not come at a better time. I still believe the Bills have a shot to stay competitive this season with how the rest of the AFC is playing this season. The Bills still control their destiny, Charles Clay injury will not define the season.

Continue to check back for further updates regarding new injuries and posts designed to educate my fellow Bills fans and keep you from the edge. Thank you and GO BILLS!!

Week 5 Injury Breakdown- Bengals

Assessing the latest injuries prior to the showdown with the Cincinnati Bengals and how it affects depth.

The injury list continues to grow for the Buffalo Bills heading into the Week 5 match up against the Cincinnati Bengals. While the only notable players that are sure to be out are LB Ramon Humber and WR Jordan Matthews, there are still many others that are dealing with injuries. Most of these injuries appear to be players getting banged up due to the rigors of the NFL season.

Today’s article will review most everyone that has appeared on the injury list this week and attempt to determine the true severity of each player’s injury. Staring off with players who have not been limited in practice with injuries are as follows: RB LeSean McCoy (wrist), RB Mike Tolbert (thumb), and DT Jerel Worthy (thumb). It was observed that Mike Tolbert injured his hand at the end of the 3rd quarter which led to a fumble that Buffalo recovered. It is unknown how Jerel Worthy injured his thumb, but it was injured enough to appear on the injury report. Both players most likely sustained sprained thumbs which will affect play, but with proper management which may consist of taping for stability or even a wrist brace to reduce risk for further re-injury.

McCoy continues to appear weekly on the injury report due to a nagging wrist injury sustained in the season opener. While he continues to be a full participant, it does worry me that he continues to re-injure this wrist. He has been observed leaving each game briefly due to wrist pain after running the ball. He appears to jam it while cradling the ball, leading to pain and possible weakness. He could tape the wrist or wear a brace, but this limits the ability to cradle the football and effectively block. I expect him to miss some time during the game due to wrist re-injury, but the upcoming bye week may allow him to get the rest he requires to prevent worsening of the injury.

Those limited in practice were WR Kaelin Clay (back), DT Marcell Dareus (ankle), CB E.J. Gaines (groin), OT Cordy Glenn (foot/ankle), RB Taiwan Jones (knee), CB Shareece Wright (back), DE Eddie Yarbrough (thigh), DT Kyle Williams (thumb), S Micah Hyde (knee), and DE Shaq Lawson (groin). Glenn continues to deal with his chronic foot/ankle injuries and Dareus is still recovering from his sprained ankle, which is consistent with this type of injury. Lawson injured his groin last week in practice and missed the Atlanta game.

Kyle Williams thumb injury may be similar to Jerel Worthy’s injury in that it may have been sprained due to the hand fighting that a defensive lineman performs during each play, getting the thumb hyperextended or caught. Williams is tough as nails and won’t let something like this slow him down. Shareece Wright and Kaelin Clay’s back injuries are injuries that not much information is available. This may be something that occurred during practice or something that is nagging. Considering that the spine is made up of bones, ligaments, and tendon attachments, it is quite possible they pulled a muscle, over rotated, or extended; causing pain and difficulty during tackling, running, and changing direction.

Eddie Yarbrough and Taiwan Jones also have little information regarding the nature of their injuries. These may be just contusions and limit the ability to go full speed, but do not concern me about underlying issues. Yarbrough continues to be a diamond in the rough, playing exceptionally well and Jones handles kickoff duties, which affect more game play rather than another body on the sidelines.

Finally, E.J. Gaines and Micah Hyde are questionable along with Cordy Glenn and Shareece Wright. As mentioned last article, Gaines’ groin severity is unknown at this moment, the team may take the approach that they did with Lawson last week and see how he feels going into the game, shutting him down if things don’t feel right. Micah Hyde is dealing with a knee injury that was not noted until Thursday afternoon. It was initially reported that he was dealing with general soreness which has since been narrowed down to a knee issue. This may be as simple as a sprain which he needs to rehab correctly or it may be something worse that the team wants to see how it responds before taking further action. Without video, it is impossible to speculate what specific injury may be ailing him. Losing Hyde going into the Bengals game will be a huge loss in the secondary considering the offensive weapons the Bengals have and several injuries already in the Buffalo secondary.

If this game were to be a non-conference opponent, I expect more players to be out include the above mentioned Glenn, Hyde, Wright, and Gaines. As the Bills would benefit from winning every game, it is more important to win the conference games if it comes down to tiebreakers at the end for playoff seeding. Excluding Gaines, I expect all the players listed above to play. Some of these players may see a limited snap count such as Dareus did last week. It remains to be seen if his snap count is limited secondary to discipline or whether they want to ensure that the ankle heals correctly. I am in favor of limiting snap counts in order to get the best players on the field.

I believe this game is winnable with the way the defense is playing, simple as that. How things play out with the questionable players, along with Ramon Humber’s and Jordan Matthews’ replacements will dictate the quality of play. McDermott and Beane have constantly been addressing depth and finding the type of players that fit their schemes, which in turn should reduce the drop off in quality of play dealing with replacement players.

Continue to check back for injury updates after the game and break down roster depth, injuries heading into the bye, and any injury highlights from around the league. Thank you for reading and GO BILLS!!

Week 4 Recap- Falcons

Breaking down the Bills latest injuries including thumb fractures, surgical approaches, and long term outlook.

This is a Bills team that continues to impress so far into the 2017 season. The defense is looking better than ever, Tyrod Taylor is moving the ball well, and serious injuries continue to be at a minimum. The Bills pulled out a solid win against the defending NFC champions, winning 23-17. These Bills look good, but I am not getting my hopes up yet. This happened in 2008 and 2011, both of which became lost seasons.

Unfortunately, with a hard nose win, comes some tough injuries which does affect how the next few weeks play out. A total of 4 players went out with some significant injuries that some will miss extended time. LB Ramon Humber and WR Jordan Matthews are out with broken thumbs, also known as the first metacarpal, the portion of the thumb that is highlighted as the broken area in the picture. Reports indicate that both will have surgery with Matthews requiring a pin to hold the fracture in place. There are not reports that Humber will require the same technique which may indicate a different type of fracture which may affect healing time.

fr_metacIllustration 1: Credit: http://www.mdguidelines.com/fracture-metacarpal-bones

While there are multiple ways to break a thumb and various ways the bone can break, the surgical options are fairly straight forward. For Matthews’, he will require a pin or “K-wire” which is inserted into the bone to hold it in place while it heals, which typically takes 3 weeks until it can be pulled out. A small piece of the wire sticks out of the skin and is protected to reduce infection. This is called a Bennett’s type approach. He may require this surgery due to a portion of the bone that has become fractured and requires stabilization to ensure proper healing.

Humber’s surgery may take the approach known as a Rolando’s type approach due to the nature of the break. Humber may have had several small breaks in the first metacarpal requiring a surgical approach to bring together all the various pieces together using a plate and screws to secure the area while it heals. Considering that the surgical area will be sewed shut, it is possible to have a cast placed over the area and continue playing. To better understand the difference between the thumb surgeries, please check out this link. While it does have basic drawings, it is the best resource that makes understanding the differences easily.

Next up is S Colt Anderson with a broken forearm. Any of my readers, please tell me what the Bills see in this guy? He continually gets hurt and I personally fail to see the value in him being on the roster. However, he suffered a broken forearm and has since been placed on IR. Typically, an injury such as this is sustained due to a direct blow to the arm such as during blocking or hitting the arm against a helmet. It is unknown which bone he broke in his arm, but he will require surgery which typically places a rod and screws to stabilize the area to ensure that it heals properly.

Finally, E.J. Gaines suffered a pulled groin on a hard tackle after changing direction in the 4th quarter and left the game. As of now, it is unknown how severe the injury is, but if it is similar to Shaq Lawson’s injury, then he should recover well. He was able to walk off on his own power and did not need any immediate attention which may indicate a mild strain. To understand further what the groin is and how it affects the football player, check out this article.

Expect to see Gaines at worst miss the next game, but considering he has more time than Lawson to recover, it’s possible for him to play in some fashion Sunday. Depending on the severity of the Humber fracture, he could come back after the bye and play in a cast while he continues to heal. Matthews on the other hand, makes his money using his hands and will require a longer recovery time because of this and the nature of the surgery. He will come back at some point during the season, but I wouldn’t expect him to come back until the Saints game on November 12th. This will give him at least 4 weeks to recover and then with the Jets playing the Bills on Thursday night, no sense in rushing him back and gives him an extra week to recover.

To make up for these losses, the Bills signed WR Philly Brown, S Trae Elston, and S Shamarko Thomas, moving S Colt Anderson to IR and releasing S Robert Blanton and DE Eric Lee. The Bills continue to make moves to keep the depth at a premium and sign players who know the system, allowing for a smaller learning curve.

Continue to check back for updates and any new injuries. These Bills may be real, let’s see how real they can get! Go Bills!!

Lawson’s Gimpy Groin

Assessing Shaq Lawson’s latest injury and impact for Sunday’s showdown against the Atlanta Falcons.

It was reported that Shaq Lawson injured his groin in practice Thursday and is now a game time decision for Sunday against Atlanta. Lawson has been on a tear this season in limited action, totaling 10 tackles, 2 sacks, nearly equaling his output from last year. He has begun to live up to draft expectations coming out of Clemson in 2016 and is a reason why the Bills defense has returned to top form this season.

As Lawson is a game time decision on Sunday, it would be better to understand what a groin injury is and how it affects his play. The groin is a series of muscles that attach from the lower hip in the hip crease to the inside portion of the thigh. These muscles assist in bringing the leg to midline, flexing the hip up, and internally/externally rotating the hip. These actions are vital to the actions of the defensive end with regards to shuffling, running, and pivoting. This is typically seen when trying to run down a player or having to stop suddenly. This can also be seen during eccentric contraction of the adductors which is seen during blocking and shuffling along the line.

groin_injuries.jpgIllustration 1: Credit: physioworks.com.au

Lawson reports that his groin is sore and that he will be alright. Despite a positive outlook from Lawson, it is still beneficial to understand how the groin is injured. Typically, the groin muscles are injured when the individual is sprinting or changing directions quickly. As this is a soft tissue injury, there are various grades that the muscle strain can be broken down into to assess severity based on location and mechanism of injury.

Grade 1 involves an injury to the area due to overloading the area, causing microtears and weakening the anchor point, causing pain and inflammation. This is usually a week-to-week injury and if rehabbed properly, should not be an issue long term. The injury typically is seen more in the muscle belly, which is the meaty portion of the muscle. Pain may be felt in the inner thigh or in the groin itself if the muscle is overloaded.

Grade 2 involves a partial tear to the muscle belly or attachment point leading to an inability to walk normally, much less perform the duties of the position. This injury takes longer, anywhere from 4-8 weeks based on severity and must be managed conservatively. Typically, injuries closer to the attachment points can become more chronic and lead to extended time missed. This is due to the nature of the muscle having to pull on the anchor in order to function properly. If the anchor point is not secure, pain and ineffective use of the muscle continue to occur.

Grade 3 typically involves tearing of the attachments closer to the femur, which is known as the distal insertion points. Commonly, the muscle is torn partially or fully away from the bone, leading to surgical intervention. These type of injuries do not happen often, but as with any muscle injury, can occur.

It is not known what caused Lawson’s injury, but it is certainly significant enough to cause him to be a game time decision. I believe that Lawson’s groin injury is a Grade 1, supported by the remark that it is sore and that he will be alright. An athlete knows his body best and barring any re-injury during warm ups, should play Sunday. There is always the risk to increase the severity by playing through, but with proper stretching and warm ups, along with the continued limited snap count, Lawson should be fine. Considering that Lawson has been playing up to the level we expected when drafted, it will be beneficial to have him pressuring Matt Ryan and the Falcons offense. This is a winnable game if the Bills play to the level they did last week against a very good Broncos team. Continue to check back for updates and further analysis regarding Bills injuries, GO BILLS!!