Preseason Injury Review- Bengals

Read up on the latest injuries following the loss to the Bengals and how these affect the Bills come the regular season.

Despite Sunday being Kid’s Day and Buffalo finally got to thank Cincinnati QB Andy Dalton for the miraculous TD to open the playoff door after a long wait, the Bills managed to stumble through an ugly loss to the Bengals. The 26-13 score led to more questions than answers especially at the QB and OL positions. Thankfully, the Bills managed to avoid serious injury and live to fight another day. Today’s post will review the few injury concerns coming out of the Bengals game and what this means going forward for the Bears game and regular season.

Amazingly, the only reported injury coming out of Sunday was LB Julian Stanford (nose). The only injury that a nose can sustain is a broken nose. This is evident from the reports that he is week-to-week and there are no further reports indicating surgery or any other facial injuries. The word is still out on whether he will make the roster but a broken nose should not cause any concern.

As the 4th preseason game will showcase most of the players that will not make the roster along with the several few that will, there are several starters that are still in question for the regular season. First up is RB LeSean McCoy (groin). The veteran starter has seen limited action this preseason and has been slowed by a groin injury sustained recently. As he is still able to participate in limited fashion in practice, I do not believe this is is anything that will linger into the season and he is more limited due to his veteran status and avoiding injury.

Another veteran dealing with a lingering injury is DE Trent Murphy (groin). He has been unable to participate with a nagging groin injury sustained early in the preseason. There is no possible reason that he would suit up in the final game but considering he has nearly 2 weeks until the preseason opener, there is reason to believe that he will be ready for the game against the Ravens. He originally sustained the injury at the very beginning of August, was able to return to full participation with practice a week after the injury and then re-injured it shortly after. He has been able to participate with individual drills and able to dress for games indicating that he is nearly ready to play given that it has nearly been a month. However, an additional 2 weeks will only benefit Murphy so that he can hopefully revert back to 2016 form prior to his ACL tear.

DT Kyle Williams (knee) is still out due to the sprained right knee he suffered in the win over the Browns. While it will be a long shot for him to return for the season opener, it is possible that he could participate in the home opener against the Chargers based on what he is able to do in practice. It has been reported that he is participating in light reps during individual drills and has been regularly seen without any bracing with the exception of a compression stocking. This indicates that the knee is stable and healing properly. Participating in individual drills also leads me to believe that he has no pain at rest and most likely full range of motion in the knee. Rehab is most likely progressing at an acceptable pace and I do not believe it is out of the question to see him in pads in 2 weeks with additional time allowing him to get game ready.

WR Brandon Reilly (rib) has been battling for a roster spot despite breaking a rib during the first preseason game against the Panthers. Injuries such as these require extra padding but otherwise the ability to withstand pain when hit. A broken rib has no long term implications besides whether Reilly has a job come September 9th.

Others dealing with injury include OT Dion Dawkins (hip), DB Kelcie McCray (hamstring), and QB AJ McCarron (shoulder). It is unknown what Dawkins specifically did to his hip, but it may just be a contusion considering he has still been able to participate in practice. He is another player the Bills would prefer to keep healthy in order to get to the regular season. McCray is battling a hamstring injury that appears to be a Grade 1 as he has not been ruled out for several weeks as some of his teammates have with other injuries. However, as all muscle strains are, rest and time must be primary factors for healing so as to avoid making this a chronic issue. Finally, McCarron was videoed tossing footballs around practice today indicating that he is feeling better and able to release the ball without compensation according to video. He got roughed up while in the pocket against the Browns but otherwise may be settling in for the backup role when the Bills travel to Baltimore. None of these injuries appear to be long term and should not hinder performance come the regular season.

As this post was very light, this just means that the Bills continue to avoid major injury and focus on becoming better football players. There are many positional battles that still need to be sorted out, but it is fortunate that these battles are between starters and second team, not 3rd stringers and street free agents due to injury. While the Bills will not avoid injury entirely this year, preseason’s such as this allow the Bills to build depth they’ve sorely lacked in previous years.

Continue to follow for the latest updates and news coming out of the Bills preseason. Follow Banged Up Bills on Facebook, on Twitter @BangedUpBills, on the web at www.bangedupbills.com, and on reddit at u/BangedUpBills. As always, thank you for reading and GO BILLS!!

McCarron’s Buffaloed Clavicle

Detailing the confusion behind why A.J. McCarron was initially diagnosed with a fracture but found to have later not have one.

It’s been several frustrating days for both the Buffalo Bills and QB A.J. McCarron. First, McCarron has a less than stellar performance against the Cleveland Browns which alone appeared to place his job in question. Then to add injury to insult, he suffered a shoulder injury that was initially reported as a hairline fracture in his clavicle. The original timetable for McCarron would have been 4-6 weeks, leaving him possibly without a job by the time he was healthy. However, McCarron sought out a second opinion and was recently reexamined to find that he did not suffer any breaks in his collarbone and that he has essentially a shoulder contusion. Today’s post will identify what the clavicle is, it’s function, and possibly why there was so much confusion regarding the original injury.

clavicle.jpg
Credit: humanbodyanatomy.co

The clavicle is a bone in the chest region that acts as a strut as part of a framework that makes up the shoulder girdle. It connects the scapula or shoulder blade via the acromion to the sternum or breastbone and allows the scapula to move freely on the back for proper arm movement. During motion, it rotates up and out of the way so that the shoulder can move without restriction. The clavicle also protects nerves and blood vessels that pass through to the shoulder to the arm. Finally, the clavicle also acts as an attachment point for several muscles in the chest and neck region including the pectoralis major, the sternocleidomastoid, deltoid, and trapezius muscles.

It is usually injured during a fall on an outstretched arm or shoulder or a direct blow as the clavicle is compressed between the sternum and shoulder on impact. The injury appears to be a direct blow to McCarron’s shoulder according to video. The clavicle is the most common bone to break in the body and we have seen NFL quarterbacks that have suffered this injury at the hands of a hungry defensive end. Based on the mechanism of injury described above, these types of injuries occur as the quarterback is driven onto the shoulder during a tackle. We have seen this befall QB Tony Romo and QB Aaron Rodgers in previous seasons. The mechanism for injury appeared to be similar for McCarron when he had the entirety of DE Myles Garrett come down on him. Interestingly, McCarron was able to finish the series despite appearing to fall onto his right shoulder, which is his throwing arm.

It was revealed after the game that McCarron allegedly suffered a hairline fracture by Buffalo News writer Vic Carruci. While this initial injury prognosis was grim, it did not deter McCarron as he sought out a second opinion. As he is fighting for a roster spot and starting job, he needed to be absolutely sure he was unable to play. Fortunately, he was found that he did not suffer a fracture and that he would be able to return to practice very soon. The big question is, why the change?

After doing some reading and asking some questions to other medical providers who deal with imaging far more often than I do in my line of work, I found some possibilities. There was thought that if he found another doctor to evaluate, they could give the green light to play despite a small fracture. It was also possible that the imaging could have been misread. As the saying goes, a picture is worth a thousand words, imaging can be interpreted differently by various medical professionals, especially when there is possibly swelling in the area which could occlude a proper view. It is worth noting that the clavicle is one of the last bones in the human body to fully ossify, or harden. This does not usually occur until ages 21-25. As McCarron is only 27, it is possible that someone saw a fused growth plate and mistook that for a fracture or the results were inconclusive but the source that reported the injury may have took inconclusive as close enough and ran with it.

Thankfully, X-rays are not the only imaging that we have to diagnose fractures. We have CT scans, MRI’s, bone scans, etc. at our disposal to help identify exactly what we cannot see. As described to me, the method for determining imaging need is known as ALARA: As low as reasonably achievable. This means that whatever they are looking for, they will use the cheapest, most efficient means possible to get the results, but move up in diagnostic imaging in order to find the problem if inconclusive. In certain cases, there may be limited options available as CT and X-ray’s use radiation and MRI’s use magnetics to view the structures inside the body. There may be contraindications that would prevent a patient from getting one type of image but be appropriate for another.

As to what method the second opinion used to identify that he did not have a fracture will probably not be revealed. However, now knowing this, McCarron will only miss several days of practice. This comes down to the injury being reclassified as a contusion. I have detailed contusions in previous articles and it is really up to McCarron when he is ready. From the original injury, my best guess is missing a week at most as he will push to get back to practicing but his major limitation will be pain. Unfortunately, with pain, it can affect function. So we may see some less zip on his throw or less reps as he works his way back into practice. After Friday’s game, he may be relegated to backup but he will still compete until he is told otherwise.

This is certainly a blow to McCarron’s starting chances but this does allow him to fight for a roster spot instead of finding a job elsewhere. He does provide a veteran presence that each team looks to have especially with younger players on the roster. I do not foresee McCarron having any long term issues following this injury.

Continue to follow for the latest updates and news coming out of One Bills Drive. Special thanks go out to @GAPeachpolymer, @Frosini_thomas, and @FischerWilliamsPhoto for their specific knowledge on imaging for injuries, I could not have completed this article without you! Follow Banged Up Bills on Facebook, on Twitter @BangedUpBills, http://www.bangedupbills.com and on reddit at u/BangedUpBills. As always, thank you for reading and GO BILLS!!

Preseason Injury Review- Browns

Analyzing the latest injuries following the preseason win over the Browns including AJ McCarron, Kyle Williams, and Cory Carter.

The Bills got their first win of the preseason with a decisive 19-17 win over the Cleveland Browns Friday night. While we saw some good things including the continued emergence of RB Marcus Murphy and darts thrown by QB Josh Allen show that there is some talent on this team and should be a force to reckon with this coming season. However, with all the good also comes the bad. The Bills have been relatively healthy over the course of this preseason, getting some bumps and bruises along the way but avoiding serious injury. Unfortunately, the Bills luck ran out Friday night on the shores of Lake Erie. Today’s post will review injuries sustained Friday and what this means going forward.

Prior to the game, DE Trent Murphy and WR Brandon Reilly were ruled out prior to the game with groin and rib injuries respectively. Hopefully both will be able to return to full health very soon and bolster depth going forward. The biggest injuries sustained Friday night with regards to name recognition were QB AJ McCarron and DT Kyle Williams. The former Alabama QB came from Cincinnati in the off season and was expected to compete for the starting job. Regrettably, McCarron reportedly sustained a hairline fracture in his collarbone towards the end of the 1st quarter.

The play that McCarron potentially suffered his collarbone fracture seemed pretty innocuous. He was tackled hard with most of his weight coming down onto his right shoulder but was able to finish the series. He did not appear to have any initial discomfort or favoring the injured area. Reports do not state which collarbone he fractured but my guess is the right side which is his throwing arm. However, after today’s press conference, there is question regarding the severity of the injury as McCarron is getting a second opinion which may change his availability. Once we have confirmation one way or another, I will be able to elaborate more.

DT Kyle Williams suffered what appeared to be a season ending injury early in the 2nd quarter. This occurred when he was getting blocked and a Browns offensive player fell into his right leg and he went down immediately in pain. The initial fear when a knee is bent like that with an outside force on the knee is an ACL tear. Thankfully, he avoided the dreaded injury and only sustained a MCL tear. The MCL is the ligament on the inside of the knee and is a commonly injured ligament during knee sprains. It appears as though Williams suffered a Grade 2 sprain which should heal on its own and will not require surgery.

Had Williams foot been planted in the ground when he got hit, he would have most likely torn his ACL and ended his final season. This is an injury that will take 4-6 weeks to heal which means he should be able to come back for Week 4 against the Packers. If things go well, Week 2 against the Chargers. As he is older, he will most likely be on the slower side of this timeline and lets face it, Kyle Williams is a national treasure when it comes to Bills fans. Training staff will not rush him back to the field unless he is truly ready to play. Once he returns, he should have no performance issues with the exception of some pain/swelling initially after playing.

One player who was hit hard by the injury bug was P Cory Carter who suffered a torn ACL after a collision late in the 3rd quarter. His plant leg was fully extended as he came down and the Browns defender rolled into his leg, preventing him from landing safely, causing his knee to hyper extend and tear the ACL on the second small hop in the above posted video. Prior to this injury, reports were coming out that he was having a solid camp and really challenging for the starting position. I have detailed ACL tears in a previous article, please check it out. Carter will be out for the entire year. I wish him the best of luck in his recovery. To note, this is the first ACL tear for the Bills since TE Chris Gragg tore in the preseason in 2016.

Another player that has had a very strong camp and warrants a roster spot is TE Jason Croom. The WR turned TE injured what appeared to be his left ankle on a punt return play the next play after Carter was injured. On the play, Croom went downfield and changed direction quickly to tackle the punt returner and LB Tanner Vallejo attempted to do the same thing, missed, and rolled into Croom’s ankle. He was able to walk off under his own power with a noticeable limp and was done for the night. It appeared as though he may have a low ankle sprain at worst. However, he was able to practice today according to reports which is something to watch for as the week progresses.

Others injured Friday include S Siran Neal, CB Taron Johnson, and OT De’Ondre Wesley. Neal was injured after a hard tackle and appeared to have the wind knocked out of him but was able to return later in the game. Johnson suffered a crackback block at the hands of WR Jarvis Landry who infamously ended the career of former Bills S Aaron Williams, thankfully no long term issues. Finally, OT De’Ondre Wesley appeared to tweak his ankle and came off the field but was able to return. I don’t see anything that warrants further concern. Also today, S Kelcie McCray was not practicing but film did not reveal any injuries at first glance.

Finally, QB Nathan Peterman appeared to sustain an injury in the last series of the game. Upon review, he took a low tackle which appeared to hit his knee but when he came up, he was hopping on his right leg and favoring his left. He was able to walk it off and finish the series but when he kneeled down to run out the clock, he did a reverse lunge and appeared to stumble backwards. It appeared as though he injured his left ankle. He may have twisted/tweaked it but as he was practicing today, it does not appear to be serious. Further reports will be made available if this becomes a problem.

Overall, the Bills escaped Cleveland without major losses.  They also have 9 days before their next game against the Cincinnati Bengals. Unfortunately, there are two more preseason games which mean two more possibilities for players to get hurt before the regular season. While all injuries cannot be prevented, preventative measures such as exercises/practice and limiting playing time appear to be the only way for now.

Continue to check back for the latest updates and injury analysis as the season progresses. Follow on Twitter @BangedUpBills, on Facebook at Banged Up Bills, online www.bangedupbills.com and on reddit at u/BangedUpBills. As always, thank you for reading and GO BILLS!!

Buffalo Bills Free Agent Haul

Analyzing the latest Bills free agent signings, their injury histories, and impact for next season.

The Bills continue to make moves which further indicate that the Bills are working towards bigger things for the draft. This new regime is serious and have a clear game plan on how to achieve their goals. Brandon Beane and company have been very busy, finding the right type of players that fit “The Process”. The pressure is on even more now that the NY Jets have traded with the Colts to move up to the 3rd overall pick in order to hopefully obtain their franchise QB. Today’s post will review the free agent signings of DT Star Lotulelei, DE Trent Murphy, S Rafael Bush, LB Julian Stanford, and QB A.J. McCarron.

First up is DT Star Lotulelei, formerly of the Carolina Panthers. The big defensive tackle has been a mainstay in Carolina for the past 5 seasons before signing with the Bills for 5 years, $50 million with $25 million guaranteed which makes him the highest paid Bills player on the roster. While these are rather eye-popping numbers, Lotulelei has shown he is able to earn his keep. The 5th year pro has missed minimal time over his short career, suffering only ankle and foot injuries in the first three years. His ankle injury did not force him to miss any time but a broken bone in his foot at the end of the 2014 season led to eventual surgery. He was able to return to in time for training camp in 2015 but suffered a “stress-reaction” after the 3rd practice. Simply put, he suffered a precursor to a stress fracture. He was able to rest the remaining portion of training camp and missed the first two regular season games but since then has not suffered any further set backs. He should remain healthy as the defense has switched to rotational play, thus ensuring always fresh players in the trenches.

Next up is S Rafael Bush, formerly of the New Orleans Saints. The 7th year pro recently signed a 2-year deal with Buffalo has been all over the league, seeing time with New Orleans over two stints along with stops in Denver and Detroit. During his time in the league, he has suffered several injuries that have caused him to miss significant time. 2013 saw him miss 3 games towards the end of the season due to an ankle injury. In 2014, Bush suffered a broken fibula which prematurely ended his season that year. Finally in 2015, he suffered a torn pectoral in the season opener which sidelined him the entire season as it typically takes 6 months to recover. Since then, Bush has been healthy over the past 2 seasons, not missing any games due to injury. While he is getting older, he still has shown the ability to play at a high level and provides depth at a position the Bills found themselves to be very effective at last season.

The Bills continue to address needs on the defense with their 3rd signing in DE Trent Murphy. The 4th year pro has dealt with many injuries during his time in the league but has shown to be effective when healthy. Looking back at his NFL injury history, his rookie year saw him miss one game with a broken bone in his hand which ended his season one game early. He also dealt with a knee injury that year which did not affect his playing time. 2015 saw a minor hip injury and 2016 saw him deal with elbow/shoulder, foot, and ankle injuries that he was able to play through.

Unfortunately in 2017, Murphy suffered a torn ACL in the preseason which forced him to miss the entire season going into the final year of his contract. It was reported that rehab went very well for the defensive end in that he was squatting 475 lbs 6 months after his surgery. While it is typical to see these kind of exercises being performed, to be squatting that much is an excellent sign. Murphy does have a higher risk to retear his ACL which is at about 20% higher compared to a healthy population, but playing in the NFL is always a risk for injury. Between the torn ACL and a 4 game suspension for PED use which he ultimately served during his time on IR allowed the Bills to sign him and they hope to rekindle the kind of production he had in 2016 before his injury. He should fit in nice with the rotation of Jerry Hughes, Eddie Yarbrough, and Shaq Lawson, among others.

The final piece of the defensive free agents is LB Julian Stanford. The 5th year veteran has made stops in Jacksonville, Detroit, New York Jets, and his latest stop in Buffalo where he signed a 2-year contract. Most of his playing time has been seen on special teams with some occasional play in defensive packages. As a result, his injuries have been minimal, suffering a hip injury in 2012 which he did not miss any games and 2016 saw him miss 4 games which landed him on the IR to end the season. Otherwise, from what I have read, he is an effective and durable player who provides depth at the LB position and makes his mark on special teams.

Finally, the Buffalo Bills let the dust settle and finally signed a veteran QB in AJ McCarron. The former Alabama star has primarily rode the bench behind Buffalo playoff hero Andy Dalton for 4 seasons. McCarron recently won his arbitration case which allowed him to become an unrestricted free agent due to an injury his rookie year to his right shoulder. This injury originally occurred during his senior season at Alabama and had been described as tightness. This caused him to start the season on the PUP list which forced him to miss 14 games. I am not quite certain what he exactly did to his shoulder as he reportedly jammed it and always felt fatigue afterward. My initial thought may be that he was dealing with shoulder impingement in where the rotator cuff is pinched during abnormal shoulder biomechanics. There is a possibility that he also suffered some type of nerve injury which could also contribute towards a fatigue like feeling. As this is not his throwing shoulder and he has not had any recurrence since 2014 leads me to believe that this is no longer an issue.

McCarron will be afforded the ability to compete for the starting job along with QB Nathan Peterman and the expected 1st round draft pick the Bills will bring in this year. The 4th year signal caller has seen minimal time with the exception of a 3 game stretch in 2015 in where he went 2-1 with 6 TD’s against 2 INT’s. He was able to show that he could play in college under Nick Saban, but time will tell whether he can be a serviceable QB when given a starting role.

Overall, all these recent signings are favorable to the team and allow them to chase the high end talent in the draft to build for years down the road. All of these players I don’t expect to have any injury issues with the exception of Murphy. He has battled smaller injuries over his career and suffered the above mentioned ACL tear which puts him at a higher risk to reinjure. He will also most likely not be ready until OTA’s in June to fully participate. I believe all these players will provide the needed depth and skill required at their respective positions should the starter go down.

Continue to check back for the latest articles and updates at Banged Up Bills. Follow me on Twitter @BangedUpBills and follow my colleagues at Grandstand Sports Network for the latest NFL draft talk. As always, thank you for reading and GO BILLS!!