Week 9 Recap- Jets & Zay’s Knee

Analysis of Zay Jones’ knee injury, Taiwan’s forearm, and a recap following the Jets game.

Whether you are a Bills fan or not, reading this, Thursday night was not a good game. Period. The offense never got moving until it was too late, the defense made Josh McCown look fantastic, and the Bills let one slip through their fingers. They’re now 5-3, 1 game back in the AFC East and currently holding the 1st wild card spot. Despite what the Bills fan base says after this loss, the sky is not falling. Every divisional game every year is a grind it out close game due to rivalry and pride. At the end of the day, the Bills came up short and now we will see how they respond. Last time they started 5-2, they lost 7 straight games. I don’t think this team is capable of a losing streak of that magnitude, but many men before me have been wrong.
Getting down to the injury side of things, it was one of the more rougher nights for the Bills this season. Several key players were returning from injury on a short week and several more key players sustained injury. First up is RB LeSean McCoy. McCoy injured his groin on the first offensive series of the game and had to leave briefly. McCoy was able to return shortly afterward but anyone could tell that he wasn’t the same. He lacked explosiveness, inability to cut hard, and unable to move the ball, rushing for only 25 yards. McCoy is the engine to our offense and if he goes down, then losses to the Jets are what happen. I don’t believe this will be a lingering issue as he was able to play the entire game and he has 10 days to rest. To add, he was able to run and perform some cutting, but lost the explosiveness he is known for. I would categorize this as a Grade 1 groin strain which should heal with proper management.
Next injury is WR Zay Jones. Jones suffered a right knee injury after being tripped late in the 2nd quarter. While trying to regain his footing and preventing falling down, Jones stepped awkwardly and hyperextended his knee, falling to the ground immediately. Upon initial observation, one may think ACL. The mechanism for injury was there but Jones avoided that. It appears as though he sustained a hyperextended knee, similar to what Bryce Harper sustained during this past MLB season. It is unknown whether he sustained a bone bruise similar to Harper but further evaluation is required.

Jones was remarkably able to return and play the rest of the game, hauling in several more passes before being injured again in the 4th quarter. There are several reasons why Jones was able to avoid the dreaded ACL tear. First, the knee acts as a hinge, similar to what is seen in a door. The knee bends and extends fully but with various forces, can go past their normal limits. In Jones case, his knee extended further than typically what is available. This injury happened due to the fact that he planted his right foot, attempting to stay upright while falling forward, leading to the joint to give.
Jones avoided a worse injury due to the fact that he was falling forward as he was planting his leg. His ankle joint was able to absorb some of the force, with the foot initially going into plantarflexion or pointed downward to stabilize as his knee was bending back. Thankfully, his foot did come up off the turf into dorsiflexion or bending up as he fell forward. Had his foot been stuck more in the turf or been hit directly through the knee, the injury would have been worse. Finally, it helps that he was not able to pivot to change directions laterally, leading to preservation of the ACL. In injuries such as this, there is concern for the PCL which prevents the knee from going backwards like that, but as he was able to return, it does not appear that he tore the PCL. There is concern for a PCL sprain or bone bruise upon further examination, but with the extended break, it may be inconsequential. As there is no updated information at this time noting severity, it is unknown whether he will miss any time. Chances are he won’t, but too early to tell. Either way, Zay Jones caught a very lucky break Thursday.
I’m overall surprised that he was able to return to the game and continue to run effectively after the injury. I believe that our medical staff would not put a player back out there that could risk further injury especially at a high level position. I did observe him wearing a compression sleeve but no bulky bracing which will assist for any swelling but provide minimal support.
Finally, Taiwan Jones got injured while trying to recover an onside kick late in the 4th quarter. Upon getting up to a seated position, the medical staff was supporting Jones’ left elbow indicating possible elbow injury or shoulder. Replays show that his arm got caught up in the pile and a helmet crashing into his forearm during the onside recovery. Unfortunately, reports indicated that Taiwan Jones fractured his forearm and will be done for the season.
A fracture is quite simple in terms of injury severity. A bone is broken at some point in the structure leading to instability and significant pain. Jones did not sustain a fracture which protruded through the skin which allows for the management to be more conservative. He will possibly require surgery depending on the severity and complexity of the fracture. He could hypothetically come back if they pushed recovery, but it is a bigger bone compared to what Jordan Matthews and Ramon Humber sustained and would require extra stability. Had this been McCoy or Taylor, it may be considered to push for a return. While Jones is an important part of the team, he is not what drives the offense. Placing him on IR will allow the Bills to bring in a new player to gain experience to provide depth and try out for next year.
As the Bills have an extended break between games, this allows these injuries to have a greater chance to get healthy with the exception of Taiwan Jones. As I’ve said before, no NFL team is immune from injury. The Bills are doing incredibly well with avoiding serious injury. However, despite that luck, the Bills still have to win those games that are winnable to turn things around for long term success. Going into the Saints game, while their offense continues to be high powered, their defense is suspect and will be playing at New Era Stadium which will provide a favorable atmosphere for the Bills to go 5-0 at home.

It has been reported that TE Charles Clay and CB E.J. Gaines should be returning from injury. It is surprising that Clay is able to return quicker than originally thought, but is a welcome addition. Gaines returning will provide an immediate upgrade to our secondary that without him, may be exploited by Drew Brees and the Saints.

Continue to check back for updates and new articles regarding Bills injuries and other topics of interest. As always, thank you for reading and GO BILLS!

Week 9 Injury Breakdown- Jets

Breaking down the Bills injury report for the New York Jets and impact on tonight’s game.

The Buffalo Bills go into their second match up of the season against the New York Jets with the best start for the franchise since 2011 and with a win, move to 6-2 and have their best start since 1993 when they started 7-1. This team continues to get healthier week after week despite key starters go down with injury. It is nearly impossible to go through an entire season without a team sustaining major injury, but the Bills are close to perfection in this area.

Breaking down the injury report for tonight’s game against the New York Jets, several injuries are worth noting. First off, TE Charles Clay (knee) and CB E.J. Gaines (hamstring) are listed as out for the game. No surprise with Clay considering the type of knee injury he sustained. Gaines is out because after coming off a groin injury, he sustained a hamstring injury the next game. While I do believe each injury alone isn’t severe enough to warrant an extended absence, the combined injuries along with their location require proper rest and rehab to ensure healing. I still believe Clay is several weeks away from returning to game shape, but is clearly progressing. Gaines should be ready for the Saints game, barring any set backs or new information.

S Jordan Poyer (knee) and LB Ramon Humber (thumb) are both listed as questionable. Poyer injured his knee during the last play of the Buccaneer’s game and missed the Raiders game as a result. I had originally thought that he sustained a Grade 1 MCL sprain and based on this latest news, still maintain that. I believe he will be a game time decision based on how he performs in warm ups. MetLife stadium is synthetic turf which can increase the ability for feet to stick in turf and can lead to the possibility of greater injury. However, if Poyer believes he can play, then I see no reason why he can’t. The medical staff has been on point this season and I do not believe he would rush back sooner than he needs to. I believe he will play Thursday without any signs of injury or risk further damage.

Humber has been out since October 1st with a broken thumb sustained against the Falcons. It has been 4 weeks since the injury which is enough time for a bone in that area to heal. It is unknown if he will play with any sort of protective bracing, but I also believe he will be ready to play Thursday night. If Humber does play, I would expect his reps to be limited in order to keep him fresh and allow LB Matt Milano to continue to develop as a rookie.

The rest of the injury report all practiced with full participation which included G Richie Incognito (ankle), T Cordy Glenn (foot/ankle), C Eric Wood (ankle), and WR Zay Jones (shoulder). Most of these injuries with the exception of Glenn appear to be the normal wear and tear of the NFL season. Nothing appears to be worse than it seems and should resolve with the extended break in between the Jets and Saints game.

Finally, despite what happens with Poyer and Humber, I believe that their replacements are suitable to fill in one more week if they play as well as they did against the Raiders. I expect a win out of these Bills and get the season sweep over the Jets. There is always a risk for injury especially in these division games where each team appears to bring their A-game, but the Bills are a deeper, more complete team that should wear down the Jets as the game wears on.

Check for my injury analysis following the Jets game and any new updates that occur. As always, thank you for reading and GO BILLS!!

Kelvin Benjamin Injury History

Analyzing the injury history of newly acquired WR Kelvin Benjamin and expectations for the rest of the season.

The Bills continue to shock and astound this fan base! Right before the trade deadline, the Buffalo Bills traded 2018 3rd and 7th round picks for WR Kelvin Benjamin from the Carolina Panthers! Brandon Beane continues to make moves to contend for a playoff spot, which is more than any recent Bills GM has done over the past 17 years. We have had splashy free agents such as Terrell Owens, Mario Williams, Shawne Merriman, and Nick Barnett, but have had to overpaid for aging talent or not gotten the money’s worth out of the talent. One constant remains, no playoff appearances. Time will tell if this Bills team will change that, but there is already greater chance than before.

With the Bills trading for Kelvin Benjamin, this does bring questions. Questions including how he will fit into a Rick Dennison offense, what kind of impact he will have, and what his injury history/risk is. Today’s post will review Benjamin’s injury history and attempt to determine whether he will be the play maker that the Bills expect of him. Or will Benjamin be the 2017 version of Sammy Watkins/Percy Harvin; supremely talented, but oft injured.

According to sportsinjurypredictor.com, Kelvin Benjamin has sustained a series of injuries over his 4 year playing career. Injuries include concussions, hamstring strains, ACL tear, AC joint sprain, and knee sprain. Starting in order, Benjamin’s concussion occurred during the 2014 season from a hit from Vontaze Burfict which knocked him out of the game but was able to return the following week. While concussion are a hot topic among today’s NFL players, the fact that he was able to return quickly indicate that it was mild at best and did not have long term effect. Having a history of concussions does predispose a player to future concussions, but so far Benjamin has avoided a recurrence of this injury.

During the 2015 offseason, Benjamin suffered two Grade 1-2 hamstring strains to both of his legs which kept him out briefly during OTA’s. Hamstrings can be chronic if not managed correctly, but considering the offseason is less strenuous, he was able to heal up with greater ease. Unfortunately, Benjamin’s 2015 season took a turn for the worse as he tore his left ACL during a non-contact drill during training camp which sidelined him for the entire season.

There is a higher risk for ACL re-tear once suffering an initial tear, but depending on surfaces, strength, and conditioning, this can affect rates. According to the MOON study, following two years after initial tear, 4.3% of patients re-tore the surgical graft and 3.6% tore the opposite ACL. This study comprised of more than 2,700 patients who had initially tore an ACL. While there is a risk, it is far from a guarantee that they re-tear. In another study that studied tears from ages 10-25 years, there was a 6 times greater chance that an athlete tore their ACL when compared to a healthy population. This study did factor females in which may skew results as there are no females in the NFL, but does demonstrate a higher risk for re-injury.

Through my personal research found at my previous article, I found that during the 2017 preseason, most injuries occurred to players 3 years and less in league. A majority of the ACL tears also occurred in this age group which can infer several things. This suggests that even though a player may be supremely talented, their bodies are still not physically ready for the NFL game right away. This also indicates that there is a higher risk for agility players to suffer major injury early in their career. Finally, consider that new NFL players coming out of school are 21-23 years old, this falls in line with the trend of ACL tears in young NFL players and in the previously mentioned study.

It was thought that during this season that Benjamin potentially re-tore his ACL during the New Orleans Saints game, but it was later diagnosed that he suffered a knee sprain which appears that he has fully recovered from. Fortunately, Benjamin did not suffer any further damage greater than a sprain and was able to return relatively quickly. Trying to predict the possibility of a prior ACL tear to re-tear or tear in the other knee is still like winning whack-a-mole. The risk is higher, but not absolute. Finally, the only other major injury he sustained came in the 2016 season in which he sprained his AC joint but did not miss any games as a result.

Looking back at all of this, it appears that while there is risk for injury, there is no greater risk than other players at his position. There also does not appear to be chronic injuries that he is coming to Buffalo with which may affect his production. I also pray that he does not suffer a Billsy injury a la Jordan Matthews did in his first practice with the team this season.

Kelvin Benjamin brings a new dimension to the passing game that was lost when Sammy Watkins was traded. He will be able to get the 50/50 balls that Tyrod Taylor throws up, he will be a red zone threat, and take pressure off Zay Jones so that he can continue to learn and grow as a rookie. Further analysis can be found by my friends at The Rockpile Report; I know for a fact that Drew and Chris have some HOT takes regarding the recent moves over the past week. Check out their podcast, you will not be disappointed!

Overall, I like this trade. Kelvin Benjamin does come with some injury baggage, but so has nearly every other player in NFL history. There are hardly any players that miss any time, unless their name is Brett Favre, Peyton Manning, or Joe Thomas. All eventually had serious injuries which affected their career in one way or another which puts into perspective when looking at Kelvin’s injury history. Though the Bills did give up some draft capital, they still have 5 picks within the top 90 picks and cap flexibility to get the players they covet and not sacrifice the future.

This is a true application of “Trust the Process”. Will it end in playoff appearances, division championships, or even dare I say it, a Super Bowl? Who knows. These Buffalo Bills are winning and still in far better position than the Browns or Colts who have tanked in order to get picks; their process has not worked in their advantage when building a championship team.

Continue to check back for further updates including the injury breakdown prior to the Jets game Thursday, post game analysis, and my thoughts on Sean McDermott during the long break before the Saints game. As always, thank you for reading and GO BILLS!!

Week 8 Injury Breakdown- Raiders

Assessing the latest Buffalo Bills injury report and implications for Sunday’s match up against the Oakland Raiders.

Since today’s injury report was released today, relatively nothing new has occurred injury wise with the Bills. LB Ramon Humber and TE Charles Clay continue to be on the mend with their respective injuries. RB LeSean McCoy, DT Kyle Williams, LB Lorenzo Alexander did not practice secondary to requiring a rest day. Those guys go hard every Sunday, a rest day is more than well deserved. CB E.J. Gaines (hamstring), S Jordan Poyer (knee), and G Richie Incognitio (ankle) did not practice secondary to their recent injuries.

I had previously given my thoughts on Gaines and Poyer in my last article. With soft tissue injuries, there are general guidelines based on severity, but it ultimately come down to each player’s response to the injury. I still believe Poyer may be able to play Sunday, but the Bills continue to be proactive, releasing CB Tony McRae and signing CB Lafayette Pitts, who has spent time with Miami and Jacksonville the past 2 seasons.

G Richie Incognito did injure his ankle early in the 2nd quarter, sat out several plays, and was able to return to the game. It appears as though he may have sprained his ankle, which is not surprising considering his position. Considering he was able to continue playing, sitting out today’s practice especially in the rainy weather, ensured that he could have an additional day to rest his ankle. With proper bracing, Incognitio may be able to play Sunday, but not knowing the severity clouds my ability to make a definitive prognosis.

It is worth mentioning that WR Jordan Matthews is no longer listed on the injury report. While I am not an expert yet in the reporting of injuries to the NFL, this indicates two things. This indicates that Matthews did not have a set back in his recovery from thumb surgery. This also indicates that he is most likely not back at 100% though. Just because he is not listed does not mean that he is still not still healing. I expect him to continue wearing his brace for protection for at least another 1-2 games until team doctors can be confident that he will not re-fracture the area.

The only other notable injury is LB Preston Brown. He was able to participate in practice despite a shoulder injury. There is not any information other than the official press release to indicate the nature of the shoulder injury. Brown’s job is to throw his body at a moving object and stop it in its tracks. I expect that his shoulder will hurt from time to time due to the repeated impacts. As the NFL injury rules are quite strict, it is in the Bills best interest to report all injuries. As there is no information on the shoulder and he was a full participant, this does not concern me at all and does not indicate any underlying chronic issues.

Minimizing the injuries continue to be a focus of this team and while the secondary has taken a hit, the team as a whole continues to be relatively healthy. The secondary was awful last year; so far it has exceeded expectations, but this will be an area that Oakland will attempt to exploit in order to win. This will be an area that I expect the Bills to continue to address on the waiver wire and in next year’s draft. I still believe the Bills have the talent to win this game, but if the Bills have to lose, I would rather be it this game than a winnable game such as the Chargers or Jets in the next several weeks. My football predictions may not be accurate, but my knowledge of the injuries are. That’s why you are here reading.

Look for future posts including my thoughts on Sean McDermott and the culture he is instilling in Buffalo. I will continue to report on the Buffalo Bills injuries as they occur and begin to incorporate new items into my posts as they become relevant. As always, thank you for your time and GO BILLS!!

Week 7 Recap- Buccaneers

Breaking down the latest on EJ Gaines and Jordan Poyer injuries and following the exciting win over the Buccaneers.

The Buffalo Bills continue to thrill and excite the fan base with a fantastic 30-27 win over the Tampa Bay Buccaneers! Despite giving up 27 points to the Bucs, the Buffalo defense made key stops including a late fumble recovery by Tre’Davious White to set up the game winning field goal. Buffalo is now 4-2, including 3-0 at home, making Sean McDermott the first Bills head coach to start 3-0 at home. These Bills continue to impress, but key injuries may derail the good times.

Thankfully, the Bills injuries continue to occur at a minimum, but injuries in the secondary may be ill timed with the Oakland Raiders offense coming to life. CB E.J. Gaines suffered a hamstring injury during a tackle on DeSean Jackson early in the 3rd quarter. Gaines was able to walk off on his own power but was unable to return. As reports are minimal at best to avoid giving a competitive advantage to their opponents, Gaines has been listed day-to-day. Based on this report, he may have suffered a Grade 1 hamstring strain.

If you recall from my article on hamstrings, this is something that can be managed conservatively and is a week-to-week injury. It’s possible that he may be able to play in time for the Oakland game, but considering that Gaines had a hamstring injury in training camp and is just recently coming off a groin injury, this doesn’t bode well. Unfortunately, these are soft tissue injuries and while can be reduced, they are not fully preventable.

I would not hang the “injury-prone” tag on Gaines though at this time. During each time he has been injured, he has been going all out trying to make the play. I would rather have him go all out trying to make a play rather than a player taking it easy, such as CB Stephon Gilmore, who we dealt with for far too long last season. However, I believe based on all the previous history, he misses next week. As Brandon Beane has been known to do, he has been preemptive, signing CB Tony McRae and releasing WR Kaelin Clay with the uncertainty following the injury.

This signing was also made with the recent injury of S Jordan Poyer. His injury came on the last play of the game in which Tampa Bay attempted their pathetic imitation of the Music City Miracle. They were playing the Bills, you’re not going to fool them twice! Video of the play shows a player hitting Poyer low and Poyer reporting he felt a pop. Based on video, it appears he did injure his right knee, though the injury does not appear to be as severe as it could have been.

During the hit, Poyer was able to begin lifting his leg and turn his hip inward away from the hit, allowing him to deflect some of the force on the knee joint. As he was able to walk off with the trainers, this also indicates that this may be a Grade 1 MCL sprain. Thankfully, this MCL sprain is nowhere near the severity of the Charles Clay injury. I believe there is a better shot at Poyer playing Sunday than Gaines at the moment. This week’s practice will dictate how each player responds to the injury. I believe that the Bills could go without one of these players, but not both.

Finally, WR Jordan Matthews was able to suit up and play, recording 3 targets for 2 catches for 10 yards. While this is not the type of production the Bills had hoped for, this far exceeded expectations considering he is still coming off a broken thumb. It was a stretch that he was able to play this week, it appeared that he was used more as a decoy to help in allowing WR Deonte Thompson to make his mark after being signed off the street earlier last week. Having Matthews return to play gives Tyrod another weapon going into next week’s game against the Raiders.

Despite missing TE Charles Clay and using a less than effective Jordan Matthews, Tyrod Taylor was able to spread the ball around to Thompson, Logan Thomas, Nick O’Leary, LeSean McCoy, and even Zay Jones. Despite missing some top end talent on the roster, the Bills still benefit from the depth at each position which allows for a next man up mentality. I believe this is why the Bills have been able to stay in every game this season and win the close ones such as Sunday’s game. This formula will not work every week, but the Bills have to begin winning the close ones in order to have a shot at turning their years’ long misfortunes around.

The Bills aren’t losing anyone to season ending injuries, unlike many other teams in the league. Depth continues to be a concern, but it is not as though other teams lose their starting player and a Pro Bowl caliber replacement is warming the bench. I believe with this depth and team first mentality, the Bills can beat the Oakland Raiders and move to 5-2 on the season. The Raiders do have a talented offense lead by Derek Carr and Amari Cooper, but if the secondary can get healthy in time, this should limit the effectiveness of the passing game. With how the Bills defense has played this season, I expect McDermott and Frazier to draw up a defensive game plan to limit the Raiders offense.

I know that many Bills fans are still on the edge despite a 4-2 start. The Bills have been here several times in the past with poor finishes. This may be another year in which that’s the case. Experience, injuries, schedule all play a part in the rest of the season. Time will tell how the rest of the season plays out; I will continue to hope for the best, but prepare for moments that remind me why I am a Bills fan. Until then, I will continue to cheer and enjoy the moment. Thank you for your time and GO BILLS!!

Week 7 Injury Breakdown- Winston’s Woes

Breaking down the Bills injury report, analyzing QB Jameis Winston’s AC sprain, and how it will impact Sunday’s match up.

Well, I was wrong. Yet I couldn’t be more happier! WR Jordan Matthews has been cleared for practice! After breaking a bone in his thumb which required surgery and a pin inserted just two weeks ago, he has already begun practicing on a limited basis. This is far faster than the anticipated month long absence the team expected. This also blew my prediction out of the water of returning at least by the Jets or Saints game.

This determination was made with full confidence of team doctors and how Matthews has responded to treatment. While there are guidelines with each surgery, they can be circumvented based on variables such as healing, pain, and strength/range of motion progress. As of today, he is listed as questionable for Sunday. He was listed as a full participant in practice today, however, it may still be beneficial to come back with an additional weeks rest. As we have found out, anything can happen, so stay tuned.

Conversely, I believed that LB Ramon Humber would be the one returning quickly as he was able to play through the Falcons game with a club on the hand until he could be examined further. As of today, he is still listed as out. This may change as he continues to be week-to-week, but LB Matt Milano is filling in place with satisfactory results.

CB E.J. Gaines continues to deal with a groin injury also sustained in the Atlanta game which indicates that it may be been more severe than DE Shaq Lawson injury. He was listed as a full participant today which is a good sign heading into Sunday. CB Leonard Johnson is listed as still dealing with a hamstring injury, but also was able to practice in full today. As previously mentioned, hamstrings can be tricky and not quite heal up completely if Johnson re-aggravates the injury. Both are listed as questionable going into Sunday’s game, but considering these are soft tissue injuries, I have much more faith in them playing than Matthews.

Finally, OT Cordy Glenn was a full participant while still dealing with a foot/ankle injury. He appears to continue to re-injure it or dealing with a chronic issue which means he may never be fully healthy this season. There was discussions that he would be moved to the Seattle Seahawks, but a trade was unable to be completed. It is also assumed that he would not pass a physical. Add into the mix that he has a hefty contract that not every team can just assume. I expect to see Cordy either get healthy and be traded, or play out his contract and leave a free agent.

While this is a Bills blog, the one big question is how QB Jameis Winston’s AC sprain will affect Sunday. Winston sustained the shoulder injury last Sunday during a tackle by LB Chandler Jones. It was reported that he was well enough to return in an emergency, but QB Ryan Fitzpatrick finished the game. As of today, Winston has participated in a limited fashion with throwing in practice and is listed as starting Sunday. While he is starting, I question the effectiveness of his abilities.

front-view-of-shoulder-joint-356986.jpg
Credit: saintlukeshealthsystem.org

To understand why this may limit Winston, the AC joint must be understood. The AC joint is important in the shoulder as this is where the top of the shoulder (acromion) articulates with the collarbone (clavicle). The AC joint is vital to the throwing motion due to the fact that as the arm is elevated, the acromion that attaches to the wingbone (scapula) begins to elevate. As the scapula begins to elevate, the articulation between the acromion and clavicle begin to move as the clavicle beings to rotate up and out of the way to allow for overhead movement. If the AC joint is sprained, this limits the ability to elevate the shoulder effectively and cock the arm back in position to throw. There are various grades of AC joint sprains as with any other sprain outlined in my previous article, but this appears to be a Grade 1 sprain.

Winston is going to attempt to play with this injury, but it’s assumed that he will not be effective to throw deep or put any speed on his throws. On average, the shoulder sprain that Winston sustained typically takes 9.8 days to fully recover from according to Dr. David Geier. He will be at day 7 by kickoff Sunday, which may affect his ability. This, and other information regarding AC joint sprains can be found at the previously linked blog. This information provided by both Dr. Geier and found by my friends from The Rockpile Report. If you aren’t already a listener, start listening, Drew and Chris are the best at what they do when it comes to Bills football!

At this point in the season, I still believe we are in a better spot both record wise and injury wise compared to previous seasons. I also believe that this team is better equipped to deal with injuries than in past years. This next month of football will really define our season, determining whether the Bills are for real or the same old Bills. Calling it now, the Bills win a close defensive battle and move to 4-2 on the year. Continue to check back for any breaking updates, new injuries, or further explanation of complex injuries. Thank you and GO BILLS!!

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.

knee.jpg
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!!