Buffalo Bills Season Injury Review- RB/FB

Season ending review of the Buffalo Bills backfield and implications for next season.

The Buffalo Bills had a variety of personnel in the backfield this year which leaves many questions regarding roster turnover for next year. Many factors go into these decisions based on production, salary, and injuries. Today’s post will address the RB/FB positions for the Buffalo Bills

This past season, there were 6 running back/fullback’s listed on the roster that saw playing time. Starting off, RB Marcus Murphy appeared in one game against the Miami Dolphins in relief for LeSean McCoy due to his sprained ankle. The most recent backfield addition thankfully suffered no injuries during his short stint with the team and showed the ability to play in the NFL. His future with the team remains murky at best as he is an unrestricted free agent and there is a dearth of talent at the position ahead of him.

Next up is RB Taiwan Jones. Jones actually never saw a carry in the RB position, instead was targeted 2 times resulting in 1 reception for 11 yards. Most of his game action occurred on special teams which unfortunately ended his season. The 7th year back broke his forearm during an onside kick return during the Week 9 loss to the Jets. Along with the fracture, Jones dealt with a knee injury early in the season that did not cause him to miss any time. Jones is also an unrestricted free agent and while his forearm is not concerning, his age and effectiveness may leave him without a team during the off season.

Travaris Cadet headlines the next RB in this post. Cadet as you may recall, suffered a traumatic left ankle fracture and dislocation during a routine play against the Patriots. Up to that point, Cadet was an effective change of pace back who allowed McCoy to stay fresh through games. Surgically, Cadet had his ankle relocated and then had a plate with screws inserted to stabilize the area. A typical rehab protocol allocates for 12+ weeks to return to walking, but may take much longer to return to full game speed. Cadet also suffered a concussion in December prior to the ankle which did not cause him to miss time. The 6th year journeyman is an unrestricted free agent and with a long recovery time factored in, his ability to recover fully will determine whether he has a roster spot next season.

Another back who saw no time in the backfield is RB Joe Banyard. The veteran back only saw time on special teams and while he does not have the carries that similar backs have at his age, he does not appear to be able to carry a workload for a NFL team. As he is a free agent right now, I do not see him on the roster for next year.

Patrick DiMarco was used sparingly in the offense this year at the fullback position. While he only saw 2 attempts for -2 yards, he saw some time in the receiving game and as a blocking fullback. DiMarco saw injuries to his ankle during the Kansas City game but did not miss any time. The 6th year fullback may find himself back on this roster next year as he was signed for 4 years for $8.4 million dollars.

The back who saw the most time in the backup role is Pro Bowl FB Mike Tolbert. The 10th year veteran carried the rock 66 attempts for 247 yards and one TD. He became the ire of the fan base due to his use during 3rd and long with short passes or runs that shut down offensive drives. Analyzing his injury complaints, he suffered a knee injury early in the season and sustained a moderate hamstring strain that sidelined him for 3 games. While he was able to return for the Colts game, he appeared to be limited until the regular season finale. Hamstring strains and tears not managed correctly can continue to limit players through the season. With the off-season to recover, he should not have any recurring issues, but his use in the offense and an unrestricted free agent determines whether he returns next season.

Finally, RB LeSean McCoy, the engine of the Bills offense continues to climb up the rushing ranks past the all time greats. Fortunately, McCoy only had a variety of minor injuries through the season which did not affect his production. The only significant injury McCoy sustained was a sprained ankle in the season finale against the Dolphins which did not limit his productiveness in the Wild Card loss against the Jaguars. Other issues McCoy dealt with included wrist, groin, and knee injuries in addition to illness that did not force him to miss any time.

McCoy has been incredibly resilient during this season & career but is approaching his age 30 season. As history has shown, many running backs begin to suffer decline in production around this time and McCoy is no exception. Those that have rushed for 1000 yard seasons after their age 30 season have seen a drop in production 1-2 years afterward. For those that rushed for over 1000 yards either did not accumulate the yards early in their careers or they were true outliers. I expect to see McCoy return to the starting RB role next season and continue to produce for the short window he has left.

While none of these small injuries are concerning for long term, that long term wear and tear adds up and he will eventually decline. With McCoy’s production both on the ground and in the receiving game, he is vital to the Bills successes. However, the Bills are aware of this and will hopefully address the backfield in the off season. As much as both McCoy and the Bills would like to remain productive, it is inevitable that he will decline in ability and relinquish his role.

Outside of McCoy and DiMarco, I expect this backfield to be turned over with fresh legs and develop the next running back for the Bills. As I am not an expert in roster management and salary cap issues, it’s possible that others from this article find their way back to the roster as depth players. The Bills do have RB Aaron Green on a futures contract but is not guarantee to make the team next season. Injury wise, everyone can come back healthy with proper rehab and time, but it will all depend on personnel needs.

I did not forget Kyle Williams contribution of his memorable rushing touchdown during the season finale. As this was atypical, I will not categorize him in with the RB’s, but give him the words and thoughts he deserves during his position review. Continue to check back with me for the latest updates on Bills injuries and season reviews. As always, thank you for reading and GO BILLS!!

Speculating Cordy Glenn’s Injuries

Analyzing possible injuries for Cordy Glenn following his injury plagued 2017 season and expectations for 2018.

As the Bills continue to make moves this off-season, several player’s futures are in question whether to keep them around for next season. Several of these players have contract issues that may not be team friendly, others are based on long term health. Not surprisingly on Banged Up Bills, discussions will be had regarding long term health. Today’s post will assess Cordy Glenn’s future in Buffalo.

Cordy Glenn’s health has been in question for the past two seasons after having a solid start to his career, missing minimal time in his first 4 seasons. This caused GM Doug Whaley’s regime to reward his play with a contract extension that is not team friendly now that he has been injured. Prior to these most recent complaints, Glenn had only missed 2 games his rookie season due to an ankle injury, missing 2 out of the next 3 games and then returning to play without difficulty after Week 8.

Glenn was a mainstay at the left tackle position for the next several years, only appearing sporadically on the injury report for various issues such as illness and back pain. He did reappear during the 2015 season during Week 5-6 with an ankle injury which did not cause him to miss time. Everything began going downhill for Glenn in the 2016 preseason when he suffered a high ankle sprain during a scrimmage in early August.

Since then, Glenn has been dealing with primarily ankle complaints in addition to foot complaints which placed him on IR this season. Unfortunately, the team was and still is tight lipped on the specific injuries Glenn sustained. Without direct knowledge, I can only speculate on the complaints he has based on photos, procedures, and reading between the lines.

I had previously stated that I believed Glenn was dealing with chronic ankle instability, similar to what RB Leonard Fournette of the Jacksonville Jaguars was dealing with. With instability to the area, surrounding structures bears the extra forces which could lead to further injury. This is evident with his game log presentation; missing several games and then returning while spending time on the injury report before finally shutting it down for the season.

Unfortunately for Glenn, it appeared that his ankle never fully recovered and he began dealing with what was described as “foot soreness” which required an injection to the area to manage pain. He was able to play off and on through the season before being shut down in Week 9. It was reported that he had surgery on this same foot by Dr. Robert Anderson who performed the original injection early in preseason.

As he has dealt with so much already, it is difficult to determine outcomes. He has ankle issues which may have exasperated a foot injury which when combined, makes looking outside in nearly impossible. From my perspective, the foot appears to be the more acute issue and by fixing that, should allow the ankle to heal properly. The foot injury in question appears to be a Lisfranc sprain based on information available. If he is truly dealing with ankle instability, there are surgeries to correct this, but he may just need additional time to rest. In today’s NFL, these players are training year round and are not afforded the ability to sit and rest for extended periods of time due to maintaining a certain level of fitness along with always preparing for the season.

Conversely, while conservative treatment is preferred when managing most injuries as surgery is not always the ideal option, conservative treatment may still not correct the issue if it is a structural issue. Case in point, ACL injuries. Ryan Tannehill is an excellent example of this. He partially tore his ACL at the end of last season, performed conservative therapy and was cleared to play. He then re-injured the same leg and was forced to have subsequent surgery.

Glenn’s most likely surgery scenario is for a foot reconstruction involving the midfoot. This would entail identifying the area that is unstable and placing screws in to promote proper alignment and healing to the area. Research has found that while screws are beneficial to assist in healing, keeping them in for too long may lead to loosening of the hardware and breaking. In some instances, removal of hardware is performed to facilitate full return to health. The procedure and rehab protocol can be found here. Return to full function may vary but conservative protocols list the time to recover up to 6 months. During the final phase of rehab, strengthening and activities that promote return to function are vital ensure a successful outcome.

Based on the timeline that we know about Glenn, he suffered the ankle sprain which appears to have become chronic. This may have led to midfoot discomfort/Lisfranc sprain which necessitated a surgical approach. It is possible that Glenn will be healthy to return for OTA’s if he had surgery in December as stated, however, he may be held out as a precaution as that time will be coinciding with his rehab protocol.

The outcome of this surgery will dictate his value for this team. The fact that Glenn was nearly traded to the Seattle Seahawks for a 6th round draft pick during the season indicates several things. This indicates that the injury is manageable and can be corrected. This also indicates that there is possibility that he can return to full health in the future. Based on this knowledge and the scarcity of effective tackles in the NFL, I envision a scenario that involves the Bills keeping Glenn on this roster and reworking his contract to a more team friendly deal.

The other scenario that is possible is that they move him for pieces that they need and stay with Dion Dawkins. While this may be beneficial for the future, the team is moving a proven player who when healthy, is quite effective. I enjoy the idea that Glenn gets healthy, stays at left tackle, Dawkins moves to right tackle, and build depth as the O line in general is aging.

I do not expect any additional news to come out about his injury besides general news stating surgery has been successful. I anticipate that his ankle issues may resolve as he will be non-weightbearing for an extended time allowing the surrounding ligaments to heal properly. Glenn can be expected to return to full health and will only be moved from the Bills if the offer is too good to pass up.

Continue to check back with me at Banged Up Bills for the latest updates and injury analysis. Thank you for reading and GO BILLS!!

Eric Wood’s Neck Injury

Analyzing the neck injury that forced Eric Wood to retire and long term implications.

Disappointing news coming out of One Bills Drive Friday with the sudden announcement of C Eric Wood retiring from the NFL after nearly a decade. The cause of his retirement appears to be related to neck issues that were discovered during a routine end of season physical intended to assess issues players made need to address in the off season.

This determination was made by Dr. Cappuccino, who is the orthopedic spine surgeon, along with other doctors and team officials. For the 9th year pro’s long term health, it was ruled that retirement was best to avoid further damage. As detailed information has finally been released, it has been revealed that Wood is dealing with a bulging disc in the C2-C3 region following stinger’s during Week’s 5 & 6. Today’s post will identify why this is career ending and long term implications.

While it is incredibly disheartening hearing this news, I believe all fans would want the health of each and every player to be most important. To identify what occurred with Wood, the anatomy of the area must be understood. The cervical region of the neck is comprised of 7 cervical vertebrae that stack on each other which curve in concave fashion to allow for support of the head in an upright position. In between these vertebrae, with the exception of the first two levels, cervical discs act as as shock absorbers and allow for the vertebrae to articulate with each other in order to move freely. Ligaments attach the vertebrae together for support and passing through the vertebrae are arteries, the spinal cord, and nerves. Eric Wood suffered a disc bulge at C2-C3, the first disc after the C1-C2 junction. To help put this all in perspective, please refer to the pictures below.

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Credit: backpain-guide.com

One of the issues that Eric Wood may have been dealing with that was described as wear and tear is cervical spondylosis. This occurs when the structural integrity of the vertebrae column becomes compromised and leads to instability within the region. This is is due to the cervical discs losing disc height which in turn reduce the space between, leading to laxity on the ligaments, causing further pressure on the discs. This can be the result of the aging process, trauma, or individuals that have to carry heavy loads on their head or shoulders. As a possible result of this condition, he stated he suffered a “stinger” in Week’s 5 & 6 and was evaluated without further treatment required. As cervical spondylosis progresses, this can cause other issues including degenerative disc disease, spinal stenosis, hypertrophy of the surrounding ligaments, subluxation of the vertebrae, along with both neural & vascular compression.

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Credit: mayoclinic.com

As a result of the disc bulging out, this can create spinal stenosis. In the case of cervical spinal stenosis, the vertebral foramen, or space in which the spinal cord passes through, becomes narrowed. In the case of Wood, repeated trauma/progressive disc protrusion is what led to his disc pressing on his spinal cord as seen below. Other causes that could occur include ventral spondylophyte formation, thickening of the ligamentum flavum, or hypertrophy of the dorsal facets. While all these are confusing terms, these are all structures that surround the spinal cord that could reduce space and compress on the spinal cord as you place the head into various positions. To put this into a simpler perspective, imagine squeezing a hose; as you tighten or bend the hose, the flow of the water decreases. If the spinal cord is compressed, certain head movements can increase pain and limit mobility, placing even greater pressure on the spinal cord. This could affect areas below the spinal cord level or the nerve roots that branch off to the extremities. With compression over time, this could lead to temporary or irreversible damage based on severity.

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Credit: http://www.houstonmethodist.org

This is something that Wood was aware of after Week 5 and appeared to manage up to this point. However, incidence of previous spondylosis could cause and progress the stenosis.  As the veteran center has never appeared on the injury report with a neck injury during his career, this doesn’t mean that he never had neck pain. This is evident with the report of the stingers that was resolved which lead to his omission on the injury report.

Following the stinger, there are variations in the presentation of symptoms based on severity. One of the concerning but manageable issues include cervical radiculopathy. This is where the nerve is compressed either at the neck or a later exit point down the nerve’s path. This compression could cause pain, tingling, numbness, and weakness to travel down specific nerves in the shoulder or arm. This is common to see in the general population, but far from a pleasant sensation. Several of these symptoms are more prevalent in the lower cervical vertebrae.

In Wood’s specific presentation, occipital headaches, often typical of migraine, with pain radiating to the eyes and behind the ears, blurring of vision, dizziness and nausea especially when attempting to lie down, numbness of the side of the neck, tension and “knots” in the neck and shoulder muscles, and swelling and stiffness of the fingers. He may have had several of these symptoms following the stinger which warranted further evaluation.

If Wood would have continued playing and ignored medical advice, he would be at risk of  developing cervical myelopathy as this is more severe in that actual damage to the spinal cord has occurred. This presents as bowel and bladder issues appear along with difficulty walking, coordination, and loss of strength, among other symptoms. Typically, those are emergency related symptoms and must be dealt with immediately. If Wood were to keep playing, he would be at higher risk to have this occur with the violent nature of the hits and further degeneration of the affected areas. The C2-C3 area is more severe as nerve roots branch off which affect head movement and assist in controlling breathing. Further damage to the area could include paralysis and/or death if not addressed immediately.

While all this does sound ominous, there are many options for conservative care. Physical therapy, chiropractics, and pain management including injections can manage the complaints for years. Primary focus on the area would to educate the patient on the condition and awareness of possible worsening symptoms. Other interventions include managing and reduce pain, maintain motion and strength in the area, and prevent further decline in the area. Personally, I have worked with a variety of patients with similar complaints with a variety of outcomes. Some have been able to resolve their complaints completely, some have significantly reduced their pain and have a strong understanding how to prevent further complications. Others have gone on to receive injections and surgery which in turn has improved their quality of life. Fortunately, through his decision to step away from the game of football, Eric Wood will not likely be bed bound and in a neck brace for the rest of his life. He will instead be able to participate in activities including exercise, avoiding strenuous, repetitive activities such as football and heavy weightlifting, and focus on raising his newborn son.

If Wood is to require surgery in the future, there are a variety of surgical procedures that can help to stabilize the affected area. This includes but is not limited to: spinal fusion surgeries and/or anterior cervical discectomy.  These procedures stabilize and partially remove the offending area to reduce pressure on the spinal cord. Right now, he may not require any surgery, instead altering activities to reduce further damage. If surgery is indicated, this will help with quality of life but would not allow him to safely return to football.

Severity of the neck complaints that are forcing Wood to retire early at least leaves him in good hands with Dr. Andrew Cappuccino.  If you recall, Dr. Cappuccino is best known for saving TE Kevin Everett‘s life during the season opener in 2007. To put into comparison how severe this Wood’s injury is, S Aaron Williams had similar issues with his neck in a lower level that were well documented, ending his career. It appeared that he was willing to continue playing, but teams knowing his medical history would not touch him for fear that the next big hit may kill him. Wood was not willing to take that risk and able to end on a high note with a playoff berth.

The next big question is who steps up and replaces him. Ryan Groy appears to be a natural fit as he can play multiple positions on the line and may be a stop gap until the Bills find their next player in the draft or free agency. I believe the Bills will address this position effectively as they have with other positions this past season. It is a shame that this occurred to such a great player, but, as many before Eric Wood have proven, time is the one opponent that no one can defeat.

I hope that you learned something today and helps put into perspective why Eric Wood is forced to end his career. Continue to check back with me on updates regarding Bills injury news! Thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- QB

Analyzing injuries sustained to Bills quarterbacks during the regular season and impact for the future.

Every season, players from all NFL teams get injured, some more severe than others. Virtually no position is immune from injury, but the frequency and long term impact may vary. Teams successes or failures can be attributed to the health of particular positions. Today’s post will look at the 2017 Buffalo Bills at the quarterback position.

Quarterbacks that suited up for the Buffalo Bills during the regular season included Tyrod Taylor, Nathan Peterman, and Joe Webb. Due to injury and performance, all saw meaningful snaps which propelled the Bills to their first playoff berth this century. Unfortunately, all experienced some degree of injury during the course of the season.

First up is QB Joe Webb who only sustained an ankle injury during the season finale against the Miami Dolphins which did not force him to miss any time. Webb most likely sustained a minor sprained ankle on special teams where he accrued most of his playing time this season. The 3rd string QB’s only significant playing time came in the memorable snow game against the Colts in which he stepped in for the second half and set up the Bills for the memorable win. Stat wise, he had 7 attempts for 2 completions and 35 yards with one interception. Injury wise, Webb will not be a liability coming back next season and a 2017 salary of $900,000 is not breaking the bank. However, a quarterback with 8 years in the league making nearly one million dollars may not be in the long term plans with the front office reshaping the roster.

Next is QB Nathan Peterman who had a rather forgettable rookie season. Injuries sustained to Peterman this year consisted of a concussion sustained during the 1st half of the Colts game. Concussions are always uncertain in regards to recovery and long term recovery but in Peterman’s case, he was able to return to action after missing one game. Total playing time for the rookie involved 4 regular season games with 2 starts and 1 playoff game. Most remember his atrocious start against the Chargers in where he threw 5 interceptions in the first half alone. Overall his stats read as: 50 attempts for 25 completions, 266 yards for 2 TD’s and 6 interceptions. As Peterman sustained minimal injury along with a rookie deal of $465,000, his salary and potential ability to grow as a quarterback are team friendly. Depending on what new OC Brian Daboll plans to do will determine whether he has a place on the roster next season.

Finally, QB Tyrod Taylor who has been one of the more polarizing players in recent Bills history. His overall stats: 420 attempts for 263 completions for 2799 yards plus 14 passing TD’s and 4 interceptions. He also added 427 yards and 4 TD’s on the ground. His play has been critically analyzed and never quite what the team or fan base has been looking for. The 6th year signal caller avoided major injury this year, starting 14 games while only missing one game to a patellar tendon contusion sustained in the first Patriots game. Taylor sustained a concussion in the preseason which landed him on the injury report for Week 1 and ended the season what appeared to be a rather nasty hit to the head in the playoff loss to the Jaguars which forced him to exit the game early.

Taylor’s injuries do not appear to be lingering for next season as he has shown he heals fast and is not out for long periods having only missed 3 games over the past 3 years. Unfortunately, the team appears to be questioning whether Taylor is in the long term plans. While he did deliver the playoffs, that may be his ceiling and unable to grow into a franchise quarterback. Factor in his mobility which increases the risk for future injury along with a salary of $7.5 million plus roster bonus makes him potentially unattractive for long term. I believe that he is appropriate to play out his contract as a bridge quarterback until a new heir is ready.

Thankfully, the Bills are not forced to make decisions based on injuries compared to what the Vikings, Dolphins, and Colts are forced to deal with this upcoming off season. The Bills are in a good financial position along with draft capital to prevent them from reaching or missing out on the quarterbacks they covet. This will undoubtedly usher in a new starting quarterback for the Bills next season.

Continue to check back with me for further updates on Bills injury news. Follow me on Twitter @kyletrimble88, thank you for reading and GO BILLS!!

Kelvin Benjamin’s Partial Meniscectomy & Recovery

Detailing the injury process of a meniscus tear, the surgical procedure known as a partial meniscectomy and recovery.

As the season is over, several Bills players are slated for surgical procedures to address injuries sustained during the season. Kelvin Benjamin is one of them.

The 4th year WR’s partial meniscectomy has been long expected following his Week 11 injury against the Chargers. Benjamin had to miss several games following the injury but was able to return to play through the final stretch of the season, becoming a buoying presence for the wide receiver corps, helping the Bills to the playoffs. Today’s post will briefly review what a meniscus tear consists of, mechanisms of injury, and the surgical procedure and rehab that generally speaking is required to return to full health. For a greater detailed description of the meniscus and its role in knee movement, please reference my previous article.

The meniscus lies over the tibia and acts as a shock absorber between the tibia and femur. It is made up two wedge shaped areas that assist in deepening the area that the femur articulates with the tibia. During meniscus tears, a rotational force is applied to the area while the knee is bent resulting in a shearing motion, causing a portion of the meniscus to tear. There are many types and degrees of meniscus tears that could occur which include complete or partial, horizontal or vertical, longitudinal or transverse.

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Credit: http://samimimd.com/services/knee/knee-meniscus-repair/

Symptoms of meniscal tears typically consist of pain, tenderness, and swelling, locking or clicking during knee movement, and initial difficulty in placing weight through the knee. Meniscal tears are typically seen in conjunction with MCL sprains/tears and ACL tears due to the rotational forces through the knee during impact. The size and location of the tear can vary, which determines the most effective course of treatment.

Thankfully, Benjamin only requires a partial meniscectomy which is typically a 4-6 week recovery to return to baseline. During a partial meniscectomy, an orthopedic surgeon goes in arthroscopically via two small holes in the knee. Once inside, the surgeon inserts a camera to observe the affected areas. From there, other tools are introduced to grab at the offending area and cut out the frayed portion of the meniscus. A shaver is introduced to smooth down the area to remodel and prevent any any future fraying or breakdown of the tissue.

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Credit: https://nydnrehab.com/what-we-treat/knee-pain/meniscal-tears/

After the surgical procedure is completed, rehab is introduced to restore the knee to full function. Immediately after any surgery, the body enters an inflammatory phase which can last up to 48 hours after the insult to the area. Typically pain and swelling are addressed first through the time tested RICE method. This includes rest, ice, compression, and elevation. This helps alleviate post surgical swelling and pain as if the leg is in a dependent position, the excess fluid builds up in the knee and lower leg, causing extra pressure on the surrounding tissues. Other ways to manage the pain include the use of a TENS unit which provide superficial electrical stimulation over the skin to assist in desensitizing the area to reduce pain.

Once pain and swelling have improved, range of motion and strengthening is implemented to focus on returning the knee to normal function. Range of motion exercises include alternating between bending and straightening the knee through stretching to normalize function. This can be accomplished through heel slides in lying or sitting, stretching with the use of a towel or belt to pull the knee into flexion, or assistance from a physical therapist through passive motion to increase range.

There are countless strengthening exercises that can be performed but simple exercises after surgery include quad sets which encourage knee straightening, short arc quads to improve quadriceps strength, hip flexion, abduction, and adduction strengthening for weight bearing and return to walking, and ankle pumps. Progression of strengthening include closed chain exercises which are where the foot is in contact with the ground include stationary bike, modified lunges, terminal knee extension, squats, etc. Further exercises included open chain exercises in where the foot is off the floor includes long arc quads, step ups, balance and proprioceptive exercises as knee function improves. Finally, running, cutting, plyometric activities are incorporated to increase towards return to sport. A general rehab protocol can be found here. Successful outcomes as high as 90% are reported and able to return to pre-injury level of activity.

Benjamin will return to full function without any complications barring infection in time for OTA’s. He will most likely work with medical staff to return to game form which will take several months. This is possibly why he did not have surgery during the season. With Benjamin’s previous history of knee injuries which include an ACL tear, knee sprain, and most recently, a meniscus tear, there is some concern for future injury. However, while he is at higher risk for injury due to the previous ACL tear, there is little evidence that I have found that supports increased risk of re-tearing the meniscus greater than normal rates.

As with other injuries, there is only so much that can be done for prevention. Strengthening, agility, and proprioceptive activities are key to reduce future injury. In the case of Benjamin’s injury, external forces through the joints can not be entirely prevented. Benjamin may be wearing a brace as he returns to his prior form to control any swelling. He may elect to play with a hard brace to prevent hyperextension, though this would reduce mobility leading to him declining this option.

Over the years, the Bills have witnessed rashes of injury, and the teams success this season in successfully rehabbing players like Kelvin very much assisted in 2017’s outcome. The Bills are primed with draft picks, free agency cap space, and what appears to be an the ability to bring players back healthy. This will allow them to address other needs this off season rather than having to plan for the unknown in terms of the return of injured contributors from 2017. Continue to check back for with me for Bills injury news, reviews by position and draft pick injury analysis. Follow me on Twitter @kyletrimble88, thank you for reading and GO BILLS!!

Zay’s Shoulder Struggles

Discussing Zay Jones recent shoulder diagnosis, types of dislocations and causes, and expected outcomes following surgery.

As the NFL continues to maintain the fans attention year round, constant news is churned out that help shed light on players issues during the season and provide answers to questions not fully explained. New information regarding Zay’s rookie season has brought up courtesy of the most recent The Bills Wire podcast. In the latest episode, managing editor Rob Quinn interviewed Robert Jones, Zay’s father, who revealed Zay had played his entire rookie season with a torn labrum in his shoulder.

What makes this comment interesting is the fact that Jones only appeared with a shoulder injury as a full participant in practice at the end of October before the Jets game. This issue was never publicly identified as a complaint until this interview. Today’s post will identify and discuss what the labrum is and its role in shoulder movement, how it possibly affected his play, and long term outlook following his upcoming surgery.

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Credit: http://gomidwestsports.com/surgical-procedures/labral-tear/

The labrum is a fibrous layer of tissue in the shoulder that deepens the socket in which the head of the humerus articulates with the glenoid fossa of the scapula. This allows for stabilization to the moving shoulder joint and prevents the joint from separating. Other structures including ligaments, rotator cuff, and connective tissue allow for additional support. Finally, the long head of the biceps tendon feeds into the glenoid and serves as an attachment for the biceps to contract. All these structures together help make up the shoulder joint and maintain stability through motion.

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Credit: moveforwardpt.com

The labrum can be torn by many different ways due to the structure of the joint. As with other joints, with increased mobility, there is decreased stability. Ways a shoulder can dislocate include a direct blow to the front of the shoulder, fall on outstretched hand also known as FOOSH which can cause posterior dislocations. In cases of anterior dislocation, extreme distraction to the area such as sudden pulling or placing the shoulder in extreme end ranges in external rotation and abduction. To picture this movement, envision the cock-backed position of the arm when throwing an object.

As a result of the shoulder dislocating, there is tearing of the labrum. There are various types of tears including SLAP tears or Bankart lesions and Hill-Sachs lesions, but not knowing the mechanism of injury prevents us from identifying specifically which lesion Jones suffered. However, upon dislocating, there is concern for damage to the nerves, blood vessels, and muscles to the surrounding area. The head of the humerus could pinch on one of those structures and cause long term issues if not addressed immediately. Once x-rays are taken and corresponding symptoms are assessed, the joint may be reduced and stabilized.

Most dislocations occur anteriorly with the literature stating that 97% occur in this manner. The remaining 3% are classified as posterior. When a dislocation occurs, the joint surfaces that articulate with each other become dislodged and remain separated until they are reduced manually. There are instances where the joint partially dislocates and relocates by itself which is defined as subluxation. In either instance, this creates damage and further instability leading to the possibility of future complications.

In Zay’s case, it was mentioned that he suffered the same injury in college during the 2015 season. While his father did not identify which shoulder he damaged, I will assume that he re-injured the same shoulder which according to the above posted article is the left shoulder. Jones did have surgery to repair the shoulder in college but due to the nature of the joint, it is very possible to re-tear the labrum on the same side, which appears to be the case. Unfortunately, the tissue in the area cannot be reinforced by other means which forces the surgeon to sew up and anchor the available tissue and immobilize in order to heal.

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Credit: http://www.shouldersandknees.com/labrum-tear.html

It is possible to surgically repair the area if it tears multiple times. However, repeated tears to the labrum has been described to me as trying to sew water together by an orthopedic surgeon as there becomes less and less tissue available to fix. Following surgery to anchor the tear down, immobilization in a sling allows the tissue to begin healing is typically the first step followed by range of motion and strengthening of the area to stabilize the area. This is followed by dynamic stability and strengthening with return to function over a 6-9 month period.

It is unknown when Jones suffered his torn labrum but due to his position, he was able to play with greater ease compared to QB Andrew Luck who had missed all of 2017 due to post surgical complications with the same injury. Had Jones suffered acute symptoms of the tear during the season, immediate pain and instability would have been present along with difficulty with overhead movements and weakness during resisted movements. This would have translated to difficulty creating separation between defensive players and himself along with trouble hauling in catches due to decreased strength of the affected arm.

The above mentioned complaints are the kind of symptoms that would have landed any player on the injury report. It is possible that these issues led to his early season struggles, but not confirmed. Jones could have also suffered the injury during the season and not initially been aware of the severity which could explain why he did not spend time on the injury report. It was reported that the tear was found at a routine end of season MRI.

Returning to comments made by Robert Jones, specifically, if Zay were to pick up a glass of water, his arm could dislocate; this is highly unlikely and hyperbole. A shoulder that has suffered a torn labrum that repeatedly dislocates can demonstrate significant instability which could eventually lead to minimal forces required to dislocate. However, picking up a glass of water would unlikely dislocate a shoulder as muscles of the upper arm and forearm primarily control this action . If his arm did dislocate this easily, he would no longer be playing football and he would have had many other conservative interventions prior to letting it get that severe. Adding in the fact that in between dislocations, the body is constantly trying to heal, laying down scar tissue to stabilize the area.

As Jones is a professional athlete, instability in a violent sport does not equal long term success when it comes to health. This surgery will assist in stabilizing the area and hopefully prevent any further issues. Thankfully, Jones should be able to return to full form in time for training camp and have no setbacks. He should not experience the issues that Andrew Luck had as he does not have to throw the ball or place his shoulder in extreme positions.

This injury news was totally unexpected, but it is common for NFL players to play through injuries varying in severity and still perform at a high level. I have full confidence that Jones will return to full health and build off his sub-par rookie season. Continue to check back for articles including Kelvin Benjamin’s meniscectomy and other procedures including possible surgical interventions for Cordy Glenn. Follow me on Twitter @kyletrimble88 for updates, thank you for reading and GO BILLS!!

The Drought Is Over

Discussing the moment the Buffalo Bills made the playoffs and my love for the Bills!

It’s been a week since the Buffalo Bills were eliminated from the 2017 NFL playoffs by the Jacksonville Jaguars. While that loss did sting as it was a very winnable game had the Bills offense not been so anemic, the pain of it has lessened as the Jaguars have advanced to the AFC title game against the New England Patriots. This is not stating that the Bills should be in the AFC Championship, but rather how unpredictable the NFL playoffs can be each and every year.

However, today’s post sets out to help me describe my thoughts following that improbable New Year’s Eve so many Bills fans will recall for years. My wonderful wife had bought me tickets to the IIHF World Junior Championships for Christmas with USA playing Finland in a thrilling 5-4 victory. However, due to the NFL having the ability to flex games, the Bills game was flexed to 4:25 pm in order to prevent teams from altering their game plans based on outcomes. Initially, this was not ideal as I wanted to watch the football game in its entirety.

As thankful as I was, I still attended the game with a friend and we decided to stop down at a restaurant near the arena, 716, to watch the remaining of the Bills game. Entering the bar area, every TV was on the Bills game and several TV’s played the Cincinnati-Baltimore game. Every seat was packed and looking around, it energized me as a Bills fan due to the sheer fact that these kinds of moments do not happen often. When I became a Bills fan in 2007, I had some idea of what I was getting into, envisioning the moments that were before me at 716.

Once the Bills did their job and won their game 22-16, all attention turned towards the Cincinnati-Baltimore game. The moment was simple, yet hopeful; if the Bengals win, we’re in. As the clocked ticked down with the Bengals down, dread crept in. That moment as a Bills fan everyone knows all too well. This moment that this is all going to fall apart and we will be left wondering what if again as a January without Bills football.

Thankfully, as Andy Dalton marched down the field, mine and those around me all thought, all we need is a field goal and we still got this. Never in my wildest dreams would I imagine that Andy Dalton throwing a strike to Tyler Boyd to score the go ahead touchdown would be that culminating point in the Bills season. The emotion pouring out of me was effusive and unbridled! I began high-fiving, hugging, screaming, running, everything I could do to express my sheer love for the Bills! And in that moment, those emotions felt exactly as I could have ever thought possible, it was a split second in time that felt exactly right and did not disappoint!

The bar going crazy, that raw happiness exuding from every single person, that’s what I signed up for when I became a Bills fan. That moment that those last second losses, those disappointing seasons, the disrespect from other fan bases, all finally validated in one singular moment. Even though this was merely a playoff berth, it was OUR playoff berth; a well deserved one at that! The week following that miracle was incredible as nothing could get me down, nothing could lessen my enthusiasm, and never have I been more excited for a Bills game!

As I write this, if you are still reading, you may be wondering why I wrote this article. I wrote this with the idea that I have a platform, as small as it may be, a platform nevertheless which I can convey my thoughts. I am proud to be a Bills fan, I am proud of my team, and proud of what they have accomplished this season. I had always been a football fan but until I became a Bills fan, I did not know what fandom was. Buffalo has shown me fandom in spades and allowed me to truly enjoy what being a Buffalo sports fan really is all about!

Yet, I, as many others as well, realize that the team is still very flawed and needs constant refinement. I am okay with this realization, as winning is a constant improvement within one’s self and if you are not moving forward, you are moving backwards. I cannot wait to see what this front office does with this team and what success awaits this team in the coming seasons!

As I finish up my thoughts on that incredible moment, I begin to further identify other topics to write about, I plan to write about Kelvin Benjamin’s meniscectomy, Zay Jones labrum repair, and any other procedures that are expected or reported. I will continue to do my best to identify topics of interest that are not not fully explained in the media that may shed light on the side of football many are not familiar with. Continue to check back regularly and GO BILLS!!