2020 Week 7 Bills Injury Review- Jets

Are the Bills finally getting healthy?

A win is a win when at the end of the year no matter how easy or ugly the game may have been. An 18-10 score completes the season sweep of the New York Jets and first sweep since 2015. Behind a strong performance of 6 field goals from K Tyler Bass, the Bills found ways to move the ball down the field and score points despite the offense sputtering. The defense came up strong in the second half, only allowing 4 total yards to the Jets offense, finishing with a game-sealing interception. 

To top it all off, there were no publicly reported injuries. In light of the good news, there are still several topics to discuss below as upcoming decisions based on injuries will take place. Check it out below.

QB Josh Allen (left shoulder)

Allen continues to deal with a left shoulder injury sustained in the Raiders game. Against the Titans and Chiefs, he has struggled for accuracy and has not looked himself while wearing a shoulder brace to protect the area. 

He came out sporting a new brace to protect the shoulder but it appears that this is less restrictive than his previous one. I was able to observe that under the shoulder brace, he did have kinesiotape which likely helped support the shoulder but allowed him change the brace without sacrificing stability. It’s also noted that he ditched the brace last week in the 4th quarter against the Chiefs in order to improve his throwing mechanics. 

I will expect to continue to see him wear the brace to protect the shoulder until the end of the season. 

CB Tre’Davious White (back)

White suited up on Sunday after being ruled questionable following Friday’s practice. White played in 100% of defensive snaps. The fact that he plays but is limited during the week indicates that this back issue he has is the pain centered with the goal of reducing activity through the week to be ready on Sundays. This is something to continue to monitor and I expect that this issue will not go away as the season progresses. 

LB Matt Milano (left pectoral) 

Milano played in 33% of snaps indicating that he was likely on a pitch count. I had thought he would miss two games and that appeared to be the case. He was also in on obvious passing downs which supports the notion that he is healthy enough to play but not quite there with regards to tackling fully. His playing time should ramp up for the Patriots game as he will be needed much more against a far better opponent. 

He was noted to be wearing a shoulder harness that limits shoulder abduction and external rotation with those movements placing stress on the healing tendon/muscle. He will likely not be 100% until after the bye, but healthy enough that his presence is greatly needed over the next 3 weeks in order to keep piling up the wins. 

G Jon Feliciano (pectoral tear)

Feliciano continues to wait to return to play following his pectoral tear back in August. I had originally thought that he would return around midseason in Week 8. While not confirmed, his 21-day practice window is closing on Wednesday with the team to make a decision on whether to activate him. It’s likely that he will be activated, but the team intends to use the full window before they make the decision. 

LB Tyrel Dodson (right hamstring)

Dodson was placed on injured reserve with a hamstring strain which indicates that the injury is possibly a Grade 2 strain which will take 4-8 weeks to fully heal. I would speculate that he is closer to the 4-week variety. It’s hard to say how long he’ll be out, but it’s likely that he will be out the next month as he rehabs. 

CB Cam Lewis (left wrist)

Lewis was active Sunday following being deemed week-to-week with a wrist injury sustained in the Chiefs game. It still isn’t clear what he is dealing with, possibly a fracture due to the club, but it’s serious enough to not play against the Jets. It appears that he was available only in the event of an emergency. With the potential return of CB Levi Wallace from IR potentially this week, this could be a one for one swap if the team goes this route. 

S Jaquan Johnson (back)

Johnson popped up on the injury report Friday with a back injury but played on Sunday, appearing in 57% of special teams indicating that this wasn’t a concerning issue. He doesn’t have any known back injuries, but something to note as he has become an important special teams contributor. 

TE Dawson Knox (calf/COVID)

Knox was ruled out prior to Sunday’s contest but was placed on the COVID/Reserve list Saturday after testing positive, also forcing TE Lee Smith, TE Tommy Sweeney, and PS TE Nate Becker onto the list due to being close contacts. While it’s highly unfortunate that Knox contracted COVID, this may benefit Knox in the long run as he can rest for the next week which may allow him to return fully healthy once cleared. According to protocols, if he was asymptomatic, he can return after 10 days from the initial positive test and have two following negative tests at least 24 hours apart.

If he was symptomatic, he would have to wait 10 days from when the symptoms first appeared and at least 72 hours from when he last experienced symptoms. So it’s possible that Knox could return by next week to play, but we won’t know that unless we know that he was symptomatic. This is a waiting game at the moment. Hopefully, Smith, Sweeney, and Becker test negative and can return to their respective roles quickly. To read more about the COVID testing, check this article out.

The team should be getting a lot of players healthy this week with the possibility of another name or two popping up on the injury report. Despite not having Knox for the foreseeable future along with potentially G Cody Ford, the additions of Feliciano and Wallace should help immensely in order to allow the Bills to take control of the AFC East next Sunday against the Patriots. 

Top Photo Credit: Buffalo News

2020 Week 7 Bills Injury Preview- Jets

The injury list is long, pick your poison.

The Bills 4-0 start seems like ages ago following two straight losses to the two best teams that the AFC had to offer last season. Sitting at 4-2, the Bills are still in a prime position to win the division and host a playoff game for the first time in a quarter-century. Despite being in the driver’s seat, it doesn’t feel like they can field a healthy team in order to keep the march going strong. 

In the time writing these weekly injury reports, this is one of the more taxing ones that have been completed. There are simply a lot of injuries. There have been other weeks within a season that have had a lot of designations, but the list thins out or guys get healthy. We are now feeling the effects of injuries piling on top of injuries with multiple guys already ruled out prior to Sunday’s matchup against the Jets. Fortunately, the depth that the Bills have is still sufficient in the short term to get through this week. Below is the extensive list of injuries.

OUT

G Cody Ford (right knee)

Ford is ruled out for Sunday after sustaining what appears to be an MCL sprain to his right knee as the result of getting rolled upon in the 4th quarter. He was able to walk off under his own power before requiring the cart to head to the locker room. I had thought he would benefit from a short term IR stay but the team has not elected to go that route quite yet. Considering he was playing through a groin, possible left shoulder/elbow, and now knee, he could use the break. Regardless of the IR decision, Ford will be out Sunday.

WR John Brown (left knee)

Brown was ruled out for Sunday due to a left knee injury sustained in the Chiefs game. This occurred in the first series as Brown was trying to catch a cross route when he fell onto the left knee. He was hobbled by it the rest of the game and was largely ineffective.

Based on the latest injury alone, he probably could play through it, but considering all the injuries he’s been dealing with including the previous knee injury along with calf and foot issues, he could use a week off and that’s what appears to be happening following a week of DNP’s. The week off should do him some good in order to get ready next week for the Patriots. 

TE Dawson Knox (calf)

Knox will miss his second straight game with a calf injury originally sustained in the Titans loss. The severity is unknown but considering he will now miss two games, this says that it isn’t minor. The literature does show that these can take some time to heal, on average, 17.4 days which means he’s not quite there yet. At this point, he will need full practices 2 out of the 3 days in order for me to be convinced he plays. The more time Knox misses, his 3rd game total due to a concussion, the less he can be relied upon as a weapon for Josh Allen.

Update: Knox has since been placed on the COVID/Reserve list along with Lee Smith, Nate Becker, and Tommy Sweeney.

CB Josh Norman (left hamstring)

Norman reportedly tweaked the same hamstring from training camp, which according to records, was the left side. He has since been ruled out and we do not know the severity of the hamstring which will make a timeline tough to establish. 

Due to the previous hamstring strain, he was at greater risk of re-injure the area with the literature showing a 33% recurrence rate. Hopefully, the injury was minor and he comes back in time for the Patriots game. If he can’t go, CB Levi Wallace will come off IR, giving the team some options.

LB Tyrel Dodson (right hamstring)

Had Dodson not been injured, we possibly would see Milano sit another week due to the lack of need. However, since Dodson injured his right hamstring on a punt return, Milano may be pressed into service Sunday. Dodson has already been ruled out and may miss the Patriots game as well. Hopefully, Dodson is not out too long to give this team depth and versatility in the second half.

Update: Dodson has since been placed on IR.

QUESTIONABLE

LB Matt Milano (left pectoral)

Milano continues to battle back from a left pectoral strain suffered against the Raiders in Week 4. He appeared to be on track against the Chiefs to play but the research didn’t support a return that quickly with him ultimately missing another week.

He is far more likely to play in the Jets game considering the lack of depth available at the linebacker position. With any injury, he would benefit from additional time off but he is probably healthy enough to play and be effective. I expect him to play with the shoulder harness and give the defense a needed shot to get right for the coming weeks. 

CB Cam Lewis (left wrist)

Lewis continues to practice with a club on his left hand following Sunday’s injury attempting to tackle Chiefs RB Clyde Edwards-Helaire. It’s not clear what he did to the wrist but it’s significant enough that he has to wear a club on his left hand and that he was ruled week-to-week. The one upside to his injury is that he can go out to perform all the duties of the cornerback position with the exception of catching interceptions. Considering the lack of depth, Lewis may be forced to be active but available only in case of an emergency. 

CB Tre’Davious White (back)

White appeared on the injury report again with his back injury that has been bothering him since the lead up to the Titans game. Outside of it being a pain-related issue, we still don’t have details as to what is flaring things up. 

While he is not playing quite at the level he was last year, he is still playing at an above-average level which makes him still one of the best options on the team even not fully healthy. I expect he plays or at worst, is active but only in case of emergency. It’s unfortunate that the team has to resort to suiting up injured players, but such is the case with the Bills this week. 

ACTIVE

QB Josh Allen (left shoulder)

Allen continues to practice in full with the left shoulder injury sustained in the Raiders game. I have thought his throwing mechanics have changed due to the injury which could explain some of the misses over the last two weeks. I expect him to come off the report soon but to linger on the report as long as he has is important to note later on. I still suspect he tore his labrum or injured his rotator cuff, but I will be looking to see if he continues to wear a brace on Sunday for stability. 

S Jaquan Johnson (back)

Johnson popped up on the injury report Friday with a back designation but practiced in full. There is absolutely no idea what he could be dealing with unless we get more information. Due to the issues in the secondary, any nick or bruise draws concerning responses from the fan base.

Other Injuries:

G Jon Feliciano (pectoral tear)

Feliciano has been discussed in the game plan this week for the first time since before his injury occurred. His 21-day window to practice without counting towards the active roster is rapidly closing and the team will have to make a decision by October 28th.

By the time you’re reading this, Feliciano will likely have been activated from IR. I do not expect him to take all the snaps in his first game back but he should see a decent amount to get live game reps to prepare for the second half of the season. A corresponding move to bring Feliciano back will either mean someone is cut or someone is placed on IR, hopefully, Cody Ford.

TE Tommy Sweeney (foot)

Sweeney is mentioned because he is now eligible to return from PUP following a six-week stay. The team has five weeks to activate him to practice and from there, they have a 21-day window to activate him to the roster. I had thought that he suffered a stress fracture and is still working back from the injury. Considering the struggles that Dawson Knox has had, Sweeney could be a nice addition in the coming weeks. I will be interested to see what the plan is moving forward.

Update: Sweeney has since been placed on COVID/Reserve list.

G Quinton Spain (foot soreness/released)

Spain was a surprise release following two games where he was declared inactive due to foot soreness. While he was a good player last year and had recently signed a contract extension, it simply did not appear to work out due to the team wanting to develop Cody Ford at the guard position. Details aren’t exact with regards to the reasoning of the release, but I would expect it was because he wasn’t happy with his playing time.

While it is not a great look to release a former starter, it is better to cut loose a player who does not want to be there rather than let any potentially negative attitudes fester in the locker room. Best of luck to Spain in his NFL journey as he looks to find a new home.

As a result of this move, the Bills elevated DT Justin Zimmer to the active roster and signed LB Ahmad Gooden to the practice squad.

Inactives:

TE Dawson Knox* COVID

CB Josh Norman

G Cody Ford

LB Tyrel Dodson* IR

QB Jake Fromm

WR John Brown

RB TJ Yeldon

Call ups:

CB Dane Jackson

CB Lafayette Pitts

The only upside is that the Bills are playing the Jets this week. Had we been forced to play another team such as the Patriots or Seahawks, this game could have been rough. Along with having a lesser team in the Jets, they are also dealing with their own injuries seen below. 

Those are some key players that are injured that could make an already depleted team even more susceptible to a loss. But according to Tom Pelissero, QB Sam Darnold is expected to play.

While there are questions about whether the Bills are the real deal following two losses, these are the kind of games where a winning team must come in and do their job, beating a lesser opponent. Ideally, the Bills take care of business and move onto the Patriots in addition to getting healthier as the team enters November and the second half of the season.

Top Photo Credit: BillsWire USA Today

2020 Week 6 Bills Injury Review- Chiefs

How did Ford hurt himself & when is Milano coming back?

Primetime is not an ideal time for the Bills to play in the year 2020. Two primetime games, albeit, an altered schedule with the end result being two losses. To keep things in perspective, the Titans and Chiefs losses come at the hands of the AFC finalists from 2019 & the defending Super Bowl champions. 

Either way, a 4-2 record and first place in the division is still nothing to scoff at. On top of it, the Bills continue to trend towards getting healthier after appearing to regress towards the mean in regards to total injuries. They continue to avoid the season-ending variety of injuries and progressing towards getting healthy for the second half of the season. Below are the known injuries from Monday night. 

In game injuries:

G Cody Ford (knee)

Ford went down at the beginning of the 4th quarter with 14:36 left as the result of a right knee injury. Looking back at the film, Ford actually injures the knee on the 3rd down play just prior with a pile of bodies falling on top of him. He stayed in during the 4th down play and injured the knee further when he got rolled up on from behind, forcing his knee to the ground. He reportedly was able to walk off under his own power but required the cart to get to the locker room.

By video, it appears he suffered a right MCL sprain due to the mechanism of the injury & the Bills designated the injury as a knee. I had originally thought he could have suffered a high ankle sprain based on having his leg rolled upon. Having an MCL sprain is a far better outcome than a high ankle sprain. MCL sprains vary by severity and it may appear that he suffered a Grade 1-2 sprain due to his week-to-week designation by the team. These can take 2-4 weeks to recover based on the literature and falls in line with what we have seen termed as week-to-week. That designation may have been made considering his other injuries as well.

Credit: PTHealth.ca

This is an injury that isn’t all that concerning as these injuries heal up well and do not have lingering problems once healed. While Ford may only miss 1-3 games, I question whether he wouldn’t benefit from a short IR stay from a pure injury standpoint. This is despite him playing some of his best football over the past few weeks. This would help the team in two ways. 

This would allow Ford to address his groin, possible left shoulder/elbow injuries, and now right knee. This would also open the door for G Jon Feliciano to return to the active roster without having to outright cut someone. Expect Ford to miss the Jets game & possibly the Patriots game as well. 

LB Tyrel Dodson (hamstring)

Dodson left the game early in the 3rd quarter on the punt return with 10:37 left with what appears to be a right hamstring strain. He appears to injure the hamstring trying to slow down once the fair catch was called. He began walking to the sideline motioning to his right leg indicating something was wrong. His night ended as a result and he has also been deemed week-to-week. 

Credit: Orthoinfo.aaos.org

Considering this is a hamstring injury & we see how conservative the team is with management, he will probably miss at least the Jets game, possibly the Patriots game as well. We typically see these hamstring strains miss anywhere from 1-3 games based on previous management by the team.

The only upside to his injury is that LB Matt Milano will possibly be returning after a two-game absence which helps cushion the loss of Dodson as depth. 

CB Cam Lewis (left wrist)

Lewis had his night end early with a wrist injury midway through the 1st quarter. This was the result of a missed tackle on Chiefs RB Clyde Edwards-Helaire. It is not clear what he injured, but he came back out to the sidelines with a heavy wrap to the area, but ultimately did not return. 

It’s hard to say what he exactly injured because he attempted to tackle Edwards-Helaire, missing the tackle and getting swung past him. The left wrist hits Edwards-Helaire and then Lewis falls to the ground. Looking at other angles doesn’t suggest he did anything differently. I don’t have clear information about the exact injury. As the week progresses, we will see in practice his availability or bracing he may have on the wrist. Right now, this one is inconclusive.

WR John Brown (calf/knee)

Brown can’t seem to get out of his own way this season when it comes to injuries. He has been dealing with the foot sorenesss/injury, likely calf strains, and recent knee injury. His lack of production Monday night could also be tied to injury as he appeared to tweak something early in the game on a catch going out of bounds. He never quite looked right in his play and finished with 0 catches on 4 targets. 

It’s difficult to identify what he injured on film early on due to the sideline being in the way, but All-22 shows that he appears to strike his left knee while he was falling to the ground to catch the ball. He came up walking gingerly, appearing to favor his left leg, the same one he appeared to injure in practice prior to the Titans game.

Regardless of the injury, he simply is not performing up to his standard of play and satisfying the needs of the offense. It appears that Brown’s injuries are not severe enough to outright bench him, but he is clearly not the effective player that he was last year. He may have to continue to battle through these nagging injuries until he gets to the bye week for some much-needed rest.

Other injury observations 

 LB Tremaine Edmunds (right shoulder) & QB Josh Allen (left shoulder)

Both Edmunds & Allen both shed their respective shoulder braces at different times for Monday’s game which was an interesting decision. Edmunds shed the brace just prior to the game which is a good sign in his healing process. The team continues to acknowledge he is working through a shoulder injury, the fact that he has ditched the shoulder brace tells me that this injury is more of an AC joint sprain.

If he had torn his labrum, instability would still be present & the chance to partially dislocate or fully dislocate would still be there. I have no doubt it is still painful for Edmunds to play, but there are pain management strategies along with rehab available to help him as he continues to heal.

Allen removed the shoulder brace for the final drive of the game which ended in an interception. I’m not certain why he ditched the brace as I do believe there is some instability present in the shoulder due to the original injury. I have thought that Allen has been forced to change his throwing mechanics as a result of the injury the past two weeks, keeping his left arm closer to his chest during throwing which limits the ability to rotate the trunk. This is something I am going to continue to dig into and reflect back on as there is more data & film available. 

He may have shed the brace for the sheer fact that he wanted no restrictions in his ability to construct a game-winning drive. Allen did not come through in the clutch but he also avoided injury. It’s also important to note that he took more runs this game, but they appeared to be more designed runs, allowing him to follow his blockers & reduce the chances for an errant hit. This will be something to continue to assess as the season progresses. 

G Jon Feliciano (pectoral injury)

Feliciano continues to practice within his 21-day window to return to the active roster following his pectoral injury from July. He has until October 27th to become activated by the team or return to the IR for the season. Sean McDermott would not comment on whether he would be activating Feliciano due to not wanting to give the Jets any possible advantage in game planning. 

I see one of two scenarios play out. The team could activate him Saturday & cut someone in time for Sunday and he begins working back into the lineup. Or he misses Sunday’s game and is activated that Monday or Tuesday when the team has the possibility of putting someone on IR in his place like I had suggested earlier in the article with Ford.

Feliciano should come back & I had suggested a return date of the end of October in my Buffalo Rumblings article from August. The only way he doesn’t come back is if he had a setback, but nothing appears to be suggesting that. Look for the big man to play against the Jets or Patriots.

LB Matt Milano (left pectoral injury)

Milano has been sorely missed the past two weeks dealing with a pectoral injury sustained against the Raiders. He was questionable leading up to this game and there were hopes that he would play. But the research did not suggest it and unfortunately, it was accurate. Considering he was close to 50/50 on playing Monday, that opens the door to return in Week 7 against the Jets. 

We still have to see him practice in full this week, but considering he was limited with also a full practice in there indicates that he is progressing. A matchup against the NFL’s worst team could be a nice welcome back game for Milano as he gears up for the second half.

G Quinton Spain (foot soreness)

There still isn’t any new information on Spain’s foot soreness from Tuesday’s game. This is something to continue to monitor but not well-timed due to the fact that Cody Ford is dealing with his injuries. Hopefully, this foot soreness is mild and he can begin practicing more this week.

The team is getting healthier, the injuries they have sustained continue to be overall minor but have prevented the team from fielding an effective roster. A bounce-back game against the Jets is needed to move to 5-2 both in terms of confidence and health. The team will need both as the following 3 games against the Patriots, Seahawks, and upstart Cardinals are true tests if the Bills want to show that the first quarter of the season wasn’t a fluke. We will see what the rest of the week brings as the team prepares for Sunday against the New York Jets.

Top Photo Credit: Rochester First

2020 Week 5 Bills Injury Preview- Titans

Which of the questionable players will suit up?

Heading into Tuesday’s unusual matchup against the Tennessee Titans, the Bills are fairly beat up with injury designations already determined on Saturday afternoon. While the injury list looks dire, things actually aren’t all that bad. Check out the details below. Let’s hope this game gets played & put in the rearview mirror.

OUT

LB Matt Milano (Left pectoral)

Milano has since been ruled out for Tuesday’s contest which isn’t a surprise considering he did not practice all week.

Milano is coming off what appears to be a left pectoral strain. Based on the literature, it’s no surprise that he will be out for the short term. In my article at Buffalo Rumblings, I had detailed that he would be out at least 2 games and potentially more. The fact that he hasn’t been placed on IR also hints at the timeline the team thinks he may return sooner than later.

QUESTIONABLE

WR John Brown (Left knee)

Brown has been battling calf and foot problems all season, none of which have been serious enough to miss any time. Brown did appear to tweak something on the left side as shown in the video below.

Per the injury report, he is dealing with a knee injury now. While there is video of the injury, it’s hard to discern what he exactly did. In the video, he planted his left foot and pushed right before taking another step and then began hopping in pain.

He took several hard steps on his left leg to turn back to the right to catch the pass. His knee appeared to bow out on the next step, but it’s possible he could have tweaked the MCL or inside knee ligament on the prior step, felt it, took an uneven step which where we saw the bowing out, and then the final hopping off the field.

Credit: PTHealth.ca

If this injury was in isolation, I would say he’s alright to play especially with the few extra days off. But considering he’s dealing with foot & calf injuries, he may be best suited to take a week off. May come down to how he feels. This is one position where the team has healthy depth.

G Cody Ford (Groin/left shoulder)

Ford is battling a groin strain apparently suffered in the Raiders game. Sean McDermott did note that Ford was battling through some things during the Raiders game. I believe he was referring more to the left shoulder which could be anything at this point. There is nothing definitive on film & would need more information for a specific injury. There is a possibility that he’s dealing with a rotator cuff issue or labral injury due to the brace, but something to monitor.

As for the groin, also not sure when he injured it which makes it difficult to determine how it will affect him. The one upside is that playing on the interior part of the line; he will not have to use as much lateral movement or sprinting which can reduce strain on the area. If he doesn’t go, then G Quinton Spain would likely get the start.

RB Zack Moss (Toe)

Moss continues to be limited with a toe injury that appears to be turf toe. He was potentially able to play Sunday against the Raiders, but he ultimately did not suit up.

He has missed the last 2 games which fits in the timeline for a turf toe. The hope is that he returns for Tuesday’s game with a few extra days rest & is more of a factor than RB TJ Yeldon. Considering all the questionable players & that he practiced in full leads me to believe he will play.

LB Del’Shawn Phillips (Left quadriceps)

Phillips has returned to practice & began practicing in full which is an excellent sign for the special teams linebacker. He has missed the last 3 games following a quadriceps injury that appeared to be a strain by video.

I expect most of his playing time to be on special teams once again unless he is called upon to play on defense if injury occurs. I also expect that he will continue to be slowly worked back in as he acclimates to not playing football for nearly a month.

Update: Phillips has since been placed on IR. The team promoted LB Deon Lacey in his spot.

WR Andre Roberts (Ankle)

There is no information on Roberts other than he injured his ankle. Nothing on film indicates that he suffered an injury and nothing in the media reports indicate the type of injury he is dealing with. The fact that he hasn’t practiced all week isn’t a great sign either.

The only two instances I could find for a possible injury came in the 1st quarter. The first was a right end around where Roberts lost 3 yards when he was flipped upside down by S Johnathan Abram. The other, three plays later, when Roberts caught a 6 yard pass to the left and was taken down by CB Nevin Lawson.

He had his left ankle get clipped on the first tackle and on the second, he was twisted down. Hard to identify if this is when he hurt his ankle or what the exact injury could be.

This will be something to monitor as the season progresses.

CB Tre’Davious White (Back)

This has been a mystery. White played in every defensive snap on Sunday & has been fairly durable throughout this season & career. He has not practiced this past week & it’s not clear whether he is even at the facility.

Watching film from Week 4, he appears to move well around the field and is not labored or slow to get up. As this is a back injury, these are harder to identify the injuries as there is typically not bracing or specific movements that are limited by the injury.

More information would be needed in order to identify what he’s dealing with. I could list a bunch of injuries & conditions, but trying to identify this injury is like throwing a dart in the dark at the dart board. The only reason that he could possibly be questionable after not practicing is if it’s a pain related issue where the team is hoping that things can calm down before Tuesday. But even that doesn’t narrow things down.

I have heard severe people say that he got his money & is not playing as hard anymore or that he is attempting to opt out because of the COVID concerns with the Titans with the team saying he has a back injury. Sure, there’s always that possibility that he is phoning it in now that he got paid. If he was, then that was a poor decision by the team to sign him to an extension. If he is not trying anymore, that’s on him. I don’t believe the Bills want guys on the team like that. I personally don’t believe this to be the case.

The COVID concerns are real, but to have the team say he has a back injury in order to keep him away from the facility, that’s a stretch. They could list him with an injury, we do see guys on injury reports often every week and don’t appear to have anything wrong. If I recall, Tom Brady was notorious for that with his right shoulder.

But to fake an injury would go against the competitive balance & intention of the injury report. To use it to cover up for something else makes me think the NFL wouldn’t take too kindly to that.

Right now, I am going with the fact that he has a back injury, details are not available, and the hope is that it isn’t serious. If he doesn’t go, the team has CB Dane Jackson they can call up for depth.

G Brian Winters (Right knee)

Winters appeared to injure his right knee on the same play that Josh Allen injured his shoulder. He fell hard on the right knee and was labored upon getting up and trying to get back into the play.

It appears to be a generalized contusion, but considering he hasn’t practiced in the past week, there’s potential it could be other things. He could have injured the bursa which is a fluid filled sac that helps lubricate the joint. A direct blow to that could cause inflammation to the area, limiting range of motion.

There are other possible injuries that he could have suffered but without more information, hard to establish a timeline. Considering the team has a bevy of offensive lineman, he could afford to sit this week.

INJURED RESERVE

CB Levi Wallace (Left ankle)

This move was a possibility but not certain as low ankle sprains can be played through, depending on the severity. Unfortunately for Wallace, he appears to have suffered a Grade 2 low ankle sprain early against the Raiders. This is due to the fact that he was placed on IR on Wednesday which requires a 3 week stay indicating a timeline for severity.

Credit: Medium.com

According to this picture sent in by a fellow Twitter user, Wallace appears to be off crutches and the swelling in the left ankle looks minimal. However, there is still likely instability due to the ligaments getting stretched out from the injury.

What we also don’t see in this picture is if he is on crutches and he put them down for the picture. We also don’t see how much weight he is putting through his left foot. Both feet could be down but he could be leaning more to the right to off weight the leg. Whatever he’s doing, he can rest for the next 3 weeks now that CB Josh Norman has returned from IR.

ACTIVE

WR Cole Beasley (Left foot)

Beasley continues to battle with numerous injuries including previous injuries to his thumb and hip. After being limited in practice earlier this week, Beasley was a full participant which signifies that he is healthy enough to play. The extra days off will certainly help his foot to heal further which will allow him to make those cuts over the middle effectively and use his speed to work around the field.

QB Josh Allen (left shoulder)

Allen practiced in full every day despite the left shoulder designation from Sunday’s injury. The injury designation officially notes that he does have an injury and that it could affect his ability to play. The concern is that he has either an AC joint sprain, rotator cuff injury, or labral tear.

He did have a brace on for Wednesday’s practice and kinesiotape on for Thursday’s practice. The hope is that he has the AC joint sprain & it’ll heal on its own. My worry still remains that he had more damage in there as mentioned above. I would anticipate to see some bracing on for Tuesday regardless of the injury.

As the season progresses, the injury will become more clear if he takes further hits to the shoulder or if he continues to wear bracing.

Inactives:

LB Matt Milano
TE Lee Smith
G Brian Winters
QB Jake Fromm
RB TJ Yeldon

A bye week would be beneficial like it was last year at this time, but the Bills are not due for one for some time. These kinds of weeks will really test the depth at each position and the training staff’s ability to get each guy ready. It is important to note that a player may be active but may not get much play, only available for depth if needed. The team was forced to do this several times last year.

While the Titans are healthier as evidenced by the list below, they also have not had the ability to practice as a team in the last 2 weeks, unless you could the unauthorized practices after their facility closed. They also still have a number of players on the COVID reserve list.

Even if they’re healthier, I would be concerned about in-game injuries due to the sudden ramping back up of game play. I do not wish injury on anyone, but there is a greater risk. That along with not having the ability to fully implement their game plan may help be an equalizer in the game.

Remember, this is a team that was an AFC finalist last year. This team is no slouch. I would expect the Bills to win because I am biased and believe we have the better team. But if they lose, they are a worthy opponent. I’d like to see a win, but more importantly, minimal injuries as the Bills prepare for a short week against the Chiefs in Week 6 at home.

Top Photo Credit: Bleacher Report

2020 Week 4 Bills Injury Review- Raiders

Is Josh Allen going to be ok? What happened to Levi Wallace? How long will Matt Milano be out for?

The Bills are 4-0 for the first time since 2008 and the fanbase is buzzing! That was about the time I began to sink my teeth into what is now my full-fledged Bills fandom & totally embraced it. While the beginning of the season was fun, the later half clearly wasn’t. However, this 2020 team is something else! 4-0 including two wins over division opponents in the Dolphins & Jets and two more wins over playoff contenders in the Rams & Raiders. 

While it’s unrealistic to run the table to a Super Bowl, the Bills are showing they know how to win games that they are expected to win. There are still several games on the schedule that aren’t automatic & realistically, they will suffer some losses. But for now, the Bills are getting stacking wins as they continue to march forward in the season.

In light of the win, there were several injuries to note of varying concern. Below you will find my thoughts and expectations for each injury moving forward.

CB Levi Wallace (left ankle)

Wallace injured his ankle with 8:22 left in the first quarter with what appeared to be a calf/ankle injury. Upon review & just prior to falling to the turf, Wallace changed directions suddenly, going backwards in order to get the tipped ball. As he was going backwards, he rolled his ankle inward. That sudden weight through the rolled ankle likely worsened the severity of the ankle sprain observed on film. He was down on the ground in obvious pain and required assistance to get back up and off the field. Regrettably, he was unable to return.

Noted above, following the game, he was on crutches as Coach McDermott was giving his post game speech. From the video, it isn’t determined whether he had a boot on, but considering the possible severity of the sprain along with the crutches, it’s very likely he did. 

McDermott has since stated that he is week-to-week which translates out to several weeks missed. Grade 1 ankle sprains can usually be played through. Grade 2, which I believe is what Wallace has, is anywhere from 3-6 weeks. Considering they have not put him on IR yet, I believe he can come back after missing 2-3 games, barring setbacks.

They do have Josh Norman available and may be the only option until Wallace is ready to return. 

WR Cole Beasley (left foot)

Beasley suffered what he termed a foot sprain on his TD catch when he got flipped into the air before coming down hard for the score. As he came down, his left foot smashed into the turf.

This appears to be a generalized foot sprain, more specifically to the midfoot. He had it taped up and returned later in the game, at times labored. He’s a guy who could benefit from some time off but he’s a baller and he’s going to play. I expect him to be limited in practice or have a day off this week. Unless the foot gets much worse Tuesday & Wednesday, I expect that he’ll have it taped up for next Sunday.

QB Josh Allen (left shoulder)

Allen scared the entire NFL when he got tackled scrambling out of the pocket before getting taken down from behind, falling with his arm outstretched, hitting at the elbow then rolling onto his left side, grabbing at his non-throwing shoulder. 

There’s a lot to unpack with the injury so stick with me here. It initially appeared that he injured his hand due to shaking it out with noticeable discomfort. Due to the elbow striking the ground, he likely hit the ulnar nerve that runs on the medial portion of the elbow, aka, the funny bone. 

That would explain the hand component. When the elbow struck the ground, he immediately grabbed at the shoulder. There are several things that he could have injured with that fall including an AC joint sprain, rotator cuff, or labrum tear due to subluxation/dislocation.

I would take the above order of injury based on severity. Best case he could have injured his AC joint with the fall. He can wear a brace for a few weeks and have no lasting effects, especially considering this is his non-throwing shoulder. 

The rotator cuff could have been strained due to the elbow hitting the turf, jamming the humerus up into the acromion, causing injury. This injury would also take several weeks to recover from. Think QB Drew Lock of the Broncos from Week 2 below.

However, the worst and I feel is most likely is the labral tear due to a subluxation/dislocation. The elbow hitting the turf and forcing the arm up and into the shoulder socket could have forced the head of the humerus away from the labrum which helps deepen the socket for the shoulder to articulate.

Credit: https://link.springer.com/article/10.1007/s00167-015-3979-8

If this is the case, I see a scenario where he wears the brace the rest of the season as he rehabs in order to keep the shoulder strong and as stable as possible. My hope is that he subluxed the shoulder, it caused a small tear in the labrum that he plays through and then the team can evaluate if he needs to undergo surgery in the offseason. There is concern that he injures the shoulder further if he falls on it.

Check out Bears QB Mitch Trubisky’s shoulder injury from two years ago for similarities.

My biggest worry if he continues to sublux or dislocate the shoulder, leading to missed time. This could cause further damage to the labrum or a significant dislocation could lead to a brachial plexus injury which is the bundle of nerves that supply the arm for sensation and movement. This is less common, but still possible. A non-throwing shoulder injury isn’t as big of a deal, but if he takes further shots, this could take him out of games even temporarily.

As it’s not his throwing shoulder, the team will unlikely give any further information and we will have to read the tea leaves. 

RG Brian Winters (right knee)

Winters suffered what appears to be a right knee contusion on the same play that Josh Allen got injured on. He was engaging his block before getting shoved down way behind the line of scrimmage, falling directly onto his right knee. He was able to get back up & finish the play, but was laboring to get back towards the action. 

He was later ruled questionable with a right knee injury & did not return. This isn’t something that should linger outside of dealing with pain. He could have played through, but considering that the team has depth & still wants to get reps for all their guys, it was a smart move to avoid having him continue to play. This might show up on the injury report but it doesn’t appear to have lasting concerns.

LB Matt Milano (left pectoral)

Milano injured his left shoulder/pectoral area attempting to tackle RB Josh Jacobs near the line of scrimmage. As he went to wrap him up, Milano’s momentum kept him moving upfield as Jacobs began to run downfield. In the process, his left arm was pulled away by Jacobs running. Milano got up, having his left shoulder/pectoral muscle checked out by the team doctor on the sidelines.

This is the exact mechanism of injury for a pectoral tear, maximal eccentric contraction of the muscle, leading to overload and tearing. However, it does not appear that a full tear is the case. This appears to be more of a strain by how Milano responded and how quickly he fell to the ground, allowing the ground to stop some of his momentum. This could be an injury that he does miss some time for, but isn’t something that I expect to hinder him all season. 

He has since been termed as week-to-week, which isn’t promising. Most of the literature I found spoke more of the pectoral tendon rupture, exactly what G Jon Feliciano is recovering from. There are some resources that note that this strain could be a 2-6 week recovery.

Considering they’re not placing him on IR at the moment, this leads me to believe that he’ll be out 2-4 weeks. Not quite enough to be placed on IR but not a quick return. I will say he’ll miss probably 2 games which will put him on track to return for the Jets game. Unfortunately, that second game missed would line up with the Chiefs game which would be vital for him to be available. More information will have to be available in order to change my mind on the timeline.

Already this season we have seen Eagles DT Javon Hargrave miss almost 4 weeks with the injury before returning to play in Week 2. Raiders LB Nick Kwiatkoski missed 2 games with a pectoral injury and returned to play with bracing. So to put him on track to return after 2-3 games should be reasonable. Had he outright ruptured, this wouldn’t even be a discussion. This is highly unfortunate considering he already missed one game with a hamstring strain. This will be another injury he simply has to battle back from. 

S Jaquan Johnson (right lower leg)

Johnson continues to show why he is active every Sunday as a special teams contributor. He successfully recovered the onside kick that the Raiders attempted to try and recover to get one more shot at the end zone. During the recovery, he was kicked hard in the lateral lower leg area during the scramble for the recovery. That kick, along with at least a dozen grown men landing on him would make even the toughest of men hurt.

Like Winters, there will be pain, but outside of that, he should be alright for next week.

Other observations:

G Cody Ford (left shoulder)

Ford was noted wearing a brace on his left shoulder signifying some type of instability. This was first noticed by Erik Turner over at Cover 1.

Looking back at the Miami game, there wasn’t any apparent instance of an AC joint sprain or even a labral tear. You could make the case for some pectoral strain possibilities, but nothing was definitive and I would have expected he would miss some time.

I then also grew concerned for a labral tear. These are highly common in NFL lineman & something that can be played through. Finding that on film would be difficult due to repeated blocking with the arms extended & I’m not certain that he even suffered this during a game. He could have injured the shoulder at practice In between the Rams and Raiders game.

Like all the others, something to monitor. To note, he had surgery on the opposite shoulder last year but details were never made public on whether it was a labrum or rotator cuff. We are once again left to speculate. 

All these injuries, most of them aren’t things that could have been prevented with preseason. These are just unfortunate and the reality of the Bills returning to the mean in regards to injuries. None of these injuries are season ending and most can return to full health. Football is a physical sport, there are injuries, I am glad that we are not seeing season ending ones yet. Looking forward, the Bills move on to play the Titans in Week 5 as they continue to maintain control of the AFC East. 

Top Photo Credit: larrybrownsports.com

OT Cody Ford Injury Profile

#70 Cody Ford
Position: OT
Height/Weight: 6’3”/329 lbs.
Age: 23
College: Oklahoma
Year joined Bills: 2019
Acquired: 2nd round draft selection

College Injuries:

2016 Freshman year:

Broken left fibula, Week 3, required surgery, missed 9 games

2017 Sophomore year:

Undisclosed injury, missed 2 games.

2018 Junior year:

No publicly reported injuries.

Pro Injuries:

Concussion, Week 5, missed 0 games

Left elbow injury, possible UCL sprain, required bracing during rest of season, missed 0 games

Right shoulder injury requiring offseason surgery, possible labrum or rotator cuff, missed 0 games

2020 Bills:

Left shoulder issue, specifics unknown, began wearing a shoulder harness Week 3, possible labral tear or pectoral strain.

Groin strain, Week 4

General links:

Broken fibula

Bills Offseason Injury Review

2020 Bills Injury Preview- Offensive Tackle

Bills 2020 Training Camp Injury Preview: Offensive Tackle

Will Ford & Nsekhe come into 2020 healthy?

This is Part 5 of the Buffalo Bills training camp preview revisiting injuries from 2019 & the impact it may have on their performance and availability in 2020. Part 5 consists of the offensive tackle room.

Not Returning

OT LaAdrian Waddle

Waddle was a Buffalo Bill barely in name, having gone through OTA’s & 2 weeks of training camp before an awful quadriceps tear ended his 2019 season. 

This occurred on a routine practice drill in which Waddle took a step and went down hard, injuring his right leg. He had surgery shortly after suffering the injury and was done for the year. While he was best suited as a swing tackle, the depth on the offensive line for 2020 indicates that he will not be returning. He has yet to find a home this offseason. 

OT Conor McDermott

McDermott appeared to be a favorite of the. Ills coaching staff over the previous two seasons. He was too good to be exposed to the practice squad, but never good enough to garner any playing time on the field. 

During training camp with the Bills, McDermott suffered a concussion during the win over the Panthers. This head injury, unfortunately, cost him a chunk of the preseason, finally playing against the Vikings. 

He then spent the first month of the season with the Bills, not seeing any action before getting waived to make room for WR Duke Williams. Unfortunately, N.Y. Jets needed offensive line help & grabbed him off waivers. He ended up playing 7 games with them and appears to be staying. 

Players Returning

OT Dion Dawkins

1 reception, 1 yard, 1 TD, 16 games, 16 starts, 1016 snaps, 3 holding, 3 false starts, 1 fumble recovery

Dawkins had a bounce-back year in 2019 that firmly established himself as the franchise left tackle. As evident above, Dawkins was durable, not missing any games and showing versatility in the offense, catching a TD pass. He has quickly become a leader in the locker room as this young core continues to develop.

As for injuries, Dawkins has been incredibly healthy during 2019 and relatively over his career. There were no instances of known injuries & he proved to be a valuable anchor in a supremely improved offensive line. He is a lock for this roster in 2020 & while his lack of injuries does not prevent him from suffering future ones, he does not have anything known that may restrict him this fall. 

OT Ty Nsekhe

10 games, 1 start, 359 snaps, 1 holding, 4 false starts

Nsekhe didn’t quite have the 2019 season he wanted to. As an aging veteran, he split snaps with rookie Cody Ford through the season to help reduce the burden as Ford transitioned to the NFL. Unfortunately, Nsekhe suffered several injuries which forced the rookie into action more frequently than the coaching staff likely wanted. One particular injury cost him nearly half of the season.

Nsekhe’s injuries below:

    • Knee tweak

He suffered a knee sprain towards the end of preseason that kept him out of the final game that was described as a “tweak”. It was not known which knee he injured and it did not prevent him from playing Week 1.

    • Left Knee

Nsekhe suffered another knee injury, this time in the win over the Giants. He injured it during the 2nd quarter where he slipped and fell on the knee. He required some time to sit out but was able to return to play to finish the game. The one thing that was never established was whether this was the same knee from preseason and if it was a re-injury or a new occurrence.

    • Right ankle

The veteran lineman suffered yet another injury, this time against the Bengals where he was bull-rushed backward, appearing to ham the right ankle. Like the knee injury, he was able to return to play in that game, getting 83% of the total snaps offensively.

He returned to play in the Patriots game the next week, re-injuring the area again, though it was not clear when he suffered the re-aggravation or it was the same side. He once again split snaps with Ford at the position and finished out the game. 

This ankle injury became so tough to deal with that Nsekhe ended up missing the following week against the Titans. He was unable to practice that entire week and sat out as injuries started piling up just prior to the bye week.

Regrettably, this is not the last instance of ankle injuries for Nsekhe.

    • Grade II-III Right low ankle sprain

Nsekhe was not finished with injuries for 2019 when he injured his right ankle yet again. This time midway through the 3rd quarter. His foot was caught from behind by a Dolphins defender, landing on the back of his heel, forcing the ankle to roll under violently.

He was in obvious pain and was quickly put on a cart for imaging and acute pain management. The initial thought was that he dislocated and fractured his distal fibula, but tests came back negative and was determined that he suffered a severe sprain.

Looking back over his early-season struggles with the ankle, it’s possible that the ankle injury could have contributed to this, but it may have also saved him. There was no way that Nsekhe could have prevented getting his ankle rolled on as bad as it did. But the previous laxity in the area along with the heel sliding out on video replay may have allowed the ankle joint to take the brunt of the forces rather than his distal fibula breaking. Check out the video of the injury below.

Nsekhe ended up missing 5 games due to that injury and while he looked healthy enough to play, his troubles were not over. A more detailed timeline of the ankle injury can be found at Buffalo Rumblings.

    • Right ankle

Nsekhe suffered yet another injury to the right ankle in the season finale over the Jets. Similar to his previous injury, he had a Jets defender fall on the back of his foot which took him down to the ground. He was observed wearing an ankle brace which helped support the area and limits inversion/eversion movement. His shoe also fell off during the play which prevented his foot from getting caught in the turf. As a result of that injury, his day was done in a meaningless game.

Looking back on all the injuries Nsekhe suffered during the season, it’s incredible that he continued to play. His knee injuries are not all that concerning and didn’t appear to cause him issues later on. However, it’s evident that his right ankle will be a big concern moving forward. It is not known whether he had surgery to the area, but it is expected that he required rehab to the ankle to tighten and strengthen it back up.

The risk for a re-injury for a lateral ankle sprain is as high as 80% in athletes which isn’t surprising considering the demands of the position. The re-injury to the ankle alone wasn’t a huge deal early on in the season. The fact that he missed 5 games with the severe ankle injury is the concern moving forward. 

It would not surprise me at all if Nsekhe continues to battle ankle issues. Prior to 2019, he did not have any documented NFL ankle injuries, though his path to the NFL was unusual, so it’s expected that there is an incomplete public record. Ideally, he rehabbed his ankle, will have bracing, and come into the season healthy. There is concern that he now has chronic ankle instability due to the repeated ankle injuries of 2019. The downside of that is he will be more likely to suffer an injury to the area. The upside is that if he does, he will miss time, but he may not miss as much time due to the laxity of the joint. This is similar to what Jaguars RB Leonard Fournette deals with dating back to college.

OT Cody Ford

While Ford is a lock to make the roster heading into 2020, he is one player that got beat up a lot during his transition to the NFL. Splitting time with Ty Nsekhe as he adjusted, Ford held his own at times as the season progressed, but several injuries could have made that transition more difficult. 

Listed below are Ford’s known injuries:

    • Concussion

Ford suffered a concussion following the win over the Titans in Week 5. Like many other players that got injured in that game, the bye week was timed well to allow everyone to recover. Ford likely was a beneficiary of the bye week as he did not miss any games with the concussion, able to progress through the NFL concussion protocol on a tight timeline.

    • Left elbow

Ford injured his left elbow late in the loss to the Eagles during Week 8 where he had his medial elbow struck while trying to maintain a block. While there are bumps and bruises during each play, this injury lingered for the rest of the season indicating that Ford may have injured his UCL, similar to the injury Josh Allen suffered in 2018. 

Due to Ford not having to throw the ball and repeatedly stress the area, the team was able to put a brace and wrap on the area to protect it while he continued to play through the season. He essentially missed the next week against Washington, playing only special teams with Ty Nsekhe getting all the offensive snaps. How much it restricted him could be up to discussion when reviewing film from last season but it certainly didn’t help make his job any easier.

    • Right trapezius/neck strain

In the regular-season finale against the Jets, Ford came off the field grabbing at his right neck/trapezius area following a play where he took on a Jets defender before losing the battle and getting hit into Spencer Long. This could have presented more like a minor whiplash injury which required some brief rest, but Ford was eventually able to return.

    • Right shoulder surgery

Following the conclusion of the season, Ford quickly had shoulder surgery on his right side with little information available. My thoughts can be found at Banged Up Bills, but he either had a rotator cuff or labrum repair based on the timeline and position he plays. He is a player who should be healthy coming into training camp, but may not quite be 100% as the season starts. 

OT Ryan Bates

8 games, 78 snaps

Bates proved to be valuable to the Bills this past season despite not playing a lot. After coming over from the Eagles during a training camp trade, he quickly found himself on the roster as insurance in case injury occurred. 

He only played in 78 snaps during his rookie year over 8 games, most of those games in the second half of the season, but his versatility is valuable as he can play every position if needed. He did not have any known injuries during 2019 & his versatility along with health suggests that he has a strong case to make the roster in 2020.

New to the roster

OT Trey Adams

Adams is an incredibly unique player in that he has the ability to play at a first-round talent level. However, his injuries are documented throughout his time at Washington. Stinger, herniated discs, torn ACL, hamstring strain. Along with a poor combine performance, he went undrafted and signed with the Bills. 

To understand his injury history, go read the article over at Cover 1. At the time, this was a purely objective analysis of the player & his injuries. For a briefer, more Bills-centric view on Adams, check out the article at Buffalo Rumblings.

Adams has a legitimate shot to make the team. If he stays healthy in this truncated training camp, he could find a home on the 53 man roster. It’s possible that he drops to the practice squad, but there is concern losing him to waivers. 

There has been discussion of putting Adams on PUP or IR and stashing him there all season to allow his body to acclimate to the NFL. Since he suffered these injuries during college football, he would be put on the Non-Football Injury list instead of PUP.  As for IR, the Bills have been known to get creative to hold onto their guys, but Adams would have to have a documented injury that could prevent him from playing, allowing them to hold onto him that way. Never want to wish injury on a player, but also want to protect all your assets.

OT Daryl Williams

The Carolina connection is strong! Williams is yet another former Panther to come up north to help bring the Bills to the promised land. Regrettably, Williams also comes with several notable injuries that have cost him considerable playing time over the years including all of 2018. His versatility on the offensive line and ability to return from the 2018 injury indicates he may still have something left. To read more about the torn right MCL & dislocated patella from 2018, check it out at Buffalo Rumblings.

Williams isn’t a lock to make the roster, but he’s a pretty close one. He could be an excellent trade candidate if the Bills suffer an injury elsewhere or could just be excellent depth at a strong tackle position. Even if he doesn’t grab a tackle job, his versatility allows him to move to guard in order to find a home for 2020.

OT Victor Salako

Salako is a well-traveled man who like McDermott mentioned above, is good enough to stick around on teams but not good enough to play. He is likely a camp body but does have health on his side as evident by this injury review at Banged Up Bills

OT Brandon Walton

Walton, a UDFA out of FAU, comes to the Bills as a developmental piece following the 2020 NFL draft. He doesn’t carry with him any serious medical injuries & he does have familiarity with RB Devin Singletary from their time together. Due to the depth at this position, Walton may have a better shot at the practice squad as he adjusts to the NFL. You can read his injury history here at Banged Up Bills

OT Garrett McGhin

McGhin is a familiar face to the Bills going through training camp with them last year before an ankle injury led to an injury settlement release. He eventually found a home in Carolina where he got some playing time before another ankle injury ended his season on IR.

In the Buffalo Rumblings article, it goes into further detail regarding the thoughts on the injury and impacts it may have in 2020. McGhin may have more of an issue cracking the depth chart than worrying about previous injuries in order to make this roster.

Outlook for 2020

This tackle position is a deep position and may stay deep even with the threat of premature roster cutdowns due to the ongoing pandemic. Dawkins, Ford, Nsekhe, Williams and Bates are likely to make this roster due to previous experience. There is a strong chance that Adams makes the roster due to the potential; this will be determined if he has a strong preseason & the team cannot risk exposing him to waivers. 

McGhin has a chance at the roster but will more likely find himself on the practice squad along with Walton and if Salako has eligibility and upside left. The two big question marks heading into 2020 will be the health of Ford’s right shoulder and Nsekhe’s right ankle. If both are ready to go, then the depth chart is set. If they are not ready or have setbacks, expect Williams, Adams, or McGhin to find a bigger role on this team. Tackle is such a vital position that the Bills have begun to lock down, but setbacks at either position on the line could result in unfavorable outcomes on the offense.

Bills Offseason Injury Updates

Get the #Bills latest injury news during these long lulls in the offseason as we inch closer to OTA’s Phase 1

Talk about some offseason doldrums! Mock draft after mock draft, continuous speculation about what player goes where. On top of that, the underwear Olympics are coming up at the end of February which will take the draft season to a whole new level of madness.

To make matters worse, there has been little to no updates regarding anything Bills content outside of DT Star Lotulelei’s restructuring of his contract. That and TE Greg Olsen signed with the Seahawks after meeting with the Bills.

But there’s still love for you Bills fans over here at Banged Up Bills. It’s been about a month since any major news was released regarding offseason surgeries. While there has been little new information, I still feel it’s beneficial to provide updates on the surgeries. This is to attempt to further identify what each player is dealing with and any possible updated timelines.

Jerry Hughes

Jerry got the Bills in some hot water over his tweet below right after the season ended. To recap, he announced that he was playing all season with torn wrist ligaments in his right wrist.

I attempted to speculate what type of injury he may have been dealing with right after the news broke. Make sure to go check it out if you haven’t already. Since then, Jerry had surgery about two and a half weeks after the news with this picture below.

Fortunately, Hughes did not get the Bills in trouble and no fines were assessed due to the injury.

While we won’t know the specifics of the wrist injury, social media does allow us to gather some information on specifics based on rehab timelines. While this is not conclusive, it appears that Hughes still has some type of cast or splint on his wrist that he attempts to hide under the table during the picture.

Click to access scapholunate-ligament-repair.pdf

If that is indeed the case, then this points more towards the theory that he had a scapholunate ligament repair as the timeline for rehab protocols indicate that he is to be in the cast/bracing for six weeks. At the time of this article, he will be a few days shy of four weeks. At this point in rehab, he will be performing any range of motion activities with his fingers, elbow, and turning of the forearm, known as pronation and supination.

He will still likely be limited for most of OTA’s, but he should be active and present as he gears up for yet another season. There should be no limitations come training camp.

Ed Oliver

Oliver’s rookie season progressively got better as he adjusted to the demands of the NFL. He began to show why the Bills selected him ninth overall in last year’s draft. Despite the improvement during the season, it was a surprise when Oliver announced that he had core muscle surgery back on January 14th.

Bills fans got some details with news stories detailing the exact reason he got the surgery later on. But these did not detail the exact area, when he injured it, how he injured it, and the severity. To get some background information on core muscle injuries, check out my article.

Since then, it has been nearly radio silent with little information. The only indication that Oliver is doing alright is that he made it down to Houston at the beginning of February. Based on general rehab guidelines, Oliver is still working on flexibility and reintroducing strengthening exercises, progressing the level of difficulty and resistance as tolerated.

He may also be limited during part of OTA’s, but should be able to participate during Phase Three when there is actual contact. He should also be fully ready for training camp.

Jon Feliciano

Feliciano continued the trend of players requiring surgery after the season, specifically for a left rotator cuff tear. He had noted that he was playing all season with the tear that dated back to the scrimmage at New Era Field in early August.

Feliciano is about five weeks out from surgery which means he has either just begun or will begin to get his arm out of the sling more. He will be progressing his range of motion, careful to not stress the healing tissue and possibly begin working on isometrics based on the doctor’s protocol. For more details regarding a rotator cuff repair, read this article I wrote last month.

Feliciano will take his time to get through the rehab and will not be available for OTA’s. Thankfully, he should be ready for training camp this summer.

Levi Wallace

Wallace was the most recent surgery added to the list, requiring shoulder surgery back on January 28th.

Unfortunately, outside of what Jay Skurski stated, there has not been any other information released. It is known he suffered a shoulder injury back against the Philadelphia Eagles, but the specifics are not available. Unless details are released, I believe he may have had a general cleanout of the shoulder arthroscopically.

It is too soon to tell if he will be able to participate in any fashion during OTA’s. But I remain hopeful that he can participate and be ready for training camp.

Cody Ford

Finally, we get to the last player who required surgery this offseason. Ford was a surprise announcement that he required surgery on his right shoulder. Like Wallace, details are scarce, but there is some information to be interpreted from pictures.

Based on the picture below, Ford is dealing with either a torn labrum in his right shoulder or a rotator cuff repair, both of which would take four to six weeks in the sling. Based on the most recent picture, he would be four weeks out.

Details may emerge later with the exact injury, but seeing updates such as this helps narrow down what the player could be dealing with. If he is dealing with either injury, range of motion is vital early on and performing isometrics to take his rehab to the next stage for strengthening is key. Regardless of the injury repair, he should be fully cleared in either case for training camp barring any unforeseen complications.

While this doesn’t get into the nitty-gritty details that people want to know, it does establish several injury timelines. This also provides updates on how the players are responding to surgery and if anything seems out of the ordinary.

I expect that more details will emerge regarding some of the injuries, but not a given. The Bills are still on track to bring nearly everyone back onto the team to maintain the culture the coaching staff strived to establish. As fans, we can only hope that the Bills are maximizing the quality of starters at each position. If any go down, it’s important to have a capable backup who can carry the torch until the starter returns.

For the latest up-to-date content, check out @BangedUpBills on Twitter and here on the website. Make sure to also check out Cover1.net for my draft injury analysis on prospects as the NFL draft approaches.

Jon Feliciano’s Rotator Cuff Repair

How did Feliciano manage to play all season with a torn rotator cuff?

The injuries continue to pile up! The latest injury comes Wednesday afternoon when a tweet dropped from OG Jon Feliciano. The tweet shows him in a recovery room with a brace on his left arm with bulky padding on the shoulder. Considering it was at a lower angle, it was initially hard to determine if there were other telltale signs that could be observed signifying the specific procedure. 

This surgery is another in a line with DT Ed Oliver Tuesday with his core muscle surgery & Wednesday morning’s tweet of OT Cody Ford with a right shoulder surgeryShortly after the Feliciano tweet, Matt Parrino from NY Upstate reported that Feliciano had a rotator cuff repair Wednesday & that the original injury occurred during the Blue & Red scrimmage on August 2nd.

I noted back in August that he suffered an injury during the scrimmage after I attended, but the actual injury was unable to be observed due to the vantage point of the stadium & the multitude of activity going on at the time. What wasn’t known at the time was that Feliciano suffered a rotator cuff tear to his left shoulder that he managed to play for  5 months. 

To understand why he was able to play that length of time, the anatomy & function of the rotator cuff must be understood. The rotator cuff is made up of 4 muscles that include the supraspinatus, infraspinatus, teres minor, & subscapularis. These muscles assist in shoulder abduction, internal & external rotation. These motions are vital for a variety of activities that we perform daily from washing hair, putting a shirt on, throwing objects, reaching behind the back, & general overhead activities. The rotator cuff also helps keep the humeral head depressed and against the labrum so that it can create enough space within the joint for the humerus to move & not ram into the acromion during elevation. There are other muscles that assist with all these functions, but these are primary movers for the above-mentioned functions. 

301px-Muscles_Rotator_Cuff
Credit: Physio-pedia.com

We tend to hear more about rotator cuff injuries in baseball but they can & do occur in football at a variety of positions. The mechanism for injury to the rotator cuff can happen in a number of ways. It can occur as a result of landing on your arm outstretched, jamming the head of the humerus into the scapula. It can occur with a fall directly onto the shoulder area, throwing an object either with increased frequency or if the object is too heavy. It can also occur from an overload of the area such as a sudden pull on the area. Finally, it can occur over a period of time with impingement due to weakness in the area with altered biomechanics leading to a wearing down on the tendon insertion.  

There are two types of rotator cuff tears that can affect any of the muscles in the cuff area: Partial-thickness and full-thickness. Based on the names, the partial-thickness is a partial tear to the tendon that can be small & can even heal on its own at times. Full-thickness is when the tendon tears completely through & there is a significant loss of function noted in the area. Any of the muscles in the rotator cuff can tear but the supraspinatus is the most commonly torn muscle. It is anchored at the top of the humerus head & is more likely to bear the brunt of an injury or become worn down. 

Size-of-Rotator-Cuff-Tear-do-I-need-surgery-or-can-physical-therapy-help-300x138
Credit: physioworkshsv.com

There are also varying grades of partial vs full-thickness tears which further indicate the severity as seen above. The tear is measured in both size & depth. So it’s possible that there could be a big superficial tear that could be managed conservatively or there could be a tear that is deep that requires surgery as seen below. Most surgeries are indicated for tears medium & above.

full-thickness-rotator-cuff-tears-value-of-clinical-tests-2-638
Credit: Google Images

Feliciano likely suffered a partial thickness tear to at least the supraspinatus & possibly others as the rotator cuff covers the humeral head like a blanket. The injury could have started out as a partial thickness tear, potentially progressing towards closer to a full-thickness tear as the season wore on. The other possibility is that the partial-thickness tear just never got better, requiring surgery.

I don’t believe that he initially had a full-thickness tear as he would have missed some time due to profound weakness in the area and positive signs of several special tests. In the clinical setting, a full-thickness tear is quite apparent & even the toughest of people have difficulty moving the shoulder. If his shoulder were to be assessed during the season, there would have likely been a painful arc noted in the picture below. This is due to the activation of the rotator cuff muscles assisting in elevation of the humerus during the range of motion from 60-120 degrees

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Credit: pivotalphysio.com

There was likely pain during every movement that Feliciano encountered throughout the season due to this tear. Between rehab, strengthening of the surrounding muscles & medications, he was still able to suit up for every game & at times play center. Thankfully, he didn’t have any issues with snapping the ball due to being right-handed. 

Feliciano’s glaring weakness would have been forcing to move his arm in abduction and external rotation, both of which would have been more difficult as a tackle, trying to keep the defensive end from bending around the edge. Thankfully, he was able to play inside & keep his arms closer to his body, taking stress off the cuff. Despite the rotator cuff not directly assisting with shoulder flexion, he still would have likely had pain with a general elevation of the arm due to the imbalance of the rotator cuff due to the injury. This could cause impingement where the rotator cuff gets pinched between the acromion & greater trochanter due to decreased space during shoulder elevation.

It will be curious to see if he did get beat more often on the left side when the pocket broke down & he was forced to use that shoulder more. It would also be interesting to note if Feliciano’s punching ability when engaging with his block was decreased due to not being able to put as much power through the left.

Either way, to play through this injury isn’t unprecedented in the NFL, but it is difficult. Cam Newton, Drew Brees, Kawaan Short, Alshon Jeffery & Johnathan Abram are just some of the examples that have torn their rotator cuffs & either tried to play through it or had their seasons end as a result. However, most of the names on this list continued to have incredibly productive careers, indicating that the injury alone isn’t a game-changer. 

To add insult to injury, the rehab for a torn rotator cuff isn’t fun either. It’s roughly a 4-6 month recovery & in some cases, take up to a year with severe tears. This is a tough surgery due to the variety of movements of the shoulder. In addition, the area where the rotator cuff attaches to the humerus contains a poor blood supply which means that it does not receive the needed nutrients to heal as quickly as other parts of the body. Reports indicate that Feliciano will take between 4-6 months which further supports the partial thickness tear that I had mentioned earlier.

The surgery is typically done arthroscopically unless there is a massive tear & they need to open up the shoulder to fully address the issue. Once inside, the tear can be further assessed, cleaned out & repaired. The repair is done by placing anchors that reconnect the tendon back to the bone to allow for proper healing of the area. Based on the severity of the tear will determine how many suture anchors are required.

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Credit: Physio-pedia.com

Rehab protocols dictating the specifics of the timeline for rehab can be accessed here & here, but to simplify it, it is tedious having worked on a number of these during my career. The first 4-6 weeks are spent in a sling with PROM initiated to work on the motion but avoiding any strengthening directly to the shoulder area. Motion is slowly progressed to stretch the tissue but not place stress on the healing area with range of motion limitations set by the doctor.

Once the patient has been cleared to begin strengthening, isometrics are initiated which is when the muscle tensed up but is not actively moving, like pushing with all your might against a wall. As strengthening progresses, higher-level activities are incorporated to increase stability in the joint. The rotator cuff has to improve with strength, but the surrounding muscles also have to strengthen in order to help move the scapula up and out of the way in order to allow the humerus to elevate. 

Eventually, the muscles are all moving properly with scapulohumeral rhythm, there is full ROM/strength and no pain, this allows the ability to return to sport-specific strengthening & activity. Rotator cuff repairs do have overall good outcomes, up to 95%, but they need a lot of patience to get there. Fortunately, delaying surgery does not appear to have negative outcomes, hence why Feliciano likely chose to play the season with the injury.

Risks for re-tear are as high as 26% in the literature, but is relatively lower in younger patients as the quality of the tissue is improved compared to older patients with more chronic tears. Furthermore, there is a correlation that for every 1 cm the initial tear increases in size, the risk to re-tear increases two-fold.

As a PT, these repairs are rewarding to observe the improvement, but there is a distinct process to them. There may be areas where a patient progresses faster & can shave some time off the overall recovery time, but you can’t speed up the biology & healing portion of the surgery. These can be successful surgeries, but they just require a lot of time & patience in order to maximize the results. 

Feliciano will be around during OTA’s but expected to be limited. He should be able to perform cardio activities & perform non-contact drills as long as he’s cleared by the MD, which is very possible. There is a chance he would be able to perform at mandatory minicamp in June during Phase 3 of the OTA’s but may be held out as a precaution as he is a veteran. Barring any setbacks, he should have no concerns going into training camp for 2020.

This sort of injury is just the reality of the game of football & is a look into how tough these guys really are when it comes to suiting up every week. The only benefit to having an early exit to the playoffs is that these injuries can get addressed sooner. However, I believe most, if not all of the players in that Bills locker room would go through hell if it meant hoisting that Lombardi trophy in February. With how this team is built, the chances for that increase daily. 

Top Photo Credit:

Kiss985.radio.com

Wild Card Weekend Bills Injury Preview- Texans

What is the status of Nsekhe, Roberts, Lawson, & Wallace?

Well, we’re finally here, the playoffs are upon us! We are moments away from the Bills playing in Houston on Wild Card Weekend for the first NFL game of 2020! The Bills are beat up but still in a better spot than the Texans. While I could detail out every injury for Houston & compare it to how the Bills could take advantage, I may be better off writing the sequel to War & Peace. But if you want to get some detailed analysis of the Texans injuries, check out my latest appearance on Locked On Bills with Joe Marino. I have nuggets on JJ Watt, Johnathan Joseph, Bradley Roby, & Will Fuller V. Make sure to check out the pod below!

Locked On Bills 

If you want to know why Houston DE JJ Watt is able to come back so quickly from his pectoral tendon tear, check out my latest article at Buffalo Rumblings!

JJ Watt’s Unexpected Return

As this blog is a Bills based site, the Bills injuries are below & my impressions of them.

QUESTIONABLE

DE Shaq Lawson (left hamstring strain)

Lawson continues to recover from his hamstring strain suffered late in the Patriots loss but appears on the right track. He has been limited the past week, but with controlled activities, he has looked great on film.

I’ve stated all season that the hamstrings are vital for running & blocking, important responsibilities for a defensive end. It’s not a muscle group that can be babied or managed with certain bracing or necessarily protected. Even with the best rehab & rest, injuries can still occur and Lawson may be a casualty of that. 

He missed the Jets game & would probably benefit from another week off, but considering each game now is single elimination, Lawson should not miss. I have a strong suspicion that he plays.

WR Andre Roberts (foot)

Little is still known about Roberts’s foot other than it cost him another game against the Jets. Matt Parrino of NYUp.com noted that he was taking punt & kick returns in practice, accelerating up the field without issue. Any foot injury would limit sudden acceleration as the toes & foot act as a lever to push off the ground to move forward. 

If he had something such as turf toe, a foot sprain, fracture; there would be difficulty getting up to speed & slowing down. As long as Roberts is able to play Saturday, then it won’t really matter what’s wrong as long as he can add another dimension to the team.

OT Ty Nsekhe (right ankle contusion)

Nsekhe continues to work back from his right ankle that cost him 5 games this season. He was rolled up on again Sunday & but appears to be working through the injury just fine. This appears to be more of a contusion which was supported by the fact that he’s practicing all week & only has a brace on, the same one that he appeared to be wearing on Sunday.

I feel strongly that Nsekhe will suit up Sunday & will be in a rotation with OT Cody Ford with Ford taking a bulk of the snaps. 

CB Levi Wallace (right medial ankle sprain)

Wallace is the big iffy for Saturday. At the end of the day, he is still dealing with an ankle sprain that requires rest. The part of the ankle he injured was the medial side which is the inside portion of the ankle. The deltoid ligament is the strong inside portion of the ankle that provides stability between the tibia, talus, calcaneus, & navicular. This is the reason why it is so difficult for the inside portion of the ankle to suffer a sprain. If the outside portion of the ankle had the same type of structure, I would imagine we would all run very differently. You can see the makeup of the deltoid ligament below.

Deltoid-Ligament-Structure-location
Credit: medicpassion.com

The next picture below is a great example of how the injury occurred with Wallace with regards to the motion & the area injured. To note, the ligament does not likely tear that severely for Wallace or a fracture sustained as dictated in the picture.

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Credit: http://www.sportsinjuryclinic.net/

If this was a regular-season game, Wallace would surely miss Saturday. Considering it’s the playoffs, I imagine that he will try to suit up with a heavy tape job similar to the one seen below. His major limitations will be pivoting, attempting to stay with his assignments. He will be able to run straight & cut off the left ankle, but forcing Wallace to jump, cut to the right, and backpedal will limit his effectiveness. I expect that CB Kevin Johnson gets the start & majority of snaps with Wallace as a backup or used in certain packages. 

Probable Inactives:

TE Tommy Sweeney

DT Vincent Taylor

S Kurt Coleman

S Dean Marlowe

OG Ike Boettger

RB TJ Yeldon

OG Ryan Bates

The Bills are in a great position to win their first playoff game since 1995 & move to the divisional round against a likely rematch with the Ravens. I could see this Bills team make a run like the Jaguars did a few years ago; anything can happen in the playoffs. 

On top of that, the injuries listed today won’t be real factors outside of Wallace heading into next week. There is always the possibility of new injuries, but thankfully the injuries we do have are at positions of depth at OT & CB. 

Regardless of the outcome, you will be hearing from me next week. However, I highly anticipate that I will be coming to you with an injury review & preview heading into the divisional round. GO BILLS!

Top Photo Credit:

USAToday.com