Wild Card Bills Injury Review- Texans

It was still a fun season despite the loss.

This wasn’t an article I wanted to write. I wasn’t in a rush to write this either. It’s not that I didn’t want to write about the injuries, but I didn’t want to write about the end of the season, at least not with that ending. That game was full of emotions, the excitement of that first drive ending in a touchdown, the Houston comeback, the game-tying field goal & inevitable loss. It just sucked to see such a great season the Bills have an end like this. But it ended and that’s the reality of the situation. 

However, there were still injuries that occurred & I have a duty to explain what exactly happened. 

CB Taron Johnson (lower-body injury) 

Johnson exited the game midway through the 2nd quarter with 7:30 left with what appeared at the time no apparent reason. He was observed down on his right knee after the play with trainers assessing him before walking off under his own power. 

Reviewing the game film, it was not apparent that he suffered an injury until the All-22 film came out. Upon reviewing the film, Johnson stuck with his man, TE Darren Fells until he got to the sideline. Fells cut back, as did Johnson rather vigorously and he appeared to take an awkward step on his right, which forced him to slow up as the play ended. Nothing appeared wrong until Johnson was down in the middle of the field before he went off.

My best guess due to having only one camera angle and a birds-eye view is that he suffered some type of strain. Possibly a groin, hamstring, or calf. To note, he wasn’t limping off at all from what I could tell, but something wasn’t right. If you recall, Johnson did suffer a hamstring strain back in the 1st game which ultimately cost him 4 games. Temperatures were in the 70’s at kickoff & the dome was closed, leading to a warm environment, raising the possibility for a strain due to dehydration. I do not believe the hamstring he suffered back in September caused the issues on Saturday.

Regardless of what it was, we probably won’t know until OTA’s start or if an article comes out later detailing the specifics. This isn’t anything that should be a problem heading into next year either.

WR Duke Williams (left low ankle sprain)

Shortly after Johnson suffered his injury, Williams had one of his own catching a diving pass from QB Josh Allen before going out of bounds with about 2:30 left in the 2nd quarter. It was a bang-bang play & required several replays to determine the injury. At first, it appeared that Williams hyperextended his left knee as his foot got caught in the turf, diving out. 

However, on further review, it clearly shows that his left ankle twists in quickly, causing the all too common inversion low ankle sprain. Williams took several plays off to get his ankle evaluated and taped before returning, at times favoring the ankle with a decreased ability to push off. 

Williams avoided a worse knee injury due to the ankle taking the brunt of the forces going out, snapping underneath instead of applying further pressure on the knee into extension. He will likely be feeling this ankle for a few weeks & possibly the knee but like most sprains, this won’t be an issue moving forward & had the Bills won, probably wouldn’t have kept him out next week.

Other Observations 

CB Levi Wallace & WR Robert Foster

There were several surprise inactives prior to the game, namely CB Levi Wallace & WR Robert Foster. Wallace was a surprise to me only because he was practicing, although on a limited basis with a heavily taped ankle, during the week. I had thought that even an injured Wallace would be able to play in some packages, but my guess is that the team felt he would be better suited to play next week had they made it. 

Foster was a surprise only because of how valuable he has become as a gunner on special teams & was continually a deep threat, despite not connecting on anything all season. Considering the lack of production from Foster, it made sense to make Williams active, but thankfully the special team’s play wasn’t harmed by the loss of Foster. 

DE JJ Watt

Houston’s DE JJ Watt made some noise as I had expected him too, appearing in 61% of the defensive plays along with 2 tackles, 1 sack, 1 tackle for loss, & 2 QB hits. I believe he played far more than the original plan dictated, but this is why he suited up, to make a difference & he did. Far from his best performance, but those skills he has, even with one arm, still made him incredibly dangerous on Saturday & the Bills paid for it. 

QB Josh Allen

During the Bills locker cleaning out Sunday, there was a video that came out of Allen walking across the fieldhouse in flip flops & an ankle brace on his right ankle. It was not known when he injured his ankle during the game as he appeared in every offensive play Saturday. This likely was one of those small injuries that would be impossible to find on film & won’t be anything that should linger.

I had briefly thought that this was the result of the injury he suffered in the loss to the Ravens last month. However, this occurred to the left ankle in that game & he was able to play through it. Merely an observation & just another one of the battle scars that Allen accumulated throughout the season in the march towards the playoffs.

Final Thoughts

Like I said above, this wasn’t an article that I wanted to write. But it had to be done. This ends the 2019 Buffalo Bills season & I’m pretty happy with the overall results. 10 wins, a playoff berth not given by sheer luck, tons of growth by the entire team & a bright future. I’m looking forward to 2020 with the idea that this Bills team can make a run. I’m a Bills fan, an eternal optimist, is there any other way to be?

Looking at the offseason, there will be some changes. I plan on taking some time off from weekly Banged Up Bills articles, only focusing on updates such as the inevitable surgeries, free agent signings, & any other news I deem worthy to report. Things will gear up again once the draft hits & the 90 man roster begins to take shape prior to training camp. I’m going to continue to work hard to update the appearance of the site, video reviews, injury breakdowns, & find new ways to deliver the content that is clearly wanted. 

However, you can still follow on Twitter for the latest news, podcasts & work I will be doing with the draft. Find my work over at Cover 1 detailing injuries regarding the 2020 draft prospects. Make sure to go check that out & all the other amazing content that’s available. Thanks, Bills Mafia, it was a fun season!

Top Photo Credit:

RochesterFirst.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.

medial-ankle-sprain419
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

Week 6 Bills Injury Review- Texans & Allen’s Elbow

Read about the latest Bills injury to QB Josh Allen and what this means going forward.

Well this isn’t good, this isn’t good at all. The ultimate form of adding insult to injury, though reversed. The Bills lost a very winnable game, dropping to 2-4 on the year, losing to the flawed Houston Texans 20-13 on a QB Nathan Peterman pick 6 to give the Texans the lead and the game. Adding the injury part, QB Josh Allen suffered what appeared to be a rather innocuous elbow injury, glancing his elbow off DE Whitney Mercilus’ helmet. However, he was able to attempt one more pass before exiting the game. Unfortunately, recent news has shed light on the severity of the injury. Today’s article will assess what Josh Allen did to his elbow and what it means going forward.

Credit: physio-pedia.com

To give a brief anatomy lesson, the elbow is made up of 3 bones: the ulna, radius, and humerus. The elbow is primary comprised of the capitulum on the humerus fitting inside the semilunar notch which is part of the olecranon process on the ulna to make a hinge joint. Surrounding the joint are ligaments that provide support to the joint to provide support. These ligaments are the lateral collateral ligament, the ulnar collateral ligament, and annular ligament. The lateral collateral sits on the outside portion of the elbow, mostly injured due to fracture or dislocation. The annular ligament holds the head of the radius in place along the elbow joint, and the ulnar collateral ligament sits on the inside of the elbow. This is similar to the MCL of the knee in its function. It is more of a stabilizing ligament due to the throwing motion required in the human body. This ligament is made up of 3 bundles that spread out like a fan to cover the entire inside portion of the elbow. The elbow is a rather stable joint as compared to the shoulder or ankle, but as with any joint, can be injured with the proper forces.

In true Bills fashion, QB Josh Allen suffered a UCL (ulnar collateral ligament) injury to the elbow. This was the result of a bang bang play as Allen got hit from the left by Clowney, followed by Mercilus hit from the right, coming up underneath, hyperextending the rookie’s elbow. Initial thoughts were that he hit his funny bone off the helmet and had some residual numbness, similar though, to a lesser extent of the QB Marcus Mariota injury. However, later video review showed the arm in hyperextension which was worse but not terrible injury. At that point, I began thinking maybe he can come back this week or miss one game. However, recent video from Thad Brown revealed ironclad proof that this is an injury more severe than anyone thought.

The ulnar collateral ligament helps to provide medial support to the elbow so that the ulna does not shift off the humerus during elbow flexion/extension. This ligament also provides support during the throwing motion seen in many sporting activities. Injuries occur to this area as the result of acute hyperextension, excessive external rotation of the shoulder leading to chronic issues such as pitching, or a sudden forceful lateral stress to the joint during elbow extension which was the case with Allen.

Credit: eorthopod.com

In the video above, you can see the medical staff performing a milking technique or moving valgus stress test. The arm is put into full external rotation and the elbow is moved throughout its range, attempting to assess whether there is a painful response. In the video, there is clearly a painful response indicating a positive test. This test would not specify which band is injured, only the area in general. Due to this testing along with the mechanism of the injury, an MRI was performed to determine the severity of the injury. At this point in time, we know that this is not a season ending injury and we know that he will not require surgery as reported by Dr. James Andrews following a second opinion.

The reason it was the UCL that was injured was due to where the force came from. It came from below and outside the arm, pushing the inner portion of the arm up and out via the hyperextension, partially tearing the ligament. The reason everyone is hyper-concerned is that this is a rather famous ligament made popular by Dr. Frank Jobe and baseball player Tommy John in 1974. This is the ligament that stabilizes the inner elbow when a pitcher is throwing a baseball 100 mph. Dr. Jobe was able to surgically repair the ligament that Tommy John had torn and John was able to return to playing, racking up more wins in the process than he had prior to the injury. Today, this is known as Tommy John surgery and is typically a death blow to a pitcher’s season, hence the concern with Allen. Incidentally, many pitchers have since tore this ligament as a result of being bigger, faster, stronger along with overuse and sport specialization.

According to Dr. Andrews, Allen does not appear to require surgery nor will he be sidelined for the remaining season with the information that we currently have. This is something that many of us in the medical community believed prior to the Andrews report. This is an injury that like any ligamentous injury, will take some time to heal. Many conservative rehab guides along with medical professionals are looking in the neighborhood of 6 weeks for this to heal to the point of playing which would take the Bills past the bye week. I believe within this amount of time, he would be able to come back and while not 100%, would be close enough to be effective and continue to grow as a player. There are reports that he could miss 2-3 games but I think the Bills would be foolish to rush him back that quickly. It is likely that he will have some type of bracing on the elbow for protection.

While this is incredibly terrible, this will allow the Bills to let Allen rest and learn until he is ready rather than rushing him back out there and causing further damage to his arm. If this had been his non-throwing elbow, it would be more likely he would have been back by next week with bracing. This is an injury that despite best prevention, could not have been avoided. It was a collision and even with padding and protection, forces can still overcome the preventative measures.

Overall, UCL injuries are relatively rare in the NFL. Studies show that from 1994-2008, there were 10 UCL injuries with 9 taking 26.4 days to return and not requiring surgery. In addition, from 2010-2018, there were 12 UCL injuries with only one requiring surgery. Based on the past 25 years from those two studies, there has been 22 UCL injuries to QB’s in the NFL with only 2 requiring surgery. These numbers are smaller due to the relatively small sample size available. This is evident in the difference of the style of the throw, the amount of times the player is throwing, how many consecutive times a throw is performed, and the speed of the throw; all significantly less in football compared to baseball. While it is the same injury, the incidence is drastically different.

Thankfully, from baseball, we know how to treat this effectively. The non-operative rehab will consist of regaining full, pain free ROM in the elbow. They will also begin light resistive training to the area involving bicep/triceps work and grip/wrist exercises to build the muscles up around the area to give support as the muscles that perform flexion in the wrist and hand attach very closely to the UCL on the medial epicondyle of the elbow. As the ligament heals, he will begin to work on dynamic stability with grip and weight bearing through the arm. He will progress towards throwing progressively weighted balls along with strength training all while managing pain before resuming football activities. This injury, along with all other injuries, DOES NOT fit the motto of no pain, no gain. That motto doesn’t fly in therapy and will only delay his return to the field. The limited NFL research along with what we know about the baseball injuries will dictate when he returns. As he is young, he can heal quicker than an older QB, but this is not an injury that he should play through before he is ready as greater damage may occur as a result.

While this was a majority of the article as it is a major topic, there were other injuries that occurred during the game. DE Trent Murphy injured his left ankle late in the 2nd quarter. He appeared to take an odd step and came up limping slightly, missing several plays. He was able to return and it does not appear that he sustained any noteworthy damage at this time.

OG Vladimir Ducasse suffered what was reported a left knee injury early in the 4th quarter and was questionable to return. He was able to jog off the field with a small limp and was seen after the game walking in the tunnel without apparent pain. On video, he got hit from behind and got rolled up on. My initial reaction thought maybe mild high ankle sprain with how he fell or some type of contusion to the calf region. He could have also came directly down on his knee due to getting hit, causing discomfort. Either way, it doesn’t appear to be serious and we will know more once the injury report comes out tomorrow.

While this was an incredibly lengthy article, I hope that you walk away from this knowing that Josh Allen will be ok, not all injuries are avoidable, and the Bills are still relatively healthy compared to other teams in the league.

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

Week 6 Bills Injury Preview- Texans

Assessing the latest Bills injuries despite a rare injury free game report.

The Bills roll into Houston with a noted distinction rarely seen in today’s NFL. They have no one on the injury report in a league where each player is one injury away from never playing again. I am not a statistician or have extensively researched this, but the incidence of this is rather low if you ever took a look at www.pro-football-reference.com injury report for any team during any season. Despite this week’s rarity, today’s article will still review injuries from this week and impact they can have on the game.

Those on the injury report this week were S Micah Hyde (groin), S Rafael Bush (shoulder), CB Tre’Davious White (ankle), & G John Miller (ankle). As previously mentioned, Hyde and Bush missed last week with their respective injuries and White & Miller appeared to have either injured or aggravated previous injuries in practice.

However, all are cleared to play though may not be 100%, as most players aren’t fully healthy during the grind of an NFL season. Miller and White appeared to have generalized sprains based on limited reporting out of practice this week. Miller did deal with what I believed was a high ankle sprain last season. I do not believe he is dealing with an aggravation of this, but is a concern if he has repeated appearances on the injury report. White did not miss an defensive snap which makes me believe this is a minor injury. These generalized sprains can be managed well with rest, rehab, and proper bracing/taping to play the next week.

Bush is coming off a shoulder injury that by video, appeared to be an AC sprain. He was able to play though the rest of the game which makes me believe this to be the case. It is possible that he could have sustained a more serious injury, but we will know if there is any bracing or additional support on the shoulder that would signify any other injury.

With those on the injury report, the only one I am concerned about is Hyde. With groin injuries, they can linger as most strains do and are at a higher risk for re-injury if coming back too soon. There is a precedent for healthy players to be ruled inactive as CB Phillip Gaines and RB Marcus Murphy were ruled out in past weeks despite practicing in full that particular week. As Hyde is a vital cog to the secondary, it is possible that he may miss the game, but less likely as he is a starter. Add in the fact that the team released S Dean Marlowe indicates that Hyde will most likely play.

This fortunate injury report allows the Bills to go into Houston with a healthy roster and everyone mentioned above active. This will give them the best chance possible to get to 3-3. These are the games that fit “The Process” exactly; games that while tough, are games that can be won with the right game plan and personnel available. I do not anticipate the Bills to have results that mirror the Ravens and Chargers games. I believe that the Bills will walk away with a win and keep pace with their AFC counterparts.

This is one of the shorter articles this season and in my book, that is an excellent thing. Continue to check back for the latest updates and news coming out of One Bills Drive. Follow Banged Up Bills on Facebook, on Twitter @BangedUpBills, on Reddit at u/BangedUpBills and online at www.bangedupbills.com. As always, thank you for reading and GO BILLS!!