Week 7 Bills Injury Preview- Colts

Read up on the latest Bills injury news heading into Week 7 against the Colts!

Things are finally starting to calm down after an eventful start to the week. Between the regrettable loss to the Texans, initial speculation about QB Josh Allen’s elbow injury, followed by the hysterical fallout of the details following the injury, it’s been a week. Today’s post will review the Bills injuries going into the Colts game.

Those already ruled out at QB Josh Allen (right elbow) & RB Taiwan Jones (neck). We know all the nitty gritty details of the Allen injury along with reports are indicating he is expected to miss 2-3 weeks. I believe the team should use the bye week to its advantage and shelve him for 4 games with rest for 5 total weeks. Time will tell how he responds but the extra time can and will help him heal to prevent further issues or complications of the injury. As mentioned in my previous article, it can take 6-10 weeks for a ligament injury such as this to heal properly.

RB Taiwan Jones (neck) is however, a mystery. Jones presented on the injury report with a neck injury and did not practice all week. Reviewing film from the last game, he did not appear to suffer any jarring hits or injuries to his head/neck that would have led to an early exit from the game. He was also able to play in most of the special teams snaps, having one of the highest percentages on the team. We also know that he did not suffer a concussion, fracture, or any injury publicly reported. So at this point, things get tricky. There is no video to even consider a diagnosis, no reports to identify what is specifically going on with the complaint; only “DNP” & “neck”.

The next section is entirely speculation and does not infer or imply that this is what is he is dealing with. Just trying to identify possibilities so as to give a timeline for a return. Reviewing injury reports since Jones came in the league did not reveal any previous neck injuries which could identify chronic conditions. There also has not been any reported concussions during his time with Oakland & Buffalo. This leads me to believe this neck injury is more acute in nature. We also know that not all injuries are always reported which means he may have been dealing with a neck injury that finally became painful enough to sideline him. This could have been something a hit could have aggravated a minor injury, another possibility that something could have occurred in practice we are not aware of, or something totally unrelated. We did see last year that C Eric Wood suffered a now career ending neck injury that was largely unknown until a season ending physical. This is not to imply that Jones is dealing with an injury or situation as dire as Wood’s, but I am stating that we never quite know the whole story. Jones may be having localized neck pain limiting his ability to move his neck; he may be having pain along with numbness going down his arm classified as radiculopathy; he may be having cervicogenic headaches related to neck pain; just a small sample of issues that could be possible, though far from exhaustive. This neck pain could also be related to the horrific shot he took against the Chargers resulting in his gnarly head wound. He may only miss a week and return without limitations, or this may leave him sidelines for several weeks if symptoms persist. Without more information, I cannot confidently state what he may be dealing with. This will be something that we will have to wait for more information to come out or if the front office begins making roster moves as a result.

Others that dealt with injury from Sunday include DE Trent Murphy (ankle) and OG Vladimir Ducasse (left knee). Both are cleared to play and their injuries were relatively minor. Based on film, I can’t even quite specifically identify the exact injuries they sustained. Murphy took what appeared to be an awkward step which slowed him on that particular play and as a result, missed several plays after but was able to return. Ducasse was hit from behind and had another lineman fall onto him but was able to jog off though with a mild limp. He may have just fell on his knee directly, plus adding in ~300 lbs from another body could certainly cause some type of discomfort. We know the defensive line is on a rotation, it’s possible that Ducasse may be on rotational play if he continues to experience issues.

Others to watch out for is CB Taron Johnson (shoulder) and P Corey Bojorquez (shoulder). Both have some type of right shoulder instability evident with bracing. This could continue to limit their effectiveness, though much more apparent in Johnson’s case due to his position. Both have not been on the injury report recently and hopefully can continue to play until the end of the season when they can address the issue with possible surgery.

This wraps up another Bills injury preview with the Bills continuing to stay healthy. On the opposite end of the spectrum lies the Colts, who have been beset by injury which helps explain their 1-5 start. Here is a link to an overview of their injury report; they are still missing key contributors at this time. Despite QB Derek Anderson making his first start for the Bills, I expect the Bills defense to contain the Colts offense, forcing turnovers, and pulling out a win to move to 3-4.

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 online at www.bangedupbills.com. As always, thank you for reading and GO BILLS!

Vontae Davis Injury Analysis

Analyzing the latest Buffalo Bills signing of Vontae Davis, reviewing injury history and expectations for next season.

More news coming out of One Bills Drive with the recent signing of CB Vontae Davis. This is a move that has been discussed for several weeks and is now official. This signing may allow the Bills to hedge their bets that CB E.J. Gaines leaves in free agency. With Davis now roaming the secondary, this allows the Bills to further add to the positional group without sacrificing other areas of need. Today’s post will go over Davis’ injury history and detail his recent core injury.

Reviewing his career, the 9th year pro is a 2-time Pro Bowl selection drafted in the first round by the Miami Dolphins out of Illinois in 2009. After 3 seasons in Miami, he was traded to the Indianapolis Colts where he spent 6 seasons with the team before leaving under difficult circumstances.. As a corner back in the NFL, Davis has had several injuries that vary in severity. These injuries include: knee, quadriceps, wrist, hamstring, neck, elbow, ankle, foot, groin, and concussions. Year by year, a hamstring injury in 2011 caused him to miss 3 games, 2012 saw him miss 6 games due to knee and ankle injuries. 2014 saw a missed game due to a concussion, 2016 saw two games missed due to ankle injury, and 2017 forced him to miss 3 games before returning to play prior to his release with a groin/core muscle injury. While Davis has had a litany of injuries throughout his career, this is not uncommon to see to a player at his position.

However, the injury that Davis sustained which ended his 2017 campaign is more commonly known as a sports hernia. Despite the name, this injury is not actually a hernia in which organs protrude through the muscle wall. Instead, a portion of the deep abdominal wall tears away from the pubic bone which is found in the groin area where the leg meets the hip near the genital region. His injury has been described as a core or groin injury. Both are correct descriptors but can be confusing when reports come out that vary which make understanding what exactly happened more difficult. A picture below helps outline anatomically what is going on.

athletic pubalgia diagram c.gif
Credit: radprotocols.webs.com/athletic-pubalgia

Causes of this injury include violet twisting, kicking, and turning along with blows to the back can contribute towards increased incidence. Unsafe or intense abdominal exercises can also cause the injury with deconditioning or overuse is present. Symptoms include sharp pain in the groin area during turning, running, kicking, twisting, tenderness to the area, and typically one sided discomfort. According to reports, Davis sustained the injury during a preseason game against the Pittsburgh Steelers and was unable to return for the next several games.

After missing the first 3 games due to the injury, he was able to play through 5 games before aggravating the injury. The Colts then benched him for as they described “poor play”, but his injury is most likely what led to his ability to play. Not being able to perform the physical requirements of the position secondary to pain led to his decline in ability. Colts team doctors then recommended to continue to rehab with conservative management and play with the injury. However, Davis went against team doctors’ wishes and opted for surgery which led to his ugly release from the team.

Davis could have recovered from his injury without surgery with rehab a more than effective intervention to return to his prior level. However with his age, positional considerations, and assumed time left in the league, Davis opted for the surgery to ensure his ability to return to top form for the 2018 season. A timeline for recovery is up to 12 weeks due to the location and nature of the surgery. The tear would be repaired and restrictions would be set in place to ensure healing. The focus on surgery would address range of motion, scar management, pain, and light strengthening in the beginning. Following proper healing of the affected tissue, agility, plyometrics, and speed drills are incorporated in order to return to sport related activities. A return to sport protocol that outlines a 12 week recovery is detailed here. Additional rehab protocol including a conservative, non-operative protocol can be found here. Please click these links, these are fantastic resources especially for an injury such as this.

As Davis has been in the league for 9 years, he demonstrates some level of ability to understand his body in regards to maintenance. He is nearing 30 years old but could still have several effective years left or change position in the secondary to remain effective. Following surgery, there has been reported rates specifically in the NFL upwards of 90% success rate and ability to return to prior level of function. While there is always a chance for re-injury, this specific injury does not appear to be one that can develop into a chronic issue or prevent him from fully participating next season.

As E.J. Gaines has battled several injuries over his career and missed 5 games this past season due to injury, he remains a liability and is commanding big money on the open market. It appears as though Davis is slightly more durable and may be an appropriate alternative if Gaines leaves. It is interesting that Gaines is trending upwards after being a low round draft pick and Davis is a high round draft pick that is trending downwards but may offer similar production. For the price, availability, and no long term commitment makes Davis a strong alternative to replace Gaines. To add in the extra benefits, with Gaines leaving, the Bills would benefit from a compensatory pick which could hypothetically be used to find Davis’ replacement in the draft.

Davis is an impact player that could add a veteran presence to a team slowly getting younger with the ability to earn one more contract if he plays well. This is a smart, low risk, low cost option that is in line with Brandon Beane’s focus to eliminate big contracts that don’t match up with production.

It is impossible to totally eliminate injuries, but the Bills are looking at the overall player and not simply production which may help guide better long term decisions. I like this signing and believe that Davis will reproduce a higher level of play earlier in his career than he has the past two seasons. If the Bills are unsatisfied, they are not stuck with him.

Continue to check back at Banged Up Bills for the latest Bills injury news and updates. Please feel free to ask questions regarding injuries and physical therapy, I enjoy the discussion and educating others regarding injuries. Thank you for reading and GO BILLS!!

Week 15 Injury Breakdown- Dolphins

Assessing the latest injury report following the brutally cold game Sunday and how it impacts the Dolphins game.

The Bills released a new injury report which means a new article! While I did expect new players to be on the injury report, thankfully it is not that extensive and overall, things look well leading up to the Dolphins game Sunday. Today’s post will outline the injuries and impact it has on for Sunday.

Starting off, those that did not practice include: OT Cordy Glenn (illness/foot/ankle), WR Andre Holmes (neck), DT Kyle Williams (groin). At this point in the season, Glenn has become a broken record in regards to his injury that does not seem to heal. I still believe it is a chronic issue which limits his availability and this should affect his off season whether he stays with the Bills or moves onto another team. As he is dealing with an illness which is most likely the flu, this will limit whether he will be ready to play.

Holmes was described as having some “neck stiffness” which is not surprising considering the hits that everyone took Sunday’s game. I don’t believe that it is anything more than general muscle soreness. Structurally, there should be no concern, but it may limit his ability to move his head effectively when running routes. Stretching and rest will be key for him to return to full function.

As for Williams, he is still dealing with a groin injury that he sustained last week again the Patriots. It does not appear to be anything more than a Grade 1 groin muscle strain. He was able to play through the Patriots and Colts game without any limitations. I expect this to be the same preparing for the Dolphins game. As we saw Sunday, Kyle Williams is far too tough to let a minor injury stop him from playing.

Those limited in practice are: WR Kelvin Benjamin (knee), TE Charles Clay (knee), T Seantrel Henderson (back), RB LeSean McCoy (knee), and QB Nathan Peterman (concussion). Starting off with Benjamin, he did re-injure his knee during Sunday but upon video review, he did not suffer any mechanism of injury when he had to leave the game. It appears that he fell hard on his knee, similar to the Taylor injury two weeks ago. Think about it, your knee hurts like no other when you fall on the snow and ice. This is what I believed happened to Benjamin and with his limited participation in practice, this is a good sign that he may be ready to play Sunday. It is also worth noting that he is still recovering from the meniscus tear even though he has been cleared to play.

Clay continues to deal with his knee injury that may be related to the chronic issue that has plagued him in season’s past; his abilities do not appear to be hampered. Henderson is still dealing with a back injury that he either sustained in the Patriots game or in practice; I believe he is dealing with a muscle strain that continues to limit him. Time will tell whether he plays Sunday.

McCoy had a fantastic day on Sunday despite the cold and snow and is dealing with a knee injury that may be more a veteran rest day than anything to truly be concerned with. Barring any new information, expect him to play without any restrictions come game time. Finally, Peterman is recovering from a concussion sustained late in the 3rd quarter and was unable to return. As he is able to return to practice in a limited fashion, this is an excellent sign as he is in either stage 3-4 of the protocol and may be available to play if he has no recurrence of symptoms.

Those that practiced in full: CB Leonard Johnson (knee), G John Miller (ankle), and QB Tyrod Taylor (knee). Johnson is still recovering from the helmet to knee hit sustained in the Patriots game and if the weather was not so poor during the Colts game, he may have played. Expect him to play as conditions will be improved. Miller is finally practicing again after missing the past several weeks with a possible high ankle sprain. At best, he may be active to provide depth at the guard position.

Finally, Taylor practiced in full with the knee injury that kept him out this past Sunday. Due to the snow, the team hedged their bets and rested him to ensure that he was not lost for the season. Due to the location of the contusion, it can continue to limit him, but with protective bracing and rest, he should be named the starter against the Dolphins which despite his shortcomings, I believe is the best shot to get the team a win.

The injury report will change over the next several days, but there should not be any reason that most of the players will be unable to play Sunday. Barring any setbacks, the team is going into their final home game with a real shot to go 8-6 and stay in the hunt towards clinching that ever elusive playoff spot.

Continue to check back for new articles and updates. For the latest information and game day thoughts, follow me on Twitter at @kyletrimble88. As always, thank you for reading and GO BILLS!!

Week 14 Post Game Thoughts- Colts

Initial thoughts regarding injuries following yesterdays cold and exciting win!

What a game, what a game, what a game!! The Bills pulled off a spectacular win at New Era Field with a 13-7 score over the Indianapolis Colts!! Man what a game! Besides the snow and the cold, the Bills came out on the winning end of things without major injury. Today’s post will break down why the Bills are in good shape health wise for a playoff push if they still have something left in the tank.

Thankfully, injures were at a minimum during yesterday’s game due to the poor footing and snow to soften some of the blows. This doesn’t mean there wasn’t any injuries, just far fewer than usual. Starting off, QB Nathan Peterman had to leave the game late in the 3rd quarter due to a head injury sustained when he dove/fell head first and was hit helmet to helmet. He had to leave the game and was able to walk off on his own power. QB Joe Webb was able to take over and while he looked shaky, he was able to maintain the lead and give Peterman his first NFL win.

It is far too early to tell how serious Peterman’s head injury is but he is in the concussion protocol. We have seen a variety of timelines from other players this season with regards to returning after a suspected concussion. CB Tre’Davious White and RB Travaris Cadet were both able to return rather quickly while DT Jerel Worthy was out several weeks. There is no real way to determine severity based on hit alone as evident by Gronkowski’s hit on White last week. Regardless of the outcome of Peterman’s injury, QB Tyrod Taylor will be ready to play against the Dolphins.

Also injured on the same play of Peterman’s head injury, OT Jordan Mills sustained a left knee injury that took him out for several plays, but was able to return later. However, with the lack of depth at the position, Mills may have been forced to play though the injury. Video shows that he merely fell after getting twisted up during line play but did not appear to suffer any injury to the joint.

Finally, WR Kelvin Benjamin re-injured his right knee twice; first on a hard hit to the knee during landing early during the 4th quarter. He was able to return later in the game and unfortunately re-injured his knee. I do not believe that he tore his meniscus further or sustained any additional structural damage, but rather landed hard similar to what Taylor sustained last week. Analyzing video of the game supports that there were no mechanisms for injury; rather just hard hits to the knee along with adding in previous pain due to the already healing meniscus. As Benjamin is being further evaluated, I do not believe anything more will come of the injury.

After that brutal game with all the slipping and sliding, I expect the injury report to be rather long with several veterans requiring rest days and most guys being banged up with minor muscle strains and contusions due to the brutal nature of the game. I expect that the Bills will be able to be able to rest up and be ready to play an always tough Dolphins team that look to end the Bills playoff chances.

Look for the next article to dive deeper into the injury report and explain any new injuries presented to the media. Until then, continue to check back for new articles and updates as more information becomes available. For the latest injury information, follow me on Twitter at @kyletrimble88. As always, thank you for reading and GO BILLS!!

Buffalo Bills Injury Update- Colts

Providing the latest updates following the latest Bills injury report including thoughts on players likely to play.

As the injury report changes so frequently as the injuries grow, it is fitting that an update is warranted. The Bills-Colts game tomorrow should ideally end up as a Bills win but should also feature minimal to no injuries as the field will be slippery, leading to decreased footing which in turn reduces major injury. Today’s post will offer any insight regarding updates on the injury report and thoughts on the effectiveness of each player.

Starting off, those listed as out are: G John Miller (ankle). He has not appeared in a game since the beginning of October when he played every snap against the Falcons. Since then, he has been a scratch with the emergence of G Vlad Ducasse. I suspect he suffered a high ankle sprain in practice which has limited his participation.

Those questionable are: OT Cordy Glenn (foot/ankle), OT Seantrel Henderson (back), CB Leonard Johnson (knee), QB Tyrod Taylor (knee), and DT Kyle Williams (groin). Between Glenn and Henderson, one of these men will play. As Henderson did not practice the past 2 days due to a back injury and Glenn has been out for the past month with his chronic foot/ankle issue, my money is on Glenn. It is not known what Henderson is dealing with; my initial thoughts are pulled muscles in his back that he aggravated in practice. It would be in poor judgment to scratch both Henderson and Glenn and with five weeks off to rehab, Glenn should be ready to go.

On the defensive side of the ball, Johnson and Williams are dealing with knee and groin injuries respectively, though could possibly play. I believe Johnson has a great shot to play due to taking a helmet to the knee during the Patriots game. Outside of pain, there should not be any major limitations to play. Williams is dealing with a groin injury that he appeared to play through. I can’t see Williams sitting this one out unless he really doesn’t feel right. He is the epitome of the blue collar attitude that is Buffalo.

Taylor on the other hand will depend on totally how he feels warming up. He suffered a patellar tendon contusion which is a bruise to the ligament/tendon connecting the kneecap to the lower leg. The biggest limitations will be pain. He has been able to participate in a limited fashion the past two days and is truly a game time decision. I could see McDermott giving him the start knowing that QB Nathan Peterman will be ready to go. My concern is that he takes another hard hit to the knee which may end his day prematurely.

Others to be mindful of is WR Kelvin Benjamin (knee), RB Travaris Cadet (concussion) and CB Tre’Davious White (concussion). Benjamin has not played since suffered a partially torn meniscus in the Chargers game on November 19th. This is a tight but realistic timeline for him to come back. As I mentioned before, he may be limited on a snap count or in certain packages, but should be able to perform especially after seeing him move in practice. If he is able to perform his routes with minimal to no pain, then he may as well play. Worst case scenario is that he re-injures the knee and they shut him down for the season.

Both Cadet and White suffered concussions in Sunday’s game but have since cleared the concussion protocol which indicates they had no recurrence of symptoms and cleared all 5 stages of the protocol. While there is always the risk to sustain another concussion after sustaining the first one, having these two play will certainly make the Bills overall better.

The Bills should win this one, moving their record to 7-6. December is make or break for these Bills; I pray they shock and surprise with the end of season results, but we will continue to take it week-to-week.

Continue to check back for the latest articles and injury updates. For game day reactions and updates, follow me on Twitter at @kyletrimble88. As always, thank you for reading and GO BILLS!!

Week 14 Injury Breakdown- Colts

Breaking down the latest injury report prior to the Colts game including updates on Kelvin Benjamin, Tyrod Taylor, and Tre’Davious White.

Not surprising, more news coming out of One Bills Drive after today’s press conference and practice. The Bills aren’t quite shutting it down for the season, but after that loss to the Patriots to leave them at 6-6 and 8th in the AFC, the playoffs are becoming less and less of a possibility. It is quite disappointing after that great 5-2 start, but this team had shades of 2011 all over it and at this point, the team is playing for pride and to hopefully build a stronger foundation for next year.

Breaking down the injury report, WR Jordan Matthews and DE Shaq Lawson have been placed on IR, ending their respective seasons. Not much is known at the moment regarding what is hampering Matthews besides a knee issue. I had suspected a recurrence of tendonitis that he was dealing with during training camp, but more may be released as time passes. Lawson injured his ankle during a goal line stand against the Patriots on Sunday and based on what I was able to see, it appeared to be a high ankle sprain. This is supported by the mechanism of injury and the fact that he is on IR.

Those not practicing today are: RB Travaris Cadet (concussion), TE Charles Clay (knee), G John Miller (ankle), QB Tyrod Taylor (knee), DE Eddie Yarbrough (chest), DT Kyle Williams (groin). There is no surprise with Cadet not practicing as he is still in concussion protocol. Miller is still not practicing due to an ankle injury that has sidelined him for the past several weeks and nothing is really known; he has been dealing with this since November 16th. He may also have suffered a high ankle sprain considering his timeline and add in the fact that he has not been able to participate in practice.

Yarbrough is not practicing secondary to what appears to be the same chest injury that he was dealing with last week. Looking back at film, he did not appear to be limited and was able to play through the entire game. This may be a pulled chest muscle that he continues to play through knowing that depth is thin at his position. Taylor is dealing with his patellar tendon contusion which was detailed in my previous article. Time will tell whether he will be ready for Sunday, otherwise QB Nathan Peterman may get the start. Finally, DT Kyle Williams is dealing with a groin injury. He was able to play the entire game and while there were some instances where he could have pulled his groin, he did not have to leave the game. The only time he was off the field was when certain defensive packages allowed him rest. I do not anticipate that he will miss next game.

Those limited in practice are: WR Kelvin Benjamin (knee), CB Tre’Davious White (concussion), CB Leonard Johnson (knee), RB Mike Tolbert (hamstring), and OT Cordy Glenn (foot/ankle). It is very promising to see that Benjamin is out and running on the field during practice today. Typically, in the general population these types of injuries do require a lengthier rehabilitation to return to full function. Benjamin is may be still dealing with some minor pain and swelling, but can at this point be expected to play through some discomfort. It helps that Benjamin has access to rehabilitation daily and expert medical advice. I expect him to be able to play Sunday but be on a possible snap count so as not to create further damage. It does help that the field conditions will be poor which in turn will reduce the likelihood of injury with inability for the feet to stick in the ground.

White returning to practice after the hit he took is quite amazing but every concussion is different in how they respond. As long as he does not have any recurrence of symptoms, he should be able to play Sunday. Johnson’s knee was of little concern as he took a helmet to the knee but he should be able return to play. Tolbert and Glenn continue dealing with their respective injuries which may allow them to return to play Sunday. However, I believe Tolbert is nearly out of the woods with his hamstring injury but Glenn will continue to be hampered with his issue as I still maintain he has chronic instability.

Those able to fully participate are OT Seantrel Henderson (back) and RB LeSean McCoy (knee). Henderson only participated in one offensive play and one special team play so its interesting that he has a back injury despite such little playing time. McCoy continues to be the engine that drives the offense and with the amount of abuse that his body goes through weekly, it is expected that he would have some type of week-to-week ailment. As he is a full participant, there should be no limitation.

Interesting to note, after FB Patrick DiMarco and TE Nick O’Leary were listed on the injury report last week with their respective ankle and back injuries. Despite O’Leary missing the Patriots game, they are not present which indicates that their issues must have been minor and should not limit them going into next week’s game against the Colts.

As the injury list gets longer along with the schedule getting shorter, this is expected at this time of the year. It is impressive that the Bills have not lost anyone significant to injury reserve which could have derailed their season. Unfortunately, poor play derailed this season and a chance to end the long suffering playoff drought. Ideally, depending on how these last 4 games play out, this should allow the season to end and everyone to get healthy to come back next year.

Hopefully the Bills get another win against the lowly Colts and continue have something to play for despite the disappointment that ends nearly every season in Buffalo. This is a very winnable game at New Era Field; they should be able to move to 5-2 and at least be respectable at home. These weather conditions are suitable to Buffalo football, the Bills should take advantage of the inclement weather and use the run game that’s worked for them so well in the past.

Continue to check back for the latest updates and articles regarding Bills injuries. Follow me on Twitter at @kyletrimble88 for the latest updates and breaking news. As always, thank you for reading and GO BILLS!

Charles Clay Clunky Knee

Reviewing Week 5 loss against the Bengals and impact of Charles Clay knee injury including long term outlook.

The Bills, well, the Bills lost. They lost a very winnable game by a score of 20-16 in Cincinnati. The offense never got going, the run game doesn’t look anything like it has the past 2 seasons, and this Bills team continues to make this fan base crazy. That’s the nice, politically correct way of saying that. Two years from now, this will be a game that won’t be marked as a trap game, the kind of game that is an expected win. However, we all have to “Trust the Process” and trust I will!

Sunday was one of those games that while the depth that has been lacking in past seasons was there, the talent and cohesiveness was not. The team continues to stay relatively healthy, not losing anyone to season ending injuries. Notable injuries to the Bills are CB Leonard Johnson who left with a hamstring injury in the first half and did not return. However, the focus of today’s article is TE Charles Clay’s left knee injury sustained after catching a pass and getting hit in the knee going out of bounds towards the end of the first quarter. This resulted in Clay ending his day early and getting carted off the field.

Anytime someone sees an elite player go down with a knee or leg injury, they automatically think ACL tear. Why do we think that? Because the ACL is the sexy injury that the media loves to talk about. Everyone knows its serious, everyone knows its season ending, and it’s all over the news constantly. As you begin to hyperventilate or start cursing the Bills, R-E-L-A-X. Clay did get injured, it didn’t look pretty, and the results aren’t great. If you care to continue reading, I will help you step back from the edge and explain what really happened.

Based on reports, Charles Clay sprained his MCL, tore his meniscus, and will be out for an extended time with surgery to fix the meniscus. Most people know that if the ACL is bad, then the MCL must be bad as well. It is but it isn’t. The knee is comprised of many different structures including but not limited to: bones of the knee: femur, tibia, patella; ligaments including: medial collateral ligament, anterior cruciate ligament, posterior cruciate ligament, and lateral collateral ligament; soft tissue includes cartilage and medial/lateral meniscus.

knee.jpg
Credit: webmd.com

The MCL runs on the inside portion of the knee connecting the femur to the tibia. The MCL allows for stabilization medially and along with the LCL, prevents the knee from going east/west and ensures that knee works as a hinge joint. When the MCL is sprained, the ligament is stretched and partially torn as with any other sprain. However, the MCL is more dynamic in that it connects into several muscles in the knee including the vastus medialis, sartorius, semimembranosus, semitendiosus, and gracillis. The MCL also attacks to the posteromedial portion of the medial meniscus. To simplify it, at various points, the MCL connects to parts of the quadriceps, hamstrings, adductor muscles, and part of the meniscus. Without these many connections, the knee would be far less stable and would not be able to change direction suddenly.

Despite a fantastic design by nature, design only allows for so much prevention. The MCL typically gets injured during sudden changes in movement such as cutting and pivoting. The MCL also becomes damaged during direct blows to the outside part of the knee during knee flexion, which is what occurred with Clay when a low tackle hit him out of bounds.

The MCL severity grades are broken down into 3 grades with the increasing grade indicate level of severity. Level 1 consists of some fibers torn with tenderness and no instability. There is some pain during application of force to the outside of the bent knee, but nothing else significant.

Grade 2 consists of increased pain and more noted swelling. There is moderate tenderness and laxity in the joint. Most of the pain is on the inside of the knee and patients typically poorly tolerate laxity testing to the MCL. There are varying degrees of a grade 2 sprain including 2- and 2+ depending on amount of damage.

Grade 3 is a complete rupture of the MCL, leading to instability along with extreme pain and swelling, resulting in difficulty with bending the knee. The knee also gives away during a valgus force which is when pressure is applied to the outside of the knee. Surgery is usually indicated as the ligament has been totally torn from the bone.

Credit: http://kingbrand.com/MCL-Injury-Information.php

Based on video of the play and difficulty with placing weight through the leg afterward, this indicates that he may have suffered a partial tear, possibly a Grade 2+. This is supported by the fact that he did not have surgery to repair the MCL itself.

To add insult to injury, Clay also tore his lateral meniscus. The meniscus acts as the shock absorber in the knee and helps with keeping the knee healthy during movement. Unfortunately, part of the lateral meniscus became torn during the hit. This likely occurred due to the direct blow along with the knee bent and planted on the ground, leading to twisting of the knee, resulting in a partial tear. Presentation of a partial tear involves pain, catching, and clicking during knee movement. While research has been proven that a nonsurgical approach can be just as effective as surgery to trim down the meniscus, this is the NFL and there is no wait and see approach. The procedure that Clay had today is called a meniscectomy which involved cutting out the frayed piece of meniscus and shaving down the area to smooth it over to ensure that more pieces do not fray off.

Reports indicate that Clay will be out at least a month, possibly indefinitely. I believe that he will be out closer to 6-8 weeks. The meniscus is something that could keep him out 2-3 weeks; the problem is the MCL. The body will need to heal and restore proper range of motion to the knee while regaining strength. There are therapeutic interventions that can encourage healing, but the body still has to do its job. Professionally, I would say place him on IR with designation to return. This gives him a guaranteed 8 weeks to heal up and return to full form. This would also allow the team to bring in another TE and not use up a valuable roster spot. This would place him on track for the Colts game in December. Considering the Bills have two games against Miami and one against New England after that, it would be an excellent time to come back healthy.

My final thoughts on Clay is that he has had several years of reported knee issues, of which I wrote about during the preseason. From observation during practice, I believe he had most of the issues on the left knee, of which he injured Sunday. However, this injury is independent from his previous issues. He was not at a higher risk for this injury as the result of the previous problems. If anything, this may help take care of the other issues by giving him time to rest.

The Bills are certainly hurting from this one. Clay has been a consistent producer and a favorite target of Tyrod Taylor. Clay should be back later this season, but whether his return will make a difference remains to be seen. I still believe that this season we have more depth than in previous years, but having depth just is not the same as the starters. That was evident in the secondary and linebackers on Sunday. Thankfully, the bye week could have not come at a better time. I still believe the Bills have a shot to stay competitive this season with how the rest of the AFC is playing this season. The Bills still control their destiny, Charles Clay injury will not define the season.

Continue to check back for further updates regarding new injuries and posts designed to educate my fellow Bills fans and keep you from the edge. Thank you and GO BILLS!!