It was expected that the Bills couldn’t stay healthy forever. NFL games are a brutal endeavor & not everyone can avoid injury. While the Bills are down a few players going into Sunday’s game, they still appear to be on track towards making the playoffs which means they could get timely reinforcements when the health improves. The injury report is pretty cut & dry this week but there are still details to discuss especially as we are rapidly approaching 2 games in 5 days. Below is the injury breakdown prior to the game & outlook for the short week.
S Siran Neal (concussion)
Neal suffered a concussion with 7:41 left in the 2nd quarter on a routine kickoff following the 2nd FG of the day by K Stephen Hauschka. He appeared to bullrush his assignment and hit his head in the process before getting up appearing to be dazed. In a twist of irony, one of his teammates patted him on the head after the play, not exactly the ideal thing to do after a possible concussion. Neal’s day ended early, getting ruled out & placed into the concussion protocol.
He was unable to practice all week & was observed watching practice from the sidelines which indicates that he is in Stage 2 of the protocol. He has already been ruled out & it is a guess when he will progress through the protocol to be cleared.
OT Ty Nsekhe (right ankle)
Nsekhe managed to avoid a severe ankle injury when Dolphins DE Avery Moss landed on the back of his foot during a routine run play midway through the 3rd quarter. I had originally stated that he suffered a fracture/dislocation & that his season would likely be done. I have the receipts to prove I am wrong. My buddy, Dr. Chao, aka @ProFootballDoc, also had thought the same thing but thankfully we are now looking at a week-to-week injury instead of season-ending IR. Below is a video detailing why he avoided a fibular fracture.
There were reports that Nsekhe was out at practice in a walking boot which appeared to rile up the masses in a good way thinking that the injury wasn’t as serious as it appeared to be. At the end of the day, he suffered a low ankle sprain which comes with it a still very real & arduous rehab timeline. The reason he was out in a walking boot was the fact that he didn’t have any restrictions in weight-bearing. In the rehab world, it’s encouraged to resume weight-bearing as tolerated unless specifically contraindicated in order to allow for the healing process to take place.
Yes, everyone has heard of PRICE (Protection, Rest, Ice, Compression, Elevation), but after that initial 24 hours of rest, exercise & mobility activities are encouraged for better outcomes. Multiple studies have shown that introducing exercise shortly after the injury reduces the time that one is out compared to immobilization with a 4-7 day reduction in the timeframe for return. Right now, that could be the difference between going to IR versus playing on Wild Card Weekend.
Allowing weight-bearing allows for joint approximation is vital for the healing process. This allows the muscles in the ankle and lower leg to cocontract & increase joint stability. This also allows the joint to begin to regain proprioception which is the perception of awareness of the body in space in relation to its surroundings. These are all fancy terms, but what does this mean? This means that just by weight-bearing, he is improving his strength and joint positioning with each step he takes. As the pain & swelling reduces, he will continue to perform active strengthening in the area along with balance exercises, increasing the difficulty until he is able to begin walking without the boot.
As he progresses to higher-level activities, jogging, running, football-specific drills will continue to increase until he is ready to resume playing. This process can take anywhere from 4-6 weeks for a Grade 2-3 sprain. As I previously mentioned in my article from Tuesday, Nsekhe is a big dude, all of 6’8” & 325 lbs. A human that big will require some extra time to fully recover from any lower-body injury.
While this is not a great injury down this tough stretch of games, having OT Cody Ford with experience helps until Nsekhe is able to come back. The hope is that he’s back in time for the playoffs, but he could realistically come back in time for the Patriots game on the 21st. We’ll see how he progresses, but it’s hopeful that the new training center allows for him to shave more time off to shore up the offensive line.
Final thoughts on Nsekhe, the team has been bringing in a multitude of offensive tackles to work out including former Bills Sam Young & Seantrel Henderson as possible options in case OT Ryan Bates can’t cut it as a backup or if Ford struggles.
SUITING UP SUNDAY
DE Jerry Hughes (groin)
Hughes continues to battle through a nagging groin injury suffered sometime earlier in the season which forced him to pop up on the injury report late last week. He was able to play in a season-high 53 snaps on defense. Considering that Hughes is a right defensive end, it’s possible that he is dealing with a left-sided groin strain. He lined up most of his snaps at his natural right side but did line up several times on the left, most likely due to the particular scheme.
Lining up on the right side means that his power is coming from his right leg driving around the corner. He appeared to not have any issues driving off the left side, but when the adrenaline is pumping, anyone can work through some pain. He was not ruled out or had any injury designation, always an excellent sign. Some may wonder why he was a DNP Wednesday & Thursday but practiced in full on Friday. This was due to veteran maintenance & to save him for Sunday. Hughes may have benefitted from sitting out the Dolphins game, but both he & the training staff felt he was ready to go.
This will be an injury that he continues to play through, unlikely practicing unless it’s a walkthrough practice in the several days between Sunday & Thursday, but barring any further injury should play Thursday as well. While Hughes has not had the stat-bursting season that was expected, he still continues to force teams to game plan for him & pressure the quarterback each and every snap.
S Jaquan Johnson (hand)
Johnson was a full participant this week despite a hand injury that popped up on the injury report Wednesday. Trying to identify a minor hand injury on film is quite difficult & it’s not clear when he suffered the injury. Johnson is a very physical player & there were many instances where he could have got his hand caught in a jersey, fell to the ground, or during tackling. Either way, he will be able to contribute to special teams & hopefully make an impact.
DT Jordan Phillips (toe)
Phillips showed up on the injury report Thursday with a toe injury. We don’t know which side, which toe, or when it happened. My guess is that this happened Thursday in practice & that it was an injury to the big toe. The big toe accounts for 50% of body weight during walking & without the toe, significant balance & walking issues arise. Injury to the other toes are rather minor & wouldn’t warrant reporting unless they were stepped on, making it a pain issue.
If this an injury to the big toe, the team can give him a stiff-soled shoe to take the pressure off the area during running and blocking. He also did practice in full on Friday which may show that this wasn’t all that serious & that he missed some drills Thursday, but didn’t have issues Friday. If he has issues in the game Sunday, we will see them.
TE Tommy Sweeney
DT Vincent Taylor
WR Duke Williams
OT Ty Nsekhe
S Siran Neal
RB TJ Yeldon
OG Ike Boettger
The Bills host the 3-7 Broncos who despite their abysmal record, carry an elite defense into the game with several pieces on offense, making them still a very dangerous team to play even at home. Like many other games this season, this is a winnable game & the Bills have to control the run game like they did last week. To move to 8-3 would be huge as the next stretch of games against the Cowboys, Ravens, Steelers, & Patriots are no easy task. Continuing to stack wins will be vital in the march towards the playoffs.
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