2020 Week 12 Bills Injury Review- Chargers

How did Josh Allen avoid serious injury?

Another week, another stressful win. Consistently winning is something this generation of Bills fans has to get used to. It’s a great feeling, but it would be nice to just absolutely dominate a team from time to time. At the end of the day, I’ll take the win because that shows up in the box score and string together enough wins and that qualifies for the postseason. I am aware the Bills are still not a finished product with glaring mistakes and continued issues, but if they can play like this and be 8-3 with the ability to fine-tune things and peak at the right time, then that’s all that matters. But this isn’t a blog that looks at the play of the Bills, it looks at the injuries of the Bills. Fortunately, there were not many in-game injuries and below are the ones noted in the game.

QB Josh Allen (right knee/ankle)

Josh Allen may very well be Gumby. The way his right leg twisted down under Joey Bosa, affecting his right ankle and knee wasn’t pretty. He walked off the field, misses one play, and then returns to finish out the half before returning is impressive.

Looking at everything after the game and his body of work, it actually looks as though he injured his knee versus his ankle based on the picture below. 

I’m going to walk through the thought process with this injury so you can understand why it’s a knee and not ankle, though it’s quite possible he suffered an ankle injury in addition to the knee injury. During the moment of play, I had originally thought a high ankle sprain based on how the ankle twisted but was not convinced that it was with how quickly he returned and played afterward.

Looking at the play initially, Bosa wraps up Allen and attempts to twist him down. Allen’s ankle gets caught up under Bosa and is pushed into eversion or twisting outward. Allen continues to be dragged down to the turf with his knee taking the brunt of the force as his knee continues to bend into flexion and into a valgus position. By this point, the ankle is pinned under Bosa as he pulls Allen up towards his head to ensure that he is down. The play finishes and Allen is in obvious pain. 

The mechanism for a high ankle sprain was clearly there with the foot in eversion and dorsiflexion as seen below. The mechanism for an MCL sprain was there with the knee bent and in valgus position. Two things really played into Allen’s favor. The fact that Bosa pulled him up over him, relieving pressure on the pinned ankle and the fact that Allen has fairly decent hip internal rotation, allowing the leg to turn out. Had Allen’s hip not continued to turn out to reduce pressure on the knee/ankle, or Bosa didn’t pull him backwards, things could have been much worse. 

Forces showing a high ankle injury
Forces showing an MCL injury
Credit: physioadvisor.com.au

It also helped that Allen was pulled down relatively slowly when it comes to tackling, things weren’t abruptly forced. Another benefit was that Chargers defensive tackle Jerry Tillery bailed out of hitting Allen at the last second, which could have potentially added more force to the stressed knee/ankle and causing further damage. 

Allen played the second half with a hinged brace on the right knee under his pants and socks and was surprisingly effective. Had he suffered a high ankle, he could have still performed and run alright with a tape job, but the swelling would have been set in as the game progressed. I’m not certain he would have been able to run as well as he did if the ankle took the brunt of the injury.

The MCL injury makes more sense because the knee was bent into flexion and stressed into a valgus position which allowed the tissues to stretch and partially tear, resulting in a sprain, but not with the force necessary to really sustain a significant injury.

It would not surprise me and it should not surprise you if Josh Allen shows up on the injury report Wednesday with a knee and ankle designation or one or the other. I personally believe that it will be more of a knee designation based on the bracing observed after the game.

It appears to be a mild MCL sprain which can take 1-3 weeks to fully heal. I’d expect him to deal with some swelling and pain in the area, but since the knee is a hinge joint, he can continue to run but may have difficulty in running to his left due to needing to push off the right side.

I’d also expect him to wear the brace for a little while to protect the knee in order to ensure that it heals properly. This might be the milder side of an MCL sprain which heals well to begin with. He should play through this and hopefully avoid further injury in order to wrap up the division and get him much needed rest. 

CB Levi Wallace (right leg)

I’m not sure what to make of this injury. This occurred during the roughing the passer call on Justin Herbert with 11:58 left in the 4th quarter covering Mike Williams. He kept with Williams going out of bounds and he jumped as they both went out of bounds in the end zone. He got up and moments later was down on his left knee.

He required attention from the training staff briefly before missing one play and returning. As he was walking off, he appeared to be shaking out his right leg. There is a thought that he injured the ankle but I’m not certain of that. This will be a wait and see approach if he ends up on the injury report. 

Other injury thoughts:

G Cody Ford (meniscus) & WR John Brown (right high ankle sprain)

Ford ended up on injured reserve with a torn meniscus following a knee injury Wednesday at practice. His recovery timeline is 3-4 months which fits in line with a meniscal repair. This will allow him to have the best outcomes possible with his knee injury and maximize his career to prevent possible problems and chronic issues such as arthritis.

Brown also earned a stay on IR due to a now confirmed right high ankle sprain sustained in the Week 10 Cardinals game. I had originally thought he suffered more of a medial eversion sprain, but according to Adam Schefter, it is a high ankle sprain. 

By the time he is eligible to return in Week 15, he will have had nearly a month to recover. By that time, it will only be a guess if he’s needed or if they wish to keep him on IR until the playoffs. 

LB Matt Milano (left pectoral)

LB Tyrel Dodson (hamstring)

CB Cam Lewis (left wrist)  

WR Isaiah Hodgins (left shoulder)

All are eligible to return from IR and have been activated for their 21-day practice window except Milano as of today. There is a strong chance that Milano gets activated for Wednesday’s practice. There are currently 3 roster spots available for which I believe Milano, Dodson, and Lewis will return. 

Milano will be 8 weeks out from his pectoral injury against the Raiders with 4 weeks since playing football, Dodson is 6 weeks out from the hamstring injury against the Chiefs, and Lewis is also 6 weeks out from his possible wrist fracture against the Chiefs. For their respective injuries, that is adequate time for those injuries to heal, but it is not certain that each are 100%.

There is a chance that Hodgins gets activated but he was put on IR with a shoulder injury sustained in training camp and has been on there ever since. It’s possible that they want to see him in-game action or at least get him on the practice field to see what they have in him. In the coming days, we should see several roster changes. I will also not be surprised to see a few names added to the injury report for various ailments and/or chronic issues.

Overall, the Bills are 8-3 as they head into a Monday Night Football against the 49ers as they set up shop in Arizona as a temporary home due to COVID. The big storylines will be the Bills warding off the demons of the Hail Murray in Arizona, the return of a variety of players from IR on both teams, and whether Jimmy Garoppolo and George Kittle will be activated for Sunday. Right now, it doesn’t appear to be the case based on their respective injuries, but with the 49ers sitting at 5-6, they still have a shot at the playoffs and the return of those two along with other players could allow them to make a push. We’ll see what happens in the coming days. Regardless of what the 49ers look like, the Bills are still relatively healthy and ready to move on to the next week.

Top Photo Credit: Larrybrownsports.com

2020 Week 12 Bills Injury Preview- Chargers

What’s going on with John Brown? How serious is Cody Ford’s knee injury? Will Tommy Sweeney be alright?

Welcome back everyone! I hope everyone had a great Thanksgiving and got a lot done on the bye week. The Bills benefited greatly from the bye, significantly reducing the number of names on the injury report. In turn, a shorter injury report alters decisions on who needs to play and who needs to rest. Below are the injuries and updates. 

OUT

WR John Brown (Right ankle)

Brown continues to be limited with a right ankle injury sustained in the Week 10 matchup against the Cardinals. This initially appeared to be a medial eversion ankle sprain. He did not practice Tuesday or Wednesday, was projected to not practice Thursday due to Thanksgiving and did not practice Friday. Ultimately he was ruled out before Friday’s practice. 

On Locked on Bills, I was more bullish on Brown playing coming off the bye due to him frequently taking rest days early in the week. I also referenced this Instagram post below that he is making progress with his ankle injury.

On top of that, he did have the week off which could have improved the ability to heal. If this is a medial eversion ankle sprain, Cardinals running back Kenyan Drake had a similar injury which caused him to miss 2 games but he came back to play effectively. Brown could have hypothetically come back following the week off and continue to build off his recent progress. 

I had noted in the postgame review from the Cardinals game that he could miss 1-2 games based on the injury and that he now appears to be trending towards that. I will admit that seeing the Instagram post did give me some false hope with the idea that he could suit up faster, but such is the power of social media.

However, if this ankle is worse than originally thought and it could be or it presents more like a high ankle, then he could be out longer. He could potentially be out next week against the 49ers and questionable against the Steelers. This has been a miserable season for John Brown but the hopes is that he can get right when it really counts.

Update: Brown has since been placed on IR.

G Cody Ford (right ankle/knee)

Ford continued to work back from his latest injury suffered against the Seahawks in Week 9. At the time, it appeared as though he suffered a low inversion ankle sprain when he was clipped from behind by Zack Moss on the scoring play by Tyler Kroft

However, it was reported Friday that Ford would be out for the season with a torn meniscus. It was confirmed that he suffered the injury in practice but it did not specify which side he injured. Ian Rapoport of NFL Network stated that he would be out 3-4 months with a full recovery. I agree with that timeline and outlook.

I have detailed out meniscus injuries in the past which you can read here. Looking at Ford’s previous knee injury from against the Chiefs, I have not found any correlation that shows that previous MCL injuries increase the risk for meniscal tears. A previous MCL injury could increase knee laxity but not associated with meniscal injuries. There is research to support knee laxity contributing to future meniscus tears when associated with previous ACL injuries, but that is more due to the rotational component of the knee that the ACL helps stabilize during movement.

Credit: Physio-pedia.com

This discussion is all based on the idea if he tore the meniscus in the right knee which has not been confirmed. If he suffered this on the left side, then this is a moot point. But I feel it is important to note the possibilities Looking back at his college injury history, there is nothing to suggest that he had previous meniscal issues either. This repair decision is a far better option than trimming or removing pieces of the meniscus because that would contribute to further knee degeneration and possibly a shorter career. If you want to remember what the effects of meniscectomies are, recall former Bills tight end Charles Clay.

Update: Ford has since been placed on IR.

ACTIVE

DE Mario Addison (knee/veteran rest)

Considering Addison is a veteran on the wrong side of 30, it’s not surprising that he shows up on the injury report with a vet rest day. He is also listed as a knee injury which hasn’t been a known issue since prior to Week 4 when he injured it in practice. 

He played in 67% of snaps which was tied with Jerry Hughes for the team lead for defensive end snaps. This may be more of a chronic issue though it’s not known which side he is dealing with. Unless more details are known, this will continue to be monitored with overall little concern. 

DE AJ Epenesa (Concussion)

Epenesa suffered his first documented concussion in Week 10, quickly getting ruled out midway through the game. He quickly entered the concussion protocol and working through the system until getting cleared following Wednesday’s practice. 

His recovery fits the timeline seen for a concussion and there is hope he avoids further injury for the remainder of the season. 

RB Taiwan Jones (Hamstring)

Jones appears ready to return following a hamstring strain suffered against the Patriots on a kickoff in the 3rd Quarter. He has missed two games plus the bye to recover which has fit the timelines we see for hamstring strains. 

He has had a multitude of injuries over his career and to see him deal with another one isn’t really all that concerning. I had thought that Brandon Beane wanted to get whatever was left in the tank and that may be the case. As he practiced in full, he will be expected to return and contribute on special teams. 

TE Dawson Knox (Hamstring)

Knox was a surprise showing up on the injury report in his first game back from COVID. He played in 70% of the snaps but was generally ineffective. This hamstring injury was not noticed on film and the fact that he’s practicing in full after a week off tells me that it was minor in the first place. Hopefully Knox can put it together in the next few games to show he’s worth keeping around next season. 

CB Josh Norman (Illness)

Honestly not sure why Norman is on the injury report. He’s been cleared off the COVID reserve list and he’s practicing in full. Things like this will have me digging into the intricacies of the injury reporting in the offseason to understand designations like this. 

TE Lee Smith (Illness)

Smith was a DNP Friday due to illness which is why he was on the injury report but that doesn’t appear to be affecting his availability for Sunday. As he has been used sparingly this year, this may not matter but for posterity, I must mention. 

DE Jerry Hughes (Back)

Hughes showed up on the injury report with a back ailment that limited him Wednesday but was projected as full on Thursday and practiced in full on Friday. I’m not certain regarding the specifics as to what he was dealing with but until he has multiple DNP’s or is ruled out prematurely due to an injury, I have faith he will play and continue to produce.

Other Thoughts

QB Josh Allen (Left shoulder) 

Allen is finally off the injury report following 6 weeks of full participation from the original shoulder injury. I can say for a fact we have seen more severe injuries get minimal to no time on the injury report. Case in point: Jerry Hughes wrist/groin, Jon Feliciano left shoulder rotator cuff tear, Zay Jones/Taron Johnson torn labrum; those are just off the top of my head. 

Either Josh Allen had fully recovered from his shoulder ailment or it is finally at a point where it is no longer an issue. This is something I still continue to watch in his runs, throws, and what he wears on the shoulder. At this point in the season, if these guys can produce and win games, then that’s all the matters because everyone is hurt in the league. It’s a harsh reality, but it is what it is for those that play in the NFL.

TE Tommy Sweeney (Myocarditis)

Tommy Sweeney never had a chance in 2020. He started off on the PUP list due to a possible stress fracture, spending the entire season on there before getting exposed to and contracting COVID.

Once cleared, he continued to work out but may have been having some issues with his endurance which likely led to a consultation with a cardiologist. Regrettably, he was diagnosed with myocarditis, the first known NFL player afflicted with this condition as the result of COVID. 

Myocarditis is a condition in where the heart muscle itself becomes inflamed, this can also affect the electrical system of the heart as well. This can be the result of a virus, fungi, or bacteria among other things. The problem with inflammation of the heart muscle compared to skeletal muscle is that the heart muscle does not have the regenerative properties that regular muscle has. There is some research that shows some recovery can happen, but at a very slow rate. This is why heart attacks are so tough to come back from, the heart muscle is damaged and does not heal as effectively as skeletal muscle.

So is there damage to Sweeney’s heart? I’m not certain of that and I hope not. But he possibly had been having issues with working out after getting COVID which led to the consultation. The hope is that they caught it early enough and prevented any damage from occurring. Research shows that he will have to stop activities from 3-6 months to allow things to recover fully.

If he were to work through this or had a severe case, he could have suffered heart damage, irregular heart beats, or heart attack/strokes. It is a terrible situation for Sweeney but at least he can access some of the best medical care available to ensure that he can return for 2021. It is far too early to tell how this will affect him but any delay in training could impact him for next season. This will be something to continue to monitor. 

Inactives:

QB Jake Fromm

WR John Brown* has been placed on IR

TE Lee Smith

DT Harrison Phillips

RB T.J. Yeldon

G Cody Ford* has been placed on IR

There are currently 52 players on the active roster. Transactions may occur later today which can affect the number of inactives.

Looking at the other side, the Chargers are dealing with their own injuries including the potential return of running back Austin Eckler from a Week 4 hamstring injury. This could drastically change up their running game which has been a point of weakness for the Bills in defending the run. The Chargers will already be without Casey Heyward, Melvin Ingram, and Uchenna Nwosu which the Bills could exploit offensively. Despite their record, they are still a talented team and rookie quarterback Justin Herbert had shown he was worth the first round draft pick earlier this year. 

Biased view but I believe the Bills have what it takes to win simply due to overall talent and health. The opportunity to stack wins before playing the Steelers will only help in case COVID hits again or an untimely injury occurs, potentially costing the team a win. A reminder: this is the last regular season game at 1:00 pm on Sunday as the team either plays in prime time or on Saturday the remainder of the season. Simply a result of a successful football team. We’re in the final stretch of the season and I’m looking forward to a potentially deep playoff run to start off 2021.

Top Photo Credit: Bills Wire USA Today

Week 2 Bills Injury Review- Chargers

Breaking down the latest injuries following the Week 2 loss to the Los Angeles Chargers.

Different week, same result. Another loss to the Chargers sends the Buffalo Bills to 0-2 on the season and more questions remain. Fortunately, the Bills began to look like a real NFL team in the 2nd half, holding the Chargers to just 3 points while scoring 14. Regrettably, the hole they dug in the first half down 28-6 was just too much to overcome. In addition to the poor outcome, several players found their way to the injury report with varying degrees of injury. Today’s post will assess the injuries sustained in the game and what this means going forward.

First point I would like to address before the injuries is the sudden retirement of CB Vontae Davis. As everyone by now knows, Davis “retired” at halftime and left the stadium, leaving the Bills a man down and questioning his motives. He has since stated that he felt he could no longer play up to his standard and knew when it was time to be done. He has his reasons for doing that and well, it’s his decision. Personally, this is not something I would do nor do I believe it is the right decision to make in the middle of a game. However, he made his decision, he’s sticking to it, and I believe that the coaching staff, the team, and fans all want players who want to play for this team to be there 100%. I wish Vontae the best in his retirement and the Bills can move forward without him.

First injury up is CB Phillip Gaines who suffered a dislocated elbow late in the 1st quarter. He suffered the dislocation during a tackle and came up having difficulty moving his right arm. He was observed requiring support to the forearm area walking off to the medical tent to have further assessment. Upon video review, he dislocated his elbow when he attempted to tackle RB Melvin Gordon. Quick anatomy review, the elbow is made up of 3 bones: the ulna, radius, and humerus. The ulna is the bony portion of the elbow that articulates with the humerus and fits rather snugly in against the humerus acting as a hinge joint. The radius is a lesser bone of the elbow but provides forearm support and motion to the wrist during rotation.

As he began wrapping the ankles up, his elbow hit the ground while Gordon continued to run forward, creating a rotational force which caused the ulna to dislodge either posteriorly or medially from the humerus and appeared to stay dislocated. This was why the training staff needed to support the area with his inability to bend the elbow. At some point later, they were able to successfully reduce the elbow and wrap it for protection and swelling management. The picture below describes the types of elbow dislocations including the posterior and medial dislocations mentioned above.

Elbow dislocation.jpg
Credit: www.orthopaedicsone.com

While this does sound rather gruesome, it is probably one of the best joints to dislocate for quick recovery as once the joint is reduced, it can regain normal function due to the makeup of the joint being as stable as it is compared to a shoulder or ankle which has much more mobility. There is no word yet on whether there was other damage that occurred but Gaines return to the lineup seems relatively hopeful. These types of injuries require 1-3 weeks to rest and recover along with rehab to increase motion and maintain swelling. He may be ready/forced to play against the Vikings unless the Bills make roster moves to address the depth with the loss of CB Vontae Davis. It does help that CB Taron Johnson should be back next week in order to fill the gaps.

Next up is RB Taiwan Jones who suffered a very hard hit to his forehead on a play whistled dead in the end zone off of a muffed punt midway through the 3rd quarter. During the recovery, Jones lost his helmet and while attempting to keep the play alive, got struck by a Chargers defender, drawing what looked to be a gash on his head, dropping him to the ground. When he got up, there was visible blood on his head wrap and he appeared to be in pain. He was taken back to the locker room for a concussion evaluation which later reports indicated that he did not suffer a concussion. Reports also mentioned that he had a CT scan of the head to assess for skull fractures. Thankfully, it appears that he only suffered a rather large gash on his head which required stitches to close up. Depending on how the wound is healing, it may be possible that he can play next week but more likely he would miss no more than a week so that he may let the skin fully heal. Brutal injury, but positive outcome.

Finally, RB LeSean McCoy suffered what was initially reported left broken ribs late in the 3rd quarter due to C Ryan Groy falling on top of McCoy after he had been tackled. The veteran back appeared to leave the game and return only to leave again later and ruled questionable with a rib injury. Reports came out that he suffered broken cartilage in the ribs which can be more difficult to manage than a single broken rib. The chest is made up of ribs that act as a cage around the vital organs such as heart and lungs and provide structural support for the abdominal wall and upper extremities. Connecting these ribs together is cartilage, a firm but pliable tissue that allows the rib cage to move with breathing motions and adapt to movement. This is the same type of cartilage that makes up your ears and nose. In the picture below, the blue tissue is the rib cartilage that McCoy fractured on the left side near the lower portion that connect the false ribs to the sternum.

Anterior-View-with-description_1.jpg
Credit: acuteinnovations.com

Unfortunately for McCoy, rib cartilage breaks are more difficult to manage as this tissue helps attach the ribs together and to the sternum or breastbone. So instead of one isolated rib, the pain can be all over the injured area, leading to greater deficits. As with most other tissues in the body, the cartilage will heal and pain will be reduced. Rib cartilage takes between 3-4 months to heal completely as it does not have a good blood supply which means it’s slower to heal. McCoy does not have this type of time frame to work with considering the NFL season. However, with proper bracing and pain management, he can play through this injury. However, all upcoming defenses are now aware of this and may try to target that area to knock him out of games quicker. He may benefit from a week off to get more rest so that he can play with greater effectiveness in future games.

Overall, the Bills did not suffer a lot of injuries, but the ones that did occur were rather moderate. All 3 players could come back to play next week if need be, but may benefit from at least 1 week’s rest in order to heal more effectively. As always, it comes down to whether the training staff, ownership, and the player have to agree that they are able to play.

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

Week 2 Bills Injury Preview- Chargers

Read the latest injuries prior to the home opener against the LA Chargers!

Football is back in Orchard Park for another season which means today is the home opener with the Bills looking to regroup after a performance against Baltimore that led Bills fans questioning many things. Last week’s game left much to be desired in terms of quality and being at home where the Bills went 6-2 last year should change things. Today’s article will review the injuries going into the game and how this will impact personnel decisions.

Roster moves made since last article include the releasing of DT Adolphus Washington and WR Jeremy Kerley for DE Nate Orchard and DT Robert Thomas respectively. These moves are surprising as both players released are veterans and have demonstrated an ability to play their respective sides of the ball. Washington throughout his career has been fairly healthy and has been available. Kerley was by far the most experienced receiver on the field and demonstrated the ability to be consistent considering the question marks at QB. These moves were made to improve depth especially with the loss of DE Shaq Lawson and improve the rotational depth at DT. The Bills move forward with new depth in the front 4 established with hopes to better control the scoreboard.

Those already ruled out for the game include DE Shaq Lawson (hamstring) and CB Taron Johnson (shoulder). Both injuries occurred last week with Lawson in the 4th quarter and Johnson in the 2nd. Lawson has a garden variety right hamstring strain that is best to let rest as to further not injure it. Johnson appeared to have a right shoulder stinger and may not be ready for contact, similar to what QB AJ McCarron suffered during the preseason. There’s always the possibility there is something else going on such as an AC joint sprain, but he was moving it freely walking off the field and did not require any support to the shoulder indicating instability. Both could be available next week based on their recovery.

Those questionable are WR Ray-Ray McCloud (knee). The rookie wideout missed the season opener with a left knee injury suffered in the final preseason game against the Bears on a punt return. Video was limited and appeared that he suffered some type of minor sprain based on the hit to the outside of the knee. As it has been 2 weeks and change, he may be healthy enough to suit up today. With the loss of WR Jeremy Kerley, the tea leaves point to him playing, though he has the final say on if he feels he’s ready.

Other injuries to consider include DT Kyle Williams (knee) and DE Trent Murphy (groin). Both have avoided the injury report with exception of Williams who requires veteran rest days. Williams, the heart and soul of the front 4, appears to be nearly full health after the right knee sprain in the preseason and doesn’t appear to be worth mentioning moving forward. Murphy played last week on a snap count and was set to increase his reps as a result but will be forced into greater service with the absence of Lawson. He will still be limited only due to not being in game shape.

Overall, the Bills are still healthy, major injury to key players remain limited, and as a fan, I’m expecting a better Bills team to show up today. I’m looking forward to sitting back and watching a much more competitive game with what I hope will be a more favorable outcome today.

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

Bills Injury Breakdown- Dolphins II

Assessing the latest Bills injury report and impact on the Dolphins game and hopefully beyond.

Week 17 is here! The first meaningful Week 17 game in 13 years is upon the Bills with a chance to end the long suffering drought. As everyone knows by now, the Bills must win their game and benefit from a Ravens loss or Chargers and Titans losses. As in any sport, all you have to do is qualify for the post season and anything can happen. Win or lose, the fact that the Bills are in the conversation and contention until the end demonstrates that talent does exist on the roster, it just needs to be harnessed to its maximum potential.

However, maximizing potential also relies on maintaining player health. Browsing Twitter recently, I found this gem of a tweet from @Jason_OTC which really encapsulates how the Bills have been able to stay in contention. The link for the tweet is here, but what it states is the top 10 NFL teams that have had the most salary cap money affected by injury. Out of the top 10, only the Patriots and Seahawks are playoff eligible teams. These are teams that have established coaches and players in their system that can absorb injuries and continue to move forward.

The one team that isn’t on there that I’m sure has been on in past seasons? The one and only Buffalo Bills! Keeping a healthy roster has been key to the team’s success this year and is clearly evident by the previous list; you can’t win in the NFL if you don’t have a healthy roster or exceptional depth. Making this point does allow an easy transition towards today’s article breaking down the injury report and impact for the Week 17 match up against the Miami Dolphins.

First up is players ruled out for Sunday which only consists of CB Shareece Wright out with a concussion. It is unknown when Wright sustained his concussion and when symptoms began to develop. Thankfully, he is a depth player and while depth is important, this is not a significant blow to the roster.

Those questionable for Sunday include C Ryan Groy (illness) and WR Deonte Thompson (shoulder/back). Flu season is in full effect and that’s most likely what Groy is dealing with, no secret there. As for Thompson, he sustained a back injury during Sunday’s game early in the 2nd quarter. It appeared he took a hard shot to the back but was able to return. To add to it, he suffered a shoulder injury in practice on Thursday, unfortunately, not much is known about how he injured it. Depending on severity of the shoulder injury, which appears to be worse than the back injury will dictate whether he suits up Sunday.

Those dealing with injury but expected to play include WR Kelvin Benjamin (knee), TE Charles Clay (knee), DT Kyle Williams (groin), and CB E.J. Gaines (knee). Benjamin and Clay continue to deal with their respective knee injuries which hasn’t greatly reduced their ability to produce, but does limit them somewhat. It would take a broken bone or significant ligament damage to prevent Kyle Williams from suiting up for this game. Even with a major diagnosis such as that, he would still possibly try to play; that man has and will continue to give 100%.

Finally, Gaines missed last week with what I believed to be a Grade 1 MCL sprain to his left knee during the previous Dolphins game. As mentioned on The Rockpile Report this week, it was theorized that Gaines was held out from the Patriots game as their was little chance to win the game and he would benefit from an additional week of rehab to be ready for this game. I support this theory as fact as medically, it makes sense. I would not expect Gaines to be limited in any fashion during his play Sunday, the only limiting factor is his hard hitting style of play. As Shareece Wright is out, it is vitally important that Gaines remains healthy. There is a rather large difference in the defensive performance when Gaines is healthy and when he is not; the Bills need every starter available.

For the past 10 years as a Bills fan, I have waited for this moment, this moment to be able to watch the Bills in the post season. This is far from guaranteed as I type this while drinking my coffee, but the possibility is exciting. I remain cautiously optimistic, but still hopeful that this year the drought may end, it has to end at some point, why not now? After tomorrows game, the narrative of this Bills season will be fully shaped and be remembered for finally entering the playoffs in the 21st century or another missed opportunity. Only time will tell.

Continue to check back for the latest articles and updates following the games. Follow me on Twitter @kyletrimble88 for the latest game time updates and injury assessments. As always, thank you for reading and GO BILLS!!!

Kelvin Benjamin’s Meniscus Tear

Detailing Kelvin Benjamin’s knee injury, causes and types of meniscus tears, and expectations for the rest of the season.

Big news coming out of One Bills Drive today! It has been reported that WR Kelvin Benjamin suffered a meniscus tear during the 1st quarter of the disastrous Chargers game last week and will be out multiple weeks per reports. Benjamin was unable to return following the hit and had already had ligament damage ruled out via MRI. This is another blow to the WR corps that has been inconsistent this season due to the inability of Tyrod Taylor to move the ball effectively, opting for check-down passes to his RB’s. Today’s post will analyze Benjamin why suffered a meniscus tear, types of meniscus tears, and expectations for the rest of the season.

The meniscus lies over the tibia and acts as a shock absorber between the tibia and femur. It is made up two wedge shaped areas to assist in deepening the area that the femur articulates with the tibia. During meniscus tears, a rotational force is applied to the area while the knee is bent and causes a shearing motion, causing a portion of the meniscus to tear.

Types_of_meniscal_tears.jpg
Credit: physio-pedia.com

There are various types of tears which include but are not limited to: complete or partial, horizontal or vertical, longitudinal or transverse. Acute tears are more likely to present as longitudinal/bucket handle and radial tears. It is very hard to determine the type of meniscal tear that occurred, but may be a longitudinal/bucket handle tear upon video review. The knee was hit from the front and partially to the outside, causing hyperextension to his knee. As mentioned above, a rotational force or bent knee is far more likely to cause the tear. In Kelvin Benjamin’s case, a hyperextended knee caused the tear, but is usually less likely.

Symptoms of a meniscal tear typically consist of pain, tenderness, and swelling, locking or clicking during knee movement, and initially difficulty in placing weight through the knee. Meniscal tears are typically seen in conjunction with MCL sprains/tears and ACL tears due to the rotational forces through the knee during impact. Thankfully, Benjamin’s injury was isolated to only the meniscus and did not affect other structures.

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Credit: physio-pedia.com

The type of tear can affect healing rates: longitudinal tears heal better than radial; simple tears heal better than complex; traumatic and acute tears heal better than degenerative. Based on location and length of tear will determine management. The meniscus has several “zones of vascularity” which include: red-red zone, red-white zone, and white-white zone. The red-red zone has the highest blood supply and lie on the outermost portion of the meniscus. The red-white zone is the area that connects the red-red and white-white zone and contains some blood supply. The white-white zone has a poor blood supply and demonstrate the poorest area for healing. If the tear is small, conservative management or a meniscectomy may be performed to remove to remove the offending piece. If the tear is larger, then a suture repair of the meniscus is warranted and an extended rehab is required. As Benjamin is slated to miss weeks, this appears to be a minor tear and could come back this season.

I’m sure most people’s thoughts are why WR Zay Jones did not sustain the same injury that Benjamin did? Why Benjamin tore a portion of his meniscus and not WR Zay Jones against the Jets game is certainly confusing. My thought is that Jones got tripped , attempted to regain his footing, and merely fell; Benjamin got hit while his foot was planted causing more of a shearing motion, causing the tear. Whether Benjamin has surgery or not, he will be out several weeks. How long Benjamin is out is unknown at this time, but I foresee him missing most likely a month. Could he come back sooner such as 2-3 weeks? Possibly but highly unlikely pending the location of the tear. He could attempt to rehab without surgery which does show good results compared to surgical intervention but this is the NFL and time is a premium. If he were to be out a month, he could return by the 1st Dolphins or 2nd Patriots game if there is still playoff hope if his recovery went incredibly well.

Finally, Benjamin did suffer a knee injury earlier this season with the Panthers but I do not believe that he was traded to the Bills with a torn meniscus. His play would have been greatly affected and team doctor’s would have caught that. Add in the fact that the knee he hurt this season was on the other side and that was his surgically repaired ACL. There is also delays in reporting of the injury due to the fact that additional imaging is sometimes required along with a clinical evaluation and testing once swelling has reduced. Most likely, the team was waiting to see if the knee would resolve on its own or whether anything would present itself after several day.

The approach should be to rehab him with the hopes that the Bills are still in the hunt. If they fall out of contention, shut him down for the year. Even with the best rehab and doctors, his body still needs to heal and return to playing form. While QB Tyrod Taylor has not built up the rapport that he has with other receivers, it is still a starting caliber receiver that is not able to contribute.

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

Week 11 Recap- Chargers

Assessing Kelvin Benjamin’s knee injury and other injuries following the Bills horrendous loss to the Chargers.

There are the Buffalo Bills we know and love! As Harry Dunne would say, Just when I thought you couldn’t possibly be any dumber, you go and do something like this… and totally redeem yourself! Similar to the quote, we all thought the Bills couldn’t get any worse, they go and turn in Sunday’s performance against the Los Angeles Chargers with a loss of 54-24. Where is the team that started 5-2? Now they are 5-5, losing ground in the playoff race, losing respect, and embarrassing themselves. To add to it, several key players went out with injury and made for an incredibly long day.

First man up, WR Kelvin Benjamin left early in the 1st quarter with a knee injury after a 20 yard catch. Upon replay, Benjamin got hit at the knee with the knee hyperextending while his foot was planted, similar to the Zay Jones injury. Benjamin had to be assisted off the field to the medical tent. After examination, he had difficulty placing weight through his leg and had to be carted off to be done for the day. As there are reports that he escaped serious injury, this does not mean he will play immediately next week. He may have hyperextended his knee as the video shows and may have sustained a bone bruise.

As outlined in my contusion article, there are several types of bone bruises. Bone bruises are actually a type of fracture that is less severe than a true bone fracture that we all think of. Keeping it brief, there are 3 types of bone bruises: Sub-periosteal hematoma, inter-osseous bruising, and sub-chondral lesion.

Sub-periosteal hematoma occurs when a direct high force trauma occurs and blood forms under the periosteum, which is a membrane that covers the outside of the bone. Inter-osseous bruising occurs when the bone marrow of the bone becomes damaged, specifically the blood supply. This occurs as the result of a repetitive high compressive forces on the bone, such as excessive running or jumping. These are seen more common in the knees and ankles.

Sub-chondral lesions occur when the cartilage layer of the bone becomes damaged. This area is found at the end of the bone and is the part that articulates with another bone. An extreme crushing force or rotational/shearing force may also cause this, commonly seen in injuries such as ACL tears. ACL tears typically not isolated, but MCL damage, meniscus damage, and even a sub-chondral lesion due to the forces that occur on the joint during the injury also occur.

At this point, if there is a bone bruise, further imaging is required which has already involved X-ray to rule out fracture and MRI. Imaging supported today that there was no ligament damage which would most likely end his season. If I had to speculate the type, I would suspect sub-periosteal hematoma based on the mechanism of injury and inability to play through it.

Bone bruises are tricky because depending on extent of injury, he could be out for 2-3 weeks or be out for the year in the case of Sam Bradford of the Vikings. I could easily see Benjamin out for at least the next game if not the next two with the possibility to come back against the Colts if the diagnosis is correct.

Next up is S Micah Hyde who also sustained a knee injury early in the 3rd quarter. Hyde was injured while trying to make a tackle and injured his knee. Replays initially indicate that he sustained a direct helmet to helmet hit but upon further review, he injured his knee as he was falling to the field. As there is no video replay of the incident, I can not speculate on what occurred. Sean McDermott did state that Hyde would be alright and did not elaborate. Hyde did suffer a knee injury at the beginning of October and unknown whether it is related.

Finally WR Deonte Thompson injured his ankle trying to catch a ball towards the sidelines at the end of the 3rd quarter. It appeared that he had his ankle rolled up on. He was able to exit under his own power but was clearly not moving well after the injury. McDermott did not mention him during today’s press conference; I do expect him to show up on the injury report but observing how his ankle was rolled on, it should not be something which should affect him playing next week.

Prior to the game, T Cordy Glenn, WR Jordan Matthews, and FB Mike Tolbert were all ruled out which severely limited the depth available today. Considering how the offensive line played, the injuries sustained today, this whole team fell apart today. I have mentioned in previous articles that depth will be key down the stretch, but considering the starters can’t even play up to snuff, depth becomes irrelevant. The Bills are horrendous these past few weeks and something has to change.

Continue to check back regularly for articles updating the injuries as more information is released. Follow me at @kyletrimble88 on Twitter for the latest up to date information. As always, thank you for reading and GO BILLS!

Week 11 Injury Breakdown- Chargers

Detailing the injuries prior to the LA Chargers game.

The Bills continue to make moves that make the fan base question the process. Sean McDermott benched starting QB Tyrod Taylor in favor of rookie QB Nathan Peterman, this year’s 5th round draft pick. This is curious as the Bills are sitting in the last wild card spot, owning a 5-4 record, and create many questions about the reason behind the decision. However, unless you’ve been under a rock, Tyrod has been awful the past 2 games against the Jets and Saints, exposing the Bills as a possible playoff pretender and into a potential free fall. With the Chargers game coming up and the season potentially slipping away, I do applaud the Bills for attempting to make a change instead of running with a system that is shaky as best and awful at worst. Whatever the decision is, I will trust the process. I believe in year’s past, changes would have not been made and success would have continued to elude this team.

Despite the Bills making this big change behind center, today’s post will once again be focused on the injury report, which unsurprisingly, grows longer as the season progresses. Starting off, LB Lorenzo Alexander, DT Kyle Williams, G Richie Incognitio, and RB LeSean McCoy did not practice yesterday due to a veteran rest day. TE Charles Clay (knee) was limited in practice due to a knee issue which I am quite confident that is related to the original injury that kept him out prior to this game. He is possibly dealing with some mild swelling due to the recent surge in activity, but I do not believe that he re-injured the knee. From my vantage point, it did appear that he was wearing some prophylactic bracing under his pants during the game as expected to decrease the injury risk.

Others not practicing today includes OT Cordy Glenn (foot/ankle), K Stephen Hauschka (right hip) and RB Mike Tolbert (hamstring). There is no surprise with Glenn as he has been dealing with his injuries all season. Tolbert is dealing with a hamstring injury which is unknown in severity. I did not see him leave the game or was limited with any of his runs. Hopefully this is not a long term issue as has been the issue with E.J. Gaines.

Hauschka did not practice secondary to a sore right hip which is the leg he kicks with. As Hauschka only deals with kickoffs and field goals, there is limited ability and time for him to injure his hip. Thankfully, kickers do not have to practice much so missing a day is not concerning. The Bills do not have any kickers on the practice squad, but training camp kicker Austin Rehkow is still a free agent and may be an option if Hauschka is unable to go Sunday.

Hughes did not practice yesterday and was limited today, but has been reclassified as a shin/calf injury which does open the door for a variety of other injuries including calf strain, foot flexor tendon injury, or a soleus strain. Considering that his position requires so much energy to push off around the edge, it is common to see a calf strain from time to time. If not managed correctly, this could develop into a tendonitis and could lead to further damage, but the training staff will not let it get to that. As Hughes is also a veteran, limiting him in practice may have been proactive to ensure proper rest and rehab.

Others limited in practice are WR Jordan Matthews (knee) and G John Miller (ankle). Miller is an interesting addition as he has not been active for several games with the recent improved play from G Vlad Ducasse. It is unknown what Miller is dealing with and the fact that he has not been active doesn’t warrant any concern.

Matthews is a new addition to the report after dealing with a thumb fracture earlier this season. There has not been any reports that he sustained any damage or had to leave early but there is concern for a re-aggravation of the knee tendonitis that he was dealing with when in Eagles training camp this season. Tendonitis is an issue that can continue to rear it’s ugly head even after clearing up the original symptoms. Tendonitis is an overuse injury due to repeated microtrauma to the area. If you would like to read more on the issue, please check out my previous article.

When dealing with tendonitis, this is something that a time frame can’t be definitively placed on. He could deal with this the rest of the season or could clear up with proper rehab and rest. This is something that can be played through, but pain may limit the ability to play at full strength.

Finally, WR Zay Jones and CB E.J. Gaines were full participants at practice which is an excellent sign. I originally thought that Jones sustained a high ankle sprain based on the mechanism of his injury during the Jets game, however, it appears he avoided this diagnosis. I did note that I believed that he may have sustained a regular ankle sprain as part of the differential diagnosis. Either way, Zay continues to progress back sooner than expected and this will be an extra weapon for Peterman come Sunday. As a disclaimer, I am only as good as the video available and the reports that surface.

As for Gaines, the fact that he is at full practice on a Thursday indicates that he will be starting Sunday. After seeing what the Saints did to the Bills defense this past Sunday, he is a welcome addition. As of right now, he is at a very high risk for re-injury due to his recent injuries and style of play, but if he is healthy, there is no reason that he is unable to contribute to the secondary.

As stated multiple times this season, the Bills continue to avoid the major injury bug. The Bills have four players on IR: TE Keith Towbridge, S Colt Anderson, RB Taiwan Jones, and WR Jerry Butler. This isn’t a group of players that strike fear into any team. They are still in better shape than other teams and while the team is not performing as expected, the depth that has been there since the beginning of training camp will be key down the stretch if they continue to be in the hunt for that long elusive playoff spot.

As a fan, I’m disappointed in how the team has played the past two games despite the hot start. I will still trust the process and know that McDermott is making decisions to better the current situation. I know complaining won’t change the current situation but will continue to have opinions because we are all entitled to that. If the Bills lose to the Chargers Sunday, then the season may be over. If they win, we’ll see what happens. The Drought has to end sometime, with how this season has been going, why not roll the dice?

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