Week 13 Bills Injury Review- Dolphins

Analyzing C Russell Bodine’s fibula fracture and other injuries sustained in the Bills loss to the Dolphins.

That loss hurt. We lose to the Patriots all the time, but we lose to the Jets and Dolphins more than we should. The NFL is “Any Given Sunday” but to lose in that fashion to the Dolphins stings. While there was an opportunity to win on the Bills final offensive play with that pass to TE Charles Clay, there were still many glaring mistakes that cost the Bills that game. Whether you thought QB Josh Allen could have thrown it better or Clay should have caught that, it doesn’t matter. There were other opportunities to win the game and that’s where the Bills have to improve on. While there were minimal injuries again this game, the injuries sustained were more significant than usual. Today’s post will review injuries in Sunday’s loss.

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Credit: teachmeanatomy.info

C Russell Bodine (fibula fx) is done for the season after breaking his fibula (seen above in red) midway through the 1st quarter on Sunday. Video is limited but Bodine is observed going down with DT Davon Godchaux falling on his leg while his knee is on the ground. The direct blow to the area from a 315 lb human will do some damage, in Bodine’s case, resulting in a fracture. Bodine was able to walk off the field without assistance because these guys are tough and won’t let pain stop them unless it’s truly unbearable. Add in the fact that the fibula is a non-weight-bearing bone which allowed him to still walk despite being part of the lower leg. The fibula makes up the outside portion of the ankle and goes up to the lower outside portion of the knee. This bone provides many attachments for the lower leg bone but does not have any actual weight bearing function in regards to walking.

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Credit: http://www.raynersmale.com

Bodine will miss the rest of the 2018 season, going to IR to have surgery with what is expected a full recovery for 2019. The surgeon performing the operation will be performing an ORIF which is short for open reduction, internal fixation on a fracture similar to the picture above. This means they will surgically open his leg, re-align the broken bone, and reinforce the fracture with screws and a plate to ensure proper healing to the area. Once the surgery is complete, Bodine will be non-weightbearing for at least 6 weeks. Despite the above statement that the fibula is not involved in walking or weight bearing, the leg still must avoid weight through the area due to the possibility of disrupting the healing process. If weight bearing were to occur, excess stress from the attached muscles performing their actions during walking could lead to weakness/instability to the healing bone. Other concerns would be a potential fall directly on the area or sudden jarring movements could lead the hardware to loosen or shift leading to the bone not healing properly. If he does indeed have the syndesmotic injury as Dr. Chao theorizes, then he could be non-weightbearing for 8-12 weeks according to this protocol which would require removal of the hardware. We will not know which type of surgery he will have and it may come down to surgeon preference or the amount of damage. Regardless, this will not affect recovery time which is about 12+ weeks. Seen below is a picture of what his ankle may look like on x-ray once surgery is completed.

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Credit: podiatrytoday.com

12 weeks will not allow him to be ready for football related activities, but will at least allow him to work towards getting back in shape. The timeline to return to football specific activities and return to full form is longer, but not exactly known. My best guess is ~6 months to fully regain what he has lost and resume activities as though he never suffered the injury. Everyone responds differently and Bodine is no exception. The Bills have begun working out centers but have not appeared to sign anyone at this point. It is likely that C/G Ryan Groy will step up and take over the starting role for the rest of the season.

Other injuries sustained were LB Tremaine Edmunds (knee/ankle) and CB Jordan Poyer (finger). Edmunds suffered an injury to his right leg midway through the 3rd quarter in which his foot got caught in the turf and he got hit from a falling body. The knee looked structurally fine as it was going into a varus position. This is when the knee is buckling out as the foot moves inward. This is opposite of the dreaded ACL/MCL mechanism of injury but Edmunds mechanism of injury could still cause damage to the knee under the right circumstances. Thankfully, the rookie LB was checked out by the medical staff, missed a few plays and was able to return rather quickly. He may be dealing with at most, a sprained ankle with the foot having been caught in the turf and rolled inward. He may show up on the injury report but it does not appear to be anything that will limit him next week.

Poyer suffered a right finger injury shortly after Edmunds sustained his injury in the 3rd quarter. He was attempting to secure an interception by QB Ryan Tannehill but was unable to come up with the ball. He appeared to be shaking his hand out as though he jammed his finger. He was able to return playing immediately and may or may not show up on the injury report. Even if he does, it is unlikely to affect his ability to play next Sunday.

Overall, the Bills did not lose much injury wise and should continue chugging along to next Sunday where they have their 2nd game against the Jets in what should be a winnable game. I am encouraged by how this offense is starting to click with the progression of QB Josh Allen & WR Zay Jones and optimistic how the team can upgrade with the cap money they have for 2019. Only time will tell how things play out.

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

 

Buffalo Bills Season Injury Review- C/G

Analyzing the injuries at the C/G position and implications for next season.

Today’s post on Banged Up Bills breaks down the guard and center positional injuries and implications for next season. A total of 5 players suited up at the C/G position that powered the Bills to the playoffs and was able to maintain a top 10 rushing attack. Unfortunately, the offensive line is aging and unexpected injuries have derailed the possibility for a repeat performance next season.

Starting off with the center position is C Eric Wood. The 9th year pro had a relatively successful season anchoring the offensive line. Injury wise, Wood suffered an ankle injury during the win over the Oakland Raiders which did not force him to miss any time and was not a factor for the rest of the season. Unfortunately, it was later revealed he did suffer two neck stingers in Week’s 5-6 which after an end of season physical resulted in his inability to continue to playing due to possible long term risks. A more detailed analysis of his injury can be found here. He is not expected to return under any circumstances and is not officially retired due to salary cap complications.

Next up is versatile C/G Ryan Groy. The 4th year pro served in mostly a backup role this season but has shown the ability to start when C Eric Wood went down in 2016 with a broken leg. Groy saw no time on the injury report with the exception of illness in Week 16. The young lineman appears to be a natural fit to replace Wood at the position as a low cost option and will either grow into the position or be a bridge piece for someone else to come in. Expect him to assume a larger role next season.

Transitioning to the guard position, there were 3 primary players that took on the job at guard. First up is G Richie Incognitio. The controversial player found a second life in Buffalo and has continued to demonstrate a Pro Bowl caliber play despite being one of the older players on the line. Injury wise, Incognitio saw minimal time on the injury report, suffering an ankle injury during the Tampa Bay game and shoulder injury during the playoff loss to the Jaguars. The 12th year pro did require weekly rest days which may have contributed to his ability to stay healthier compared to others. Incognitio is still very effective despite his age and is a great transitional piece as the front office slowly begins to rebuild the offensive line. Recently, he restructured his contract to allow him to stay on a more team friendly deal to allow the team to focus on other assets this off season.

Next man up is G Vladmir Ducasse who after not initially starting the season, came in and performed effectively, playing in 12 regular season games and 1 post season game. Ducasse was thought to be a depth player going into the season but questionable play by G John Miller led to Ducasse’s starting opportunity after 4 games. In addition to winning the starting job from Miller, the 7th year pro stayed injury free and proved how effective he can be in a run heavy offense. As for next season, the Bills would be making a poor decision if he were to leave. Like Incognitio, his contract and availability is favorable and he also provides a nice transition as the line gets older. Expect to see Ducasse on the line again in 2018.

Finally, G John Miller rounds out the guard review for the 2018 season. Miller had a pretty rough season, winning the job out of training camp before relinquishing his job after 4 games to Ducasse. To add insult to injury, Miller began to be ruled inactive thereafter and suffered what I suspected to be a high ankle sprain in practice right before Thanksgiving which forced him to miss 6 games. Despite Miller’s horrendous season, it is possible that he returns for next season. He is only 24, has demonstrated the ability to play well in past seasons and is going into the final season of his rookie contract. He does provide another veteran body in an aging line but is still young enough that could be moved in a trade for other pieces if needed.

In addition to all these players likely to come back next season, C Adam Redmon is on a futures contract which may allow the Bills to not have to search far for their next center if Groy does not work out or is injured. Continue to check back with Banged Up Bills for the latest injury updates. Check out Grandstand Sports Network for other injury related articles that I post and please check out the latest content by my fellow colleagues. GSN is truly an unique site comprised of passionate individuals providing the latest stories and shows not found anywhere else. GSN is the #1 place to go for the 2018 NFL draft! As always, thank you for reading and GO BILLS!!

Eric Wood’s Neck Injury

Analyzing the neck injury that forced Eric Wood to retire and long term implications.

Disappointing news coming out of One Bills Drive Friday with the sudden announcement of C Eric Wood retiring from the NFL after nearly a decade. The cause of his retirement appears to be related to neck issues that were discovered during a routine end of season physical intended to assess issues players made need to address in the off season.

This determination was made by Dr. Cappuccino, who is the orthopedic spine surgeon, along with other doctors and team officials. For the 9th year pro’s long term health, it was ruled that retirement was best to avoid further damage. As detailed information has finally been released, it has been revealed that Wood is dealing with a bulging disc in the C2-C3 region following stinger’s during Week’s 5 & 6. Today’s post will identify why this is career ending and long term implications.

While it is incredibly disheartening hearing this news, I believe all fans would want the health of each and every player to be most important. To identify what occurred with Wood, the anatomy of the area must be understood. The cervical region of the neck is comprised of 7 cervical vertebrae that stack on each other which curve in concave fashion to allow for support of the head in an upright position. In between these vertebrae, with the exception of the first two levels, cervical discs act as as shock absorbers and allow for the vertebrae to articulate with each other in order to move freely. Ligaments attach the vertebrae together for support and passing through the vertebrae are arteries, the spinal cord, and nerves. Eric Wood suffered a disc bulge at C2-C3, the first disc after the C1-C2 junction. To help put this all in perspective, please refer to the pictures below.

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Credit: backpain-guide.com

One of the issues that Eric Wood may have been dealing with that was described as wear and tear is cervical spondylosis. This occurs when the structural integrity of the vertebrae column becomes compromised and leads to instability within the region. This is is due to the cervical discs losing disc height which in turn reduce the space between, leading to laxity on the ligaments, causing further pressure on the discs. This can be the result of the aging process, trauma, or individuals that have to carry heavy loads on their head or shoulders. As a possible result of this condition, he stated he suffered a “stinger” in Week’s 5 & 6 and was evaluated without further treatment required. As cervical spondylosis progresses, this can cause other issues including degenerative disc disease, spinal stenosis, hypertrophy of the surrounding ligaments, subluxation of the vertebrae, along with both neural & vascular compression.

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Credit: mayoclinic.com

As a result of the disc bulging out, this can create spinal stenosis. In the case of cervical spinal stenosis, the vertebral foramen, or space in which the spinal cord passes through, becomes narrowed. In the case of Wood, repeated trauma/progressive disc protrusion is what led to his disc pressing on his spinal cord as seen below. Other causes that could occur include ventral spondylophyte formation, thickening of the ligamentum flavum, or hypertrophy of the dorsal facets. While all these are confusing terms, these are all structures that surround the spinal cord that could reduce space and compress on the spinal cord as you place the head into various positions. To put this into a simpler perspective, imagine squeezing a hose; as you tighten or bend the hose, the flow of the water decreases. If the spinal cord is compressed, certain head movements can increase pain and limit mobility, placing even greater pressure on the spinal cord. This could affect areas below the spinal cord level or the nerve roots that branch off to the extremities. With compression over time, this could lead to temporary or irreversible damage based on severity.

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Credit: http://www.houstonmethodist.org

This is something that Wood was aware of after Week 5 and appeared to manage up to this point. However, incidence of previous spondylosis could cause and progress the stenosis.  As the veteran center has never appeared on the injury report with a neck injury during his career, this doesn’t mean that he never had neck pain. This is evident with the report of the stingers that was resolved which lead to his omission on the injury report.

Following the stinger, there are variations in the presentation of symptoms based on severity. One of the concerning but manageable issues include cervical radiculopathy. This is where the nerve is compressed either at the neck or a later exit point down the nerve’s path. This compression could cause pain, tingling, numbness, and weakness to travel down specific nerves in the shoulder or arm. This is common to see in the general population, but far from a pleasant sensation. Several of these symptoms are more prevalent in the lower cervical vertebrae.

In Wood’s specific presentation, occipital headaches, often typical of migraine, with pain radiating to the eyes and behind the ears, blurring of vision, dizziness and nausea especially when attempting to lie down, numbness of the side of the neck, tension and “knots” in the neck and shoulder muscles, and swelling and stiffness of the fingers. He may have had several of these symptoms following the stinger which warranted further evaluation.

If Wood would have continued playing and ignored medical advice, he would be at risk of  developing cervical myelopathy as this is more severe in that actual damage to the spinal cord has occurred. This presents as bowel and bladder issues appear along with difficulty walking, coordination, and loss of strength, among other symptoms. Typically, those are emergency related symptoms and must be dealt with immediately. If Wood were to keep playing, he would be at higher risk to have this occur with the violent nature of the hits and further degeneration of the affected areas. The C2-C3 area is more severe as nerve roots branch off which affect head movement and assist in controlling breathing. Further damage to the area could include paralysis and/or death if not addressed immediately.

While all this does sound ominous, there are many options for conservative care. Physical therapy, chiropractics, and pain management including injections can manage the complaints for years. Primary focus on the area would to educate the patient on the condition and awareness of possible worsening symptoms. Other interventions include managing and reduce pain, maintain motion and strength in the area, and prevent further decline in the area. Personally, I have worked with a variety of patients with similar complaints with a variety of outcomes. Some have been able to resolve their complaints completely, some have significantly reduced their pain and have a strong understanding how to prevent further complications. Others have gone on to receive injections and surgery which in turn has improved their quality of life. Fortunately, through his decision to step away from the game of football, Eric Wood will not likely be bed bound and in a neck brace for the rest of his life. He will instead be able to participate in activities including exercise, avoiding strenuous, repetitive activities such as football and heavy weightlifting, and focus on raising his newborn son.

If Wood is to require surgery in the future, there are a variety of surgical procedures that can help to stabilize the affected area. This includes but is not limited to: spinal fusion surgeries and/or anterior cervical discectomy.  These procedures stabilize and partially remove the offending area to reduce pressure on the spinal cord. Right now, he may not require any surgery, instead altering activities to reduce further damage. If surgery is indicated, this will help with quality of life but would not allow him to safely return to football.

Severity of the neck complaints that are forcing Wood to retire early at least leaves him in good hands with Dr. Andrew Cappuccino.  If you recall, Dr. Cappuccino is best known for saving TE Kevin Everett‘s life during the season opener in 2007. To put into comparison how severe this Wood’s injury is, S Aaron Williams had similar issues with his neck in a lower level that were well documented, ending his career. It appeared that he was willing to continue playing, but teams knowing his medical history would not touch him for fear that the next big hit may kill him. Wood was not willing to take that risk and able to end on a high note with a playoff berth.

The next big question is who steps up and replaces him. Ryan Groy appears to be a natural fit as he can play multiple positions on the line and may be a stop gap until the Bills find their next player in the draft or free agency. I believe the Bills will address this position effectively as they have with other positions this past season. It is a shame that this occurred to such a great player, but, as many before Eric Wood have proven, time is the one opponent that no one can defeat.

I hope that you learned something today and helps put into perspective why Eric Wood is forced to end his career. Continue to check back with me on updates regarding Bills injury news! 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!!!