Week 2 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!!

Buffalo Bills Training Camp Injury Primer

Reviewing last season’s major injuries and how they will impact the 2018 season.

Training camp is upon us! Thursday is the first full day for the Buffalo Bills to begin training camp at St. John Fisher in suburban Rochester, NY. This training camp, as many others, will shape the 2018 roster. We will see new players rise up to the challenge and find themselves on an NFL roster. Others will experience the heartbreak of falling short of their dreams. Finally, we will see many players whose seasons will end before they even really began due to injury. Today’s post will review some of the high profile Bills players and their previous injuries and what this means going forward. If you would like to listen to the audio version of this article, I appeared on the Cover 1 podcast last night and discussed these injuries, check it out!!

First up is RB Travaris Cadet. The 6th year back was an effective backup behind RB LeSean McCoy and allowed the offense to keep defenses on their toes. Regrettably, Cadet fractured his ankle in a gruesome manner late in the season and was placed on IR. After an injury such as that, there are natural concerns for his ability to recover and rejoin the team. According to what we know regarding the timeline for his recovery, he is fully healed and videos such as this indicate that he is at full health. I do not believe his injury will hold him back; rather his skill may be the biggest detriment as the Bills have loaded themselves up on running back. Look for a full contribution from Cadet and time will tell whether he finds himself on the 53.

Next man up is WR Kelvin Benjamin. The gigantic wideout comes back to the Bills for the final year of his contract and his production this season will determine his future home. Fortunately, Benjamin comes into this season healthy after being limited with a partially torn meniscus sustained in the dumpster fire that was the Chargers game. The 4th year wideout had surgery in the offseason and while he may have issues well after his playing career, he should not have any setbacks in camp as the offending tissue has been excised and rehab fully complete. Hopefully he will have a QB that is more likely to throw, leading to a big season for Benjamin.

Continuing our trend of injured Bills, TE Charles Clay. The 7th year tight end suffered a partially torn meniscus and MCL tear in the loss to Cincinnati but was able to return down the stretch to push the Bills into the playoffs. Clay should not have any limitations following that injury going into training camp. However, he may continue to have issues with his chronic knee condition he has dealt with in previous seasons. I believe this will slow him down but as he has shown in previous seasons, it really does not stop his ability as he has been able to appear in at least 13 games every year over his career. He will need veteran rest days but should be fully healthy in training camp.

DE Trent Murphy enters his first training camp with the Bills after spending the first 4 years with the Redskins. Up until last year, Murphy had shown the ability to provide pressure on the end and get to the quarterback, racking up 9 sacks in the process in 2016. His 2017 season ended quickly with a torn ACL in the preseason opener and was lost for the season and released afterward. Typical ACL recoveries take roughly a year to return to full form and this is evident with Murphy starting the season on the active roster after being limited in OTA’s. He should not be limited due to his previous injury, but he still carries a higher risk to re-tear his graft or tear the other ACL for up to 2 years.

LB Ramon Humber is another veteran returning to camp this season. The 9th year linebacker had a hot start to his season before suffering a broken thumb in the win over the Falcons last season which cost him 3 games. He was able to return and still contribute, but rookie Matt Milano got some game time experience which allowed him to excel in McDermott’s defense and hold onto the starting job. Humber will continue to provide a veteran presence and leadership on this team going into 2018.

Newly acquired CB Vontae Davis comes from the Colts after an injury shortened season in where he suffered a sports hernia, limiting him to 5 games. Davis elected to take the surgery which led to his release from the Colts, but I believe that he made the right choice in order to extend his career. As indicated in the hyperlinked article, 90% of NFL players who suffer a sports hernia are able to return to the NFL after surgery. While talent may differ due to each player, the ability to come back at all is the most important thing. I believe Davis will not miss a step and will actually be an upgrade to former Bill CB E. J. Gaines.

Our final defensive player on this list today is LB Matt Milano. The rookie linebacker out of Boston College outplayed where he was drafted in the 5th round and provided a bright spot at what was a weak linebacker corps. Milano had issues with his hamstrings last season and continued to be limited during OTA’s. He should be at full health coming into training camp but should be eased in slowly, avoiding game speed reps until he is confident that he is ready. I do not expect him to fully avoid re-injury, but limit the severity of the strain if it does occur again. Look for another solid contribution this year barring major injury.

Rounding out this article is WR Zay Jones. The NFL has not been kind to the rookie WR so far in his young career, suffering what appeared to be the yips early in the season. We now know that this was attributed to a labral tear which limited his ability to catch effectively. He had surgery in late January and should be cleared medically. In addition, Jones also had surgery on his knee in mid May. As he was recently placed on the active/non-football injury list, this indicates this injury occurred in the off-season. Whether this is tied to the well publicized hotel incident is in question, we may never know. Once Jones is cleared medically for his knee, he should not have any further complications moving forward. He will need a big season to right the ship and maintain a long career in a Bills uniform.

This wraps up the the major injuries heading into training camp. We will begin to see a host of new injuries, some minor, some major, but Banged Up Bills will be here to report all of those! As a fan, I am looking forward to this upcoming season after such a memorable 2017. Continue to follow on Twitter @BangedUpBills and at www.bangedupbills.com. As always, thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- CB

Assessing the injuries sustained at the cornerback position from the 2017 season.

Continuing in our off-season reporting is positional reporting at Banged Up Bills.. Today’s post addresses the cornerback position which was a bright spot this season after being outright dreadful in 2016. The cornerback position dealt with a variety of injuries that at times cost the Bills crucial games that thankfully did not cause the Bills to miss the playoffs. However, Brandon Beane realized that even though this unit was superb, there is still room for improvement going into the 2018 season.

First up is CB E.J. Gaines. The 4th year veteran came to Buffalo in a trade that included WR Sammy Watkins that worked out favorably for the Bills. Stat wise, Gaines was able to haul in one interception, 3 forced fumbles and 59 total tackles with 48 solo and 11 assisted. There was a gigantic difference between when Gaines was on the field and when he wasn’t. In games that Gaines participated in, they were 8-3, in games he missed they were 1-4 which indicated how valuable he was. However, Gaines suffered several injuries which cost him playing time during several key points during the season. He suffered a shoulder injury in the win over Atlanta that forced him to miss the Cincinnati game which was a loss. Immediately after this injury, Gaines suffered a groin injury that did not appear to be serious, but possibly led into a hamstring injury that cost him 3 games in which the Bills went 1-2. Gaines returned to health, playing in 5 straight games before injuring his knee during the first Miami game which cost him a game against New England. Prior to this season, Gaines had been fairly durable, only suffering a Lisfranc injury which cost him the 2015 season. His injuries likely stemmed from his hard-hitting reckless play. After this injury filled season, the Bills elected not to re-sign Gaines, letting him walk in free agency and taking a rather questionable one year, $4 million with the Cleveland Browns. For a player that was due a potentially big contract with limited availability, the Bills were smart to move on from Gaines despite his stellar play.

Next up is CB Leonard Johnson. The 6th year back saw time in 15 games and starting 7. Johnson managed to stay relatively healthy this season, only missing one game due to a knee injury in the loss in the first New England game. Otherwise, he suffered a quadriceps injury in the season opener and a minor hamstring injury in the loss to Cincinnati in which he did not miss any time. Johnson had been pretty healthy up to this season, only suffering a torn Achilles during his time in Carolina but was able to recover to previous form. Stat wise, he accumulated one forced fumble with one fumble recovery to go along with 51 tackles, 40 solo and 11 assisted. As with Gaines, the Bills elected not to re-sign Johnson as his veteran status most likely became cost prohibitive.

CB Shareece Wright continues the Bills exodus of cornerbacks from the 2017 season. The 7th year back saw playing time in 12 games, starting 5 with stats of one interception, one forced fumble with 2 fumble recoveries to go along with 42 tackles, 35 solo and 7 assisted. Wright suffered a minor back injury in the win over Atlanta but suffered a concussion during the second New England loss which costed him the season finale win over Miami and the playoffs. As he is no longer on this roster for what I assume are similar reasons as Johnson, I do not see him coming back unless there are several injuries which would require him to be re-signed as a depth player.

One of the true bright spots on this 2017 Buffalo Bills roster was CB Tre’Davious White. The rookie from LSU quickly became a fan favorite and helped re-establish the secondary with incredible plays that appeared to allow people to forget he was only a rookie. Numbers wise, he had 4 interceptions, one forced fumble with 2 fumble recoveries with one returned for a TD and 69 total tackles, 53 solo with 16 assists. White stayed injury free all season with the exception of a concussion from Rob Gronkowski. If you recall, Gronk gave White the People’s Elbow after a clearly dead play on the sidelines. White thankfully did not miss time, but repeated hits to the head can have a detrimental effect on a players health later in his career. As White begins his second season, look for him to hopefully stay healthy and continue to produce at a high level to establish himself as one of the best in the league at his position.

Finally, CB Lafayette Pitts rounds out players that suited up at the CB position for the Bills this season. The 2nd year pro joined Buffalo in late October after spending time with Jacksonville earlier in the season. During his time in Buffalo, Pitts only recorded one tackle and one assist on defense with most of his playing time coming on special teams. Despite the lack of stats, the Bills re-signed Pitts to a one year contract in hopes that he adds to the depth going forward.

The Bills position at cornerback appears to be solidified with CB Tre’Davious White manning one side and CB Vontae Davis manning the other. There are questions regarding Davis going into the 2018 season after he missed most of 2017 with a sports hernia that eventually required surgery. As indicated in the previous article, most players sustaining his type of injury are able to return to playing in the NFL without complications. These two players are formidable in their own right and together should really improve the quality of play at the position. Davis is an upgrade from Gaines at the position, but time will tell if the production matches.

Rounding out the rest of the cornerbacks on the roster include CB Levi Wallace, CB Phillip Gaines, CB Taron Johnson, CB Ryan Carter, and CB Breon Borders. Wallace and Carter come to the Bills via UDFA’s, Borders comes back for the 2018 season after spending the end of 2017 on the practice squad. Phillip Gaines came via free agency from the Kansas City Chiefs, and finally, CB Taron Johnson was drafted in the 4th round with the 121st pick. None of these players are guaranteed to make the roster but I expect to see Gaines and Johnson stick with the team as depth in the event a starter is unavailable. Considering the talent at the position, I could see the Bills stocking up on the position, leading one of the remaining names to sneak on to the 53 man roster with an impressive training camp.

That wraps up the cornerback review for the 2017 Buffalo Bills. Our series is nearly done, with positional reviews of safety and special teams rounding out the remaining articles. As this 6 week period between OTA’s and training camp occurs, look for remaining positional review articles along with spotlights on common injuries in the NFL. The goal at Banged Up Bills is to educate my fellow fans. I enjoy any and all feedback via Facebook at Banged Up Bills and on Twitter @BangedUpBills. As always, thank you for your time 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!!