Preseason Injury Review- Panthers

Reviewing the injuries sustained during the loss to the Carolina Panthers.

Football is back! The Bills opened the 2018 season with a preseason tilt against the Carolina Panthers with an unfavorable outcome in a 28-23 loss. Overall, it appeared as though the Bills played pretty well despite the loss with the QB competition beginning to parse itself out. Today’s post will review the injuries sustained in the Panthers game and what these mean going forward. Thankfully, the Bills didn’t suffer any season ending injuries and move onto next week against the Browns with a healthy roster.

Prior to the game WR Zay Jones, WR Corey Coleman, WR Cam Phillips, LB Corey Thompson, and DE Trent Murphy were all ruled out prior to the game. Jones did not play as he is still recovering from off-season knee surgery and while he is medically cleared, he is not quite ready to participate in full contact football. I expect that he should be ready next week against the Browns once he gets in better shape. It was reported that he was participating in 11-on-11 drills today at practice.

Coleman was ruled out due to his recent trade and inability to learn the offense quickly enough to participate. Prior to the acquisition, it was reported that he was having a strong training camp after initially being slowed up with a hamstring injury. It was not disclosed what Thompson is dealing with and no further information has been revealed since then. Phillips is still dealing with a groin injury sustained late last week in practice and is most likely what is still affecting his availability.

Finally, Murphy has been dealing what appears to be a Grade 1 groin strain. He has been limited in practice over the past week and the team is not willing to let their new DE injure himself further after coming back from an ACL tear which wiped out his entire 2017 season. Expect Murphy to play against the Browns barring any setback.

Following the loss, several players along the defensive line were reported injured which may affect their availability next week. First up is DT Star Lotulelei who suffered a back/neck injury. While I do not have video to fully assess the specifics, I can speculate that he may have sustained a trapezius injury. The trapezius muscle is a large muscle that covers the upper back and neck which provides support to the arms and shoulders which in turn assist in raising the arms. It also assists in extending the neck and adduction of the scapula which allows a person to pinch their shoulder blades together.Trapezius.jpg

I suspect a trapezius injury due to the fact that the muscle covers such a large area, it connects from the head down to middle of the back as seen above and the nature of the injury falls in line with his positional duties. He may have sustained a neck injury which is affecting his upper back with movement. Typically, violent twisting or collisions cause trapezius injuries which could explain the back/neck designation due to the location. Either way, it was reportedly not severe which may limit his practice availability but should be able to play next week.

DT John Hughes suffered a groin injury and while there is not video, it appears to be a Grade 1 strain according to the team. He may ideally need a week off similar to what DE Trent Murphy is going through but Hughes may not have the opportunity to rest as he has not exactly stood out in practice and is in danger of being cut. DT Marquavius Lewis also suffered an ankle injury which may appear to be a mild lateral ankle sprain. This is something that Lewis should be able to play through with some rest and rehab along with taping to support the area.

Finally, WR Brandon Reilly suffered a rib injury as reported. Rib injuries are typically more painful limitations than functional issues. As it was reported not serious, it may be bruised ribs which will require rest and extra padding but could resolve over the next week with no long lasting issues.

Fortunately, the Bills did not suffer any major injuries unlike the Redskins and Colts who suffered ACL tears in their respective games last night. The Bills continue to manage their injuries effectively and have been fortuitous in maintaining their depth players. Expect to see all these players be available for next week against the Browns with continued limited participation from starters.

Continue to follow Banged Up Bills on Facebook, on Twitter @BangedUpBills, and at www.bangedupbills.com. Continue to look for new articles on common NFL injuries and the latest injury news. 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!!

Zay Jones Knee Surgery Speculation

Speculating the type of knee surgery that WR Zay Jones may have had which is forcing him out of spring practices.

This new regime knows how to keep secrets! It appears nothing seems to escape the fortress that is One Bills Drive. This explains why news that WR Zay Jones underwent knee surgery last week which will force him out of the rest of spring practices. Today’s article will attempt to identify what the procedure may have been and explain the timing.

If you recall, Jones had a repair of the labrum in his shoulder which limited his production during his rookie season. Looking at a general protocol following a labral repair, Zay would be in the 3rd phase of his recovery by now according to the timeline as stated in January. By reaching this stage, he would demonstrate the strength required to adequately use crutches to assist in weight bearing following a knee surgery. This would explain why he is having knee surgery now at this time in the off-season rather than immediately such as most other players do. What this knee surgery also tells is us that his shoulder rehabilitation is progressing as expected and should be able to return to full health by the time the regular season rolls around.

As in most cases, we always want to know what type of procedure that the players have. While this is private information for both HIPPA and competitive reasons, I am still able to speculate the type of procedure. The information released is generally vague which indicates Jones escaped serious injury including ACL, MCL, severe meniscus tears, patellar fractures, etc. These types of injuries are almost always reported and would have ramifications regarding his availability for the season.

I believe this injury is related to the injury sustained during the Jets game during their 3 game slide in the middle of the season. If you recall, he hyperextended his right leg as the result of being tripped during a route run. He was later listed on the injury report with an ankle injury which may have bore the brunt of the injury acutely, but he may have suffered minor damage in the knee which may not have affected his production at the time.

Due to the hyperextension, Jones may have suffered a frayed meniscus that could have possibly caused pain, swelling, catching, occasional locking, and general discomfort. He may have also suffered from plica syndrome. This is a condition that is due to to irritated synovial membrane that may be the result of a meniscal tear, repetitive knee bending or straightening, blunt trauma or twisting, or altered knee motion. Both of these issues can be managed conservatively and addressed with physical therapy with effective results. Unfortunately, In Zay’s case, there was apparently not enough progress which warranted surgery.

There were some Twitter trolls who believe this surgery may have been related to his meltdown in Los Angeles in where he was in an altered mental state and attempted to kick through a window and jump out. I do not believe that to be the case as he would have suffered more superficial injuries to his foot, ankle, and lower leg which would have required immediate surgery compared to a scheduled surgery.

McDermott during his press conference noted that this was a procedure that he has needed, he had addressed it during rehab while addressing his shoulder, and that he miss only the spring session. According to the schedule, there are OTA’s until mandatory minicamp from June 12-14. This would give Jones about 4 weeks to recover in order to participate in some fashion, though it was made known he would likely miss minicamp. There is no timeline so in case there are any setbacks, he will not be held to any standard. The average time to recover is 4-6 weeks for both types of surgeries which fit the limited timeline that the Bills suggested missing the spring.

Either way, this is something that should not warrant any complications. It appears he is addressing his injuries, his shoulder is on track with rehabilitation, and looks as though he will be at full health come training camp. It is unfortunate that he has to deal with these issues, but sometimes, this is unavoidable.

Continue to check back for the latest updates at Banged Up Bills. Follow on Facebook at Banged Up Bills and on Twitter @BangedUpBills. As always thank you for reading and GO BILLS!!

Buffalo Bills Season Injury Review- WR

Assessing the WR corps injuries sustained this season and impact for next season.

Continuing with the off-season coverage of Buffalo Bills position review, today’s post reviews the WR position. As other posts have shown, no position is immune from injury and lots of analysis continues. A total of 7 wide receivers suited up at the position for the team this season with a variety of outcomes this season. First up is WR Kaelin Clay who came over from the Carolina Panthers in a trade during training camp. Clay did not stay long as he saw 4 targets for 1 reception totaling 28 yards. He was shortly released afterward and reclaimed by Carolina. During his time in Buffalo, he did suffer a foot and back injury which possibly contributed to his lack of productivity but did not cause him to miss time. As he returned to Carolina, finding his way back to Buffalo unlikely anytime soon.

WR Brandon Tate saw most of his playing time during special teams in the return game. Tate’s limited playing time at the position saw him targeted 14 times for 6 receptions totaling 81 yards and 1 TD. Thankfully, Tate did not suffer any injuries this season. The 9th year pro’s value remains at the special team position and with his lack of recent injury history remains an appealing target to bring back with his versatility.

WR Andre Holmes became a steady player after coming from the Raiders last season. While he has career low as a regular player totaling 13 receptions for 120 yards and 3 TD’s, he was still a key depth player, appearing in 14 games. Holmes was limited around Thanksgiving with an ankle injury that he was able to play through. Unfortunately, the 7th year veteran suffered a neck injury which sent him to injured reserve. It is undetermined what type of neck injury Holmes dealt with. Neck injuries are a hot button in Buffalo at the moment with C Eric Wood forced to end his playing career and former S Aaron Williams announcing his retirement shortly after. My educated guess is that Holmes strained several muscles in his neck and wasn’t responding well to treatment, forcing the team shut him down. He still has 2 years left on a 3 year contract at an affordable rate which allows the Bills to bring him back for depth. Pending his neck injury, he should find his way onto New Era Field next season.

Next up is WR Deonte Thompson. The 8th year pro was quite productive after coming over to the Bills after being cut by Chicago earlier in the season. Playing in 11 games, he was able to snag 27 receptions for 430 yards and 1 TD. While none of these numbers are eye popping, the receivers as a whole were down due to QB Tyrod Taylor’s limited passing abilities. Thompson suffered several injuries throughout the season including an ankle injury sustained during the Chargers loss in which he attempted to catch a ball while going out of bounds. Towards the end of the season Thompson suffered a nondescript back injury during the first Patriots game. He then suffered a shoulder injury that was either identified later in the week or injured in practice which placed him on the injury report but did not cause any time missed. As Thompson is getting older and a unrestricted free agent, roster turnover will determine if he returns. As he earned the veteran minimum for his experience, he may command more money in free agency but an affordable option to bring back for next season.

Assessing the receivers who have some injury questions for next season include WR Jordan Matthews. The 5th year pro suffered a series of injuries that eventually landed him on IR for the end of the season. Starting off, Matthews sustained a chip fracture during the first practice after he was acquired in a trade with Philadelphia. The chip fracture limited his ability to participate during the preseason but he was able to return to start the season. After getting used to the offense, Matthews sustained a thumb fracture during the crucial win over the Falcons. Matthews only missed one week and was able to return far faster than anyone had expected. This is another injury that will not cause any issues next season.

However, Matthews’ knee landed him on IR and while there is not one particular injury that landed him there, it may have been a recurrence of knee tendonitis he was dealing with during the early parts of training camp when he was still with the Eagles. This knee injury may determine how much he can command on the open market. His stats for the season included 27 receptions for 282 yards and 1 TD may limit his bargaining power considering he is in the same class as former Bill Sammy Watkins, along with Odell Beckham Jr., & Mike Evans. Considering his contemporaries, he could command more money than what the Bills are willing to pay and I expect the front office to move on from Matthews.

WR Zay Jones suffered an up and down rookie season which is not uncommon for a new player to the NFL. Unfortunately, expectations may have been set too high as he came out of college as the all time leader in receptions which did not initially translate well to the NFL. Jones’ stats were similar to other receivers on the team with 27 receptions for 316 yards and 2 TD’s. A slow start to the season along with several now known injuries were contributing factors to his lackluster season. Jones suffered an low ankle sprain which had appeared to be a severe knee injury during the Jets game. Thankfully, his knee hyperextended and his ankle absorbed the brunt of the force causing the sprain. This did not force him to miss additional games outside of some plays in an ugly loss to the Jets.

The unknown injury that came out after the season in an interview with Zay’s father revealed a torn labrum in what was possibly his left shoulder. He did appear on the injury report during the last week of October but this did not force him to miss anytime. My article on his injury appears here, please take the time to read. He has since had successful surgery to fix the tear and should be back in time for the regular season. He will continue to be an integral piece of the offense and production should increase if the QB position improves.

Finally, WR Kelvin Benjamin was the biggest acquisition by the Bills this season of unexpected trades. Upon arriving to Buffalo, Benjamin never really took off, injuring his knee in his 2nd game against the Chargers which resulted in a partially torn meniscus. Missing 2 games to rehab and recover, he was able to return against the Colts and play through the injury for the rest of the season. His production, 16 receptions for 217 yards for 1 TD, was limited as expected but playing through the injury did not cause further injury. He has since had successful knee surgery to shave down the partial tear and will be able to return in time for OTA’s. As for injury risk next year, his previous ACL tear is more of a long term concern to re-injure than the meniscus tear. Benjamin will be back next year and pending salary cap ramifications, I hope the Bills find a way to keep him long term.

The Bills WR corps will look different next year with the exception of Jones, Holmes, and Benjamin. There is the possibility of Thompson coming back along with futures contracts of WR Malachi Dupre, WR Quan Bray, and preseason favorites WR Brandon Reilly and WR Rod Streater. In addition, the Bills also had WR Jeremy Butler on injured reserve due to a concussion during the preseason. The Bills are building something to create more stability in the offense and give either QB Tyrod Taylor or whoever the new Bills QB will be more weapons to energize the offense and build off the anemic passing offense of 2017.

Continue to check back with me regarding injury updates and news coming out of One Bills Drive. Thank you for reading and GO BILLS!!

Zay’s Shoulder Struggles

Discussing Zay Jones recent shoulder diagnosis, types of dislocations and causes, and expected outcomes following surgery.

As the NFL continues to maintain the fans attention year round, constant news is churned out that help shed light on players issues during the season and provide answers to questions not fully explained. New information regarding Zay’s rookie season has brought up courtesy of the most recent The Bills Wire podcast. In the latest episode, managing editor Rob Quinn interviewed Robert Jones, Zay’s father, who revealed Zay had played his entire rookie season with a torn labrum in his shoulder.

What makes this comment interesting is the fact that Jones only appeared with a shoulder injury as a full participant in practice at the end of October before the Jets game. This issue was never publicly identified as a complaint until this interview. Today’s post will identify and discuss what the labrum is and its role in shoulder movement, how it possibly affected his play, and long term outlook following his upcoming surgery.

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Credit: http://gomidwestsports.com/surgical-procedures/labral-tear/

The labrum is a fibrous layer of tissue in the shoulder that deepens the socket in which the head of the humerus articulates with the glenoid fossa of the scapula. This allows for stabilization to the moving shoulder joint and prevents the joint from separating. Other structures including ligaments, rotator cuff, and connective tissue allow for additional support. Finally, the long head of the biceps tendon feeds into the glenoid and serves as an attachment for the biceps to contract. All these structures together help make up the shoulder joint and maintain stability through motion.

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Credit: moveforwardpt.com

The labrum can be torn by many different ways due to the structure of the joint. As with other joints, with increased mobility, there is decreased stability. Ways a shoulder can dislocate include a direct blow to the front of the shoulder, fall on outstretched hand also known as FOOSH which can cause posterior dislocations. In cases of anterior dislocation, extreme distraction to the area such as sudden pulling or placing the shoulder in extreme end ranges in external rotation and abduction. To picture this movement, envision the cock-backed position of the arm when throwing an object.

As a result of the shoulder dislocating, there is tearing of the labrum. There are various types of tears including SLAP tears or Bankart lesions and Hill-Sachs lesions, but not knowing the mechanism of injury prevents us from identifying specifically which lesion Jones suffered. However, upon dislocating, there is concern for damage to the nerves, blood vessels, and muscles to the surrounding area. The head of the humerus could pinch on one of those structures and cause long term issues if not addressed immediately. Once x-rays are taken and corresponding symptoms are assessed, the joint may be reduced and stabilized.

Most dislocations occur anteriorly with the literature stating that 97% occur in this manner. The remaining 3% are classified as posterior. When a dislocation occurs, the joint surfaces that articulate with each other become dislodged and remain separated until they are reduced manually. There are instances where the joint partially dislocates and relocates by itself which is defined as subluxation. In either instance, this creates damage and further instability leading to the possibility of future complications.

In Zay’s case, it was mentioned that he suffered the same injury in college during the 2015 season. While his father did not identify which shoulder he damaged, I will assume that he re-injured the same shoulder which according to the above posted article is the left shoulder. Jones did have surgery to repair the shoulder in college but due to the nature of the joint, it is very possible to re-tear the labrum on the same side, which appears to be the case. Unfortunately, the tissue in the area cannot be reinforced by other means which forces the surgeon to sew up and anchor the available tissue and immobilize in order to heal.

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Credit: http://www.shouldersandknees.com/labrum-tear.html

It is possible to surgically repair the area if it tears multiple times. However, repeated tears to the labrum has been described to me as trying to sew water together by an orthopedic surgeon as there becomes less and less tissue available to fix. Following surgery to anchor the tear down, immobilization in a sling allows the tissue to begin healing is typically the first step followed by range of motion and strengthening of the area to stabilize the area. This is followed by dynamic stability and strengthening with return to function over a 6-9 month period.

It is unknown when Jones suffered his torn labrum but due to his position, he was able to play with greater ease compared to QB Andrew Luck who had missed all of 2017 due to post surgical complications with the same injury. Had Jones suffered acute symptoms of the tear during the season, immediate pain and instability would have been present along with difficulty with overhead movements and weakness during resisted movements. This would have translated to difficulty creating separation between defensive players and himself along with trouble hauling in catches due to decreased strength of the affected arm.

The above mentioned complaints are the kind of symptoms that would have landed any player on the injury report. It is possible that these issues led to his early season struggles, but not confirmed. Jones could have also suffered the injury during the season and not initially been aware of the severity which could explain why he did not spend time on the injury report. It was reported that the tear was found at a routine end of season MRI.

Returning to comments made by Robert Jones, specifically, if Zay were to pick up a glass of water, his arm could dislocate; this is highly unlikely and hyperbole. A shoulder that has suffered a torn labrum that repeatedly dislocates can demonstrate significant instability which could eventually lead to minimal forces required to dislocate. However, picking up a glass of water would unlikely dislocate a shoulder as muscles of the upper arm and forearm primarily control this action . If his arm did dislocate this easily, he would no longer be playing football and he would have had many other conservative interventions prior to letting it get that severe. Adding in the fact that in between dislocations, the body is constantly trying to heal, laying down scar tissue to stabilize the area.

As Jones is a professional athlete, instability in a violent sport does not equal long term success when it comes to health. This surgery will assist in stabilizing the area and hopefully prevent any further issues. Thankfully, Jones should be able to return to full form in time for training camp and have no setbacks. He should not experience the issues that Andrew Luck had as he does not have to throw the ball or place his shoulder in extreme positions.

This injury news was totally unexpected, but it is common for NFL players to play through injuries varying in severity and still perform at a high level. I have full confidence that Jones will return to full health and build off his sub-par rookie season. Continue to check back for articles including Kelvin Benjamin’s meniscectomy and other procedures including possible surgical interventions for Cordy Glenn. Follow me on Twitter @kyletrimble88 for updates, 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.

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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!