Sunday’s game against the New York Jets was a terrible event for the Buffalo Bills, and it seems like it just got a little bit worse. On Tuesday night, Ian Rapoport reported that quarterback Josh Allen has a sprained UCL (ulnar collateral ligament of the elbow) and will try to play but could miss time.
On Wednesday afternoon, Bills head coach Sean McDermott addressed the media and referred to Allen as “day-to-day” based on the medical report the team had. McDermott acknowledged that Allen is “as competitive as there is. He loves to play the game and we’ll see where it goes.”
While that opens up the possibility that Allen will try to play on Sunday against the Vikings, McDermott also mentioned that Allen will not practice on Wednesday and the team will “use common sense” including relying on “the doctor’s wisdom and knowledge.”
Considering the Bills are still in a good spot to make the playoffs, it’s likely the team would err on the side of extreme caution with their star player. However, overall, this needs to be taken as good news for Buffalo.
On Monday Chris Mortensen suggested that there was some concern about damage to the nerves in Allen’s elbow. Speculation ran rampant in the NFL and Buffalo Bills communities that Allen could miss anywhere from 2-4 weeks, so him being considered day-to-day would seem to be a clear indication that any long-term injury can be ruled out for now.
The team will see how Allen feels during the week and likely ensure that he’s 100% before bringing him back onto the field. Could that be this week? Sure, but it might also be a couple of weeks down the road. There is simply no way to know at this juncture until Allen returns to practice and is able to see how his elbow responds to throwing.
How did Josh Allen Get Hurt?
As best we can discern, the injury happened on the third to last play of the game, when Allen’s arm was hit by Bryce Huff while he was in the middle of his throwing motion.
Looking again, certainly could be a medial elbow sprain.
Could have stretched the ulnar nerve.
Could have a flexor tendon strain as he was trying to grip & throw the ball forward.
All structures in area where he was rubbing.
Need more info. #Bills
— Banged Up Bills (@BangedUpBills) November 7, 2022
One play later, Allen short-hopped Stefon Diggs on a 15-yard pass, but he was able to heave a 70-yard dime to Gabe Davis on the last play of the game that the wide receiver dropped. That throw had many Bills fans hoping that their star quarterback was alright, and early indications after the game were that he was just feeling “slight pain.“
What is a UCL Injury?
I highly recommend this article by Banged Up Bills to get a full breakdown of the UCL injury.
How Long Will Allen Be Out?
As mentioned above, we don’t really know just yet.
Allen suffered an injury to his UCL back in 2018 in a Week 6 loss to the Texans in 2018 when his arm hit a helmet in the middle of a throw. During that season, Allen missed four games and a bye week, so the possibility of four games makes some sense.
However, it’s important to remember that Josh Allen was just in his second season back in 2018, and the Bills were 2-4 at the time of Allen’s injury and would go on to lose the next two games by a combined score of 62-11 with Derek Anderson at the helm. As a result, there was no need for the Bills to rush Allen back in the middle of a 2-6 season, so expecting him to miss just one or two games this year could also be feasible.
If we look at Buffalo’s upcoming schedule, we can also try to guess when Allen could return to the field.
Ian Rapoport’s latest suggests that Allen will likely try to play on Sunday against the Vikings, but we already addressed why that feels unlikely. Allen would then be considered day-by-day for next Sunday’s matchup against Cleveland, which could also be a winnable game without Allen if the defense is healthy. If Case Keenum is also able to guide the Bills to a win against the Vikings then the team would obviously handle Allen’s situation differently headed into the Browns game.
The Bills then play the Lions on a short week, and given the short turnaround time and the current state of the Lions, Buffalo could decide to hold Allen out for that game as well, if they’re able to win one of the two prior games.
That would put Allen back for the Week 13 showdown against the Patriots and give him almost a month to rest his elbow. However, we know this is now on the longer side of his recovery estimate.
How Good Will Allen Be When He’s Back?
This is almost impossible to answer and will be directly connected to how long he sits out. The nerve issues connected with a UCL injury are more of a short-term concern, so Allen could be fully healed by Week 13. He’s also worn a brace and played through this injury before, which should give some reassurance that he knows how to handle any discomfort.
The most likely issues will arise from his ability to grip the football and the velocity on his throws.
It’s hard to believe the Bills would let him play if he wasn’t able to grip the football properly, so by the time he returns we might expect some lingering issues with the power on his throws or his accuracy as he shakes the rust. However, Allen can certainly still be a good quarterback even at 75% of his current power and the rust would be expected for anybody coming off a month-long absence.
You could also talk yourself into the idea that defenses might expect Allen to take fewer chances down the field in his return, if his elbow isn’t 100%. That could mean more coverage close to the line instead of the deep Cover-2 he has been seeing, which could mean deep ball opportunities like the one he had to Gabe Davis.
However, that’s obviously all speculation. What we can infer is that, when the Bills do decide to bring their quarterback back onto the field, we should expect him to be pretty close to the Josh Allen we know, albeit with some rust.
Can the Bills Compete Without Josh Allen?
The obvious answer here is that Buffalo will not be close to the same team without Josh Allen. He simply does too many things that a defense can’t gameplan for and uses his legs and improvisational ability to bail the offense out of plenty of tight spots.
However, this is a deep roster from top to bottom, and provided Matt Milano, Jordan Poyer, and Tre’Davious White are healthy enough to play while Allen is out, this defense will become the driving force of this team. It’s a unit that has stepped up repeatedly throughout this season and will likely remain stingy against offenses like Cleveland and Detroit, even though Minnesota could pose a challenge.
That means Case Keenum shouldn’t need to put up 30+ points in order to win games.
The veteran was brought in because he is a tremendous game manager, who has shown the ability to captain teams to victories while filling in at quarterback. For his career, he has a 62.3% completion rate and has led six comebacks and 10 game-winning drives.
“We believe Case Keenum, he’s here for a reason,” said McDermott. “He’s been a great addition to our team in more ways than one.”
In his one year starting at quarterback in Minnesota, with Stefon Diggs at receiver, Keenum threw for 3,547 yards with 22 touchdowns and just seven interceptions. The season before as a starter for Denver, he threw for 3,890 yards with 18 touchdowns and 15 interceptions, so he is a capable passer, even if he is prone to a poor throw or two.
While he lacks Josh Allen’s rushing ability, Keenum also has just a 5.4% sack rate in his career. Allen’s is 5.5%. Keenum has proven to have a strong pocket presence and uses dump-offs to running backs to avoid sacks in the way Allen uses his legs.
Since the Bills now have Devin Singletary, James Cook, and Nyheim Hines in the backfield, using the running backs in the passing game will actually be a strength for this offense.
It will just be a test for first-year offensive coordinator Ken Dorsey to see if he can adapt his gameplan around a totally different quarterback. Buffalo will need to lean into the run game more and use more of the intermediate passing game with guys like Dawson Knox and Isaiah McKenzie. Keenum and Diggs having familiarity from their time in Minnesota will also be crucial since Diggs will be needed in all areas of the field as a safety blanket for his new quarterback.
The Bills may only need to lean on Keenum for one game, but even if they rested Allen until that Patriots game, going 2-1 with wins over the Browns and Lions would seem an entirely realistic outcome, provided that they can fix their run defense issues.
If those persist, beating the Browns will be just a bit harder, which means Buffalo could be looking at a 1-2 stretch that would still put them at 7-4, and in a pretty solid position considering how things could have gone if the news on Allen were worse.
Or, Allen could miss just this Sunday’s game and come back ready to play against Cleveland and Detroit with Buffalo being, at worst, 6-3 on the season.
How Does This Impact the Bills’ Playoff Chances?
It’s important to understand that this is a secondary concern, which is weird to say.
The Bills currently have six wins and hold tiebreakers over all of the Chiefs, Titans, and Ravens. If Allen misses just one game then even a loss wouldn’t significantly dampen any hopes of gaining the AFC’s top seed. They would just need to perform well to close out the season.
If we assume Allen misses the next three games, as in the hypothetical discussed above, the team would have him back for the final five games of the season and would need to compile three of four wins from this point on.
If Buffalo is able to win one of those three hypothetical games with Case Keenum under center, a totally feasible result, then the Bills would need to go 2-3 or 3-2 in their final five games with Allen back to feel comfortable about a playoff spot.
Obviously, the biggest impact is that Buffalo’s chances of gaining the top seed in the AFC and hosting playoff games appear to have taken a major hit, but if this team is able to get Allen back to full strength and secure a playoff bid, they would remain a major threat to take home a Super Bowl title.
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