Cole Beasley’s Leg Injury: Some possible diagnoses

The dynasty is over. The 20+ years of torture inflicted by the New England Patriots is over. For me, this was the official passing of the torch. I know the Bills defeated New England earlier this season in Orchard Park, but I was still waiting for Josh Allen to prove he can beat Bill Belichick’s defense and do so at ease. Entering Monday night, Allen had 3 TDs and 6 INTs against Belichick in his career. After Monday night’s blowout, where Allen tossed over 300 yards and 4 TDs, it was all finally over. The torch has been passed, and the Bills should be AFC East favorites for the near future.

The Bills were able to escape Foxboro, MA, relatively healthy. Dion Dawkins was dinged up a bit and had to finish the game with a brace on his elbow but did not miss any snaps. Jordan Poyer had to leave the game as well to be evaluated for a concussion after a big hit on QB Cam Newton.

Cole Beasley Injury

However, midway through the 4th quarter, WR Cole Beasley appeared to get caught up in the turf and had to leave the game. It was a weird-looking injury in that nothing looked extraordinary on the replay. Nothing happened where you could watch it and come away with a confident diagnosis. When discussing with other BF contributors, some thought possible turf toe, some thought ankle, and I was concerned about his knee. Why I was concerned about his knee is because while on the sideline, the training staff appeared to be doing assessments of his left knee, and Beasley appeared to be in discomfort. After an initial examination, the broadcast then showed Beasley walking to the locker room without assistance but was doing so gingerly. On WGR Tuesday morning, callers who were at the airport to greet the team upon their arrival said they noticed a significant limp from Beasley when exiting the plane.  

During his Zoom meeting with reporters on Tuesday afternoon, HC Sean McDermott relayed that Beasley is “week to week” with a leg injury. The team did not practice, so there was not an official designation. However, the team does practice on Wednesday, so there will be an injury report released in the early evening. It is safe to assume that Beasley will be a DNP all week and not play on Sunday, but hopefully, they will give us some more clarity on this. The team may also opt to continue with the vague “leg” injury on the report.

With the vague report, it leaves us fans wondering what exactly he is dealing with.  Let’s take a look at a couple screen shots of when the injury occurred. Interestingly, there’s not much here to take away.

Possible injuries:

After discussing with Alex Lucci (@ThighDoctor), we were looking into some possibilities that include quad strain and patellar subluxation (partial dislocation of the kneecap). If you look at the pictures above, you see Beasley’s left leg is outstretched, but he also gets his foot jammed into the ground and lands awkwardly. There is a possibility of a quad strain when the leg is outstretched, and there is a possibility of patellar subluxation if the knee buckles or locked after the foot gets caught.

Quad Strain

The quadriceps muscle is the main bulk of the anterior thigh and is made up of four muscles (hence the prefix quad) including the rectus femoris, vastus lateralis, vastus intermedius, and the vastus medialis. Our quad muscles are important because they produce action at both our hips and knees. The quadriceps can become strained during activity with high forces across the muscle-tendon with eccentric contraction Excessive passive stretching or activation of a maximally stretched muscle can also cause strains, which is the possibility here for Beasley when we see his left leg maximally stretched out during his route. When a quad strain occurs in athletes, the rectus femoris is the most common one to be strained of the four muscles. Here is a picture to show you the 4 different muscles from sportsandspinal.net

There are three grades of strains with the muscle, with each grade increasing in pain and decreasing in ambulation.

  • Grade 1: muscle tightness with mild discomfort with activity
  • Grade 2: sharp intensity pain in the thigh, unable to continue activity after injury sustained
  • Grade 3: severe and sudden pain, usually requires assistive device with ambulation (crutches)

After Beasley was looked at on the bench, we saw him walk to the locker room without any assistance. If quad strain is the injury, we are most likely looking at Grade 2. If this is the case, Beasley is looking at a timeline anywhere between 2-6 weeks. It can take six weeks for it to fully heal, but he may be feeling good enough to play in the playoffs. Missing Week 17 will give Beasley a nice rest period, and he can focus on rehab (anti-inflammatory medications, ice therapy, stretching).  My gut tells me he won’t be available for the first playoff game but could be back on the field for the divisional round should the Bills handle their business in the Wild Card round.

Patellar Subluxation:

Patellar subluxation very well may be the injury Beasley sustained. If you go back and watch the game, when Beasley is on the sideline with the trainers (Josh Allen sitting next to him to check on him too), they are mainly focused on Beasley’s left knee, specifically the lateral (outer) part of the knee. If it were a definite quad injury, the trainers would have been more focused on the thigh. Interestingly enough, when patellar subluxations occur, it is most common that the dislocation occurs to the lateral aspect of the knee.

What causes a patellar subluxation? Athletes can experience these injuries from twisting of the knee with rapid change of direction when the foot is planted or from a direct hit to the knee. In Beasley’s case, we saw his foot plant awkwardly into the turf and the knee sort of buckle at the end of the route.

When treating this injury, the first-line approach is supportive measures and physical therapy for those who have never suffered this injury before. If they have had this same injury in the past, then surgery is typically required. Recent studies show there is around a 33% chance of sustaining this injury a second time. I did not see this in any of Beasley’s injury history, so this leads me to believe it would be his first should this be the actual diagnosis. Treatment for first-timers usually includes immobilization for the first week to allow a reduction in swelling and pain. Slowly re-introducing mobility and exercises can begin after the first week, and the timeframe for this injury is 3-6 weeks for full recovery of the patella.

Here is a picture to help visualize a healthy patella, a subluxation and a dislocation courtesy of OrthoHyd.com

Outlook:

McDermott is generally tight-lipped and everything “stays in the building”. It wouldn’t be a surprise at all if the actual injury designation is never released, and the PR team continues to call it a “leg injury”. Either way, we are looking at anywhere from 2-6 weeks for Beasley, and two is being generous. When McDermott calls something “week to week” (as he did with Beasley on Tuesday), it’s not encouraging. My gut tells me the earliest we see Beasley is in the 2nd round of the playoffs. Beasley is a tough guy, and he might try and push it to be out there for the first round. I would love to see it, as he deserves to be out there, but I don’t think it will happen.

Thanks for reading everyone!

As always,

Go Bills!

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