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Josh Allen’s Knee Injury

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Happy Week 13, everyone! 8-3 feels great, and the Bills now have an 87% chance of making the playoffs. The defense looks great again, and we know the offense is capable of putting up 30+ points per game. Hopefully, they can string together some wins and lock up the division before Week 17’s matchup at home vs. Miami.

The health of Josh Allen will be vital to their chances of doing so, as he suffered an injury in the 2nd quarter of Sunday’s game against the Chargers. With 3:50 left on the clock in the 2nd quarter, Allen tried doing a little too much on a play that was dead and resulted in him being tacked awkwardly by Chargers’ DE Joey Bosa (who is an absolute game wrecker). All of Bills Mafia around the world was holding their collective breath when Allen was on the ground in obvious pain. It was encouraging and relieving when Allen got up and was able to jog off of the field, and he didn’t go into the blue medical tent or even get looked at by the trainers. He missed one play. (NFL rules require an injured player to sit out the play following the injury that forced them to leave the field.) Allen came back out to finish the drive, which ended with a Tyler Bass field goal.

Initially, I thought it was an ankle injury myself when it first occurred. The replay showed him get bent awkwardly, and it looked like his ankle buckled. However, if you look closely, you can see it’s the knee that gets twisted up, not the ankle. Photo credit: Larry Brown Sports

When Allen returned to the field for the 2nd half, he was wearing a brace to his right knee, something he has not worn before. This helps rule out the ankle and clearly shows that he suffered a right knee injury. Thankfully, an ACL injury can be ruled out, as this would have been caught by the training staff during halftime, and Allen would not have returned. What we are looking at is probably an MCL injury, which is usually associated with the type of awkward twisting that occurred with Allen on the tackle. In the second half with the brace, Allen had three rushes with one for a touchdown. He did not appear to be limited from it. After the game, Allen said, “I just got twisted up a little bit. It happens, but it’s not going to affect me.” There have been no additional comments on the injury from Allen or the team at this time.

The photo below is from the 2nd half of the game with the knee brace clearly visible under Allen’s sock. Photo credit to The Athletic.

The MCL:

The medial collateral ligament (MCL) is the ligament that connects the femur to the tibia and is located on the inside of the knee. Like other ligaments, it helps keep the knee intact and prevents the knee from moving sideways. Here is a photo to highlight the ligaments of the knee from Access Sports Medicine and Orthopedics.

MCL sprain grades:

There are three grades of sprains.

  • Grade 1– Involves stretching and slight tearing of the fibers of the ligament
  • Grade 2– Involves partial tearing of the ligament, usually around 50% of it
  • Grade 3– Involves a complete tear or rupture of the ligament

Here is photo from Beacon Orthopedics to highlight the different grades of injury.

Treatment and Time Missed:

Grade 1 and 2 MCL sprains are treated with supportive measures which include the famous RICE (rest, ice, compression, and elevation). Physical therapy will be done as well (once the swelling subsides) that includes mobility and strengthening exercises to facilitate the full restoration of the ligament. Grade 3, which is a complete tear or rupture usually requires surgery. For a timeframe, grade 1 and 2 sprains can take between 3-6 weeks to return to 100%. Grade 3 usually takes around 12 weeks.

For Allen, Grade 3 can be ruled out. If MCL sprain is the case for Allen, it’s most likely a grade 1 sprain. Allen returned to the game and only missed one play. He played the entire second half with the brace on, but it didn’t appear to limit him all that much. He was able to plant the leg and throw effectively, and he looked more than comfortable running the ball as well.

It would take a lot for Josh Allen to miss games, as he is an insane competitor. I don’t expect Allen to miss any time, and I expect he will continue to play with the brace on until the playoffs. However, if he does play, this does raise the risk for further injury that could be much worse, as the knee has lost some stability. Brian Daboll may want to dial back on the called QB runs, and the offensive line needs to step up because Allen was under duress all game on Sunday. Allen needs to be kept clean and given great pockets, so he doesn’t get banged up even more.

Conclusion:

It is important for me to remind you all that this has not been confirmed by the team or any reporters. At this time, my guess is a Grade 1 MCL sprain, and I don’t think Allen will miss any time. Do not be shocked if Allen pops up on the injury report at practice this week and is listed as a limited participant.