Grading Buffalo Bills CB E.J. Gaines’s groin injury

Another year, another injury for CB E.J. Gaines. The sixth-year cornerback suffered a groin strain that will reportedly cause him to miss several weeks. Considering the current injury along with his previous injury history, it warrants a further look at what happened and what to expect in 2019.

Gaines has spent time with the St. Louis Rams, Buffalo Bills, Cleveland Browns, and now his second stint in Buffalo. During that time, he’s suffered a multitude of injuries:

2014: concussion, missed one game

2015: Lisfranc injury- season ending IR

2016: a recurring thigh injury that cost him five total games

2017: shoulder, groin, hamstring injuries, missed five games

2018: MCL injury, missed part of preseason; two concussions, missed ten games total; sent to IR

While Gaines has shown an ability to be a playmaker in the secondary when it counts, he has never played in more than 11 games in a season and has suffered several major injuries during his NFL career.

Regarding his most recent injury, groin strains or adductor strains are similar to any other strain in the body where a muscle is overworked to the point the tissues tear either at the myotendinous junction or in the muscle belly itself. A groin strain occurs due to either a direct blow to the area or a forceful contraction usually consisting of a change in direction, kicking, jumping, or reaching.

The adductors are key with side shuffling and eccentrically load as someone moves sideways and cuts in the case of a cornerback. Based on the demands of a cornerback, my thought is that he strained the groin changing direction and attempting to keep up with the drill as it was 1-on-1 WR/DB drills.

Muscle strains are graded 1-3 based on severity. Considering the reports of missing several weeks, this is likely a Grade 2 strain. It can be reasonably expected that he will miss 3-6 weeks, though that timeline could vary a week or two each way based on his healing rates. This is supported by the fact that he was able to remove himself from practice and walk under his own power to the trainers’ tent. If he had suffered a true Grade 3, there would have been a loss of function and he would’ve needed to be carted off.

Move Forward PT

Gaines’s rehab will consist of resting, gentle stretching to improve range of motion (ROM) and progressive strengthening incorporated. This is an injury that takes time to heal and requires frequent monitoring to ensure proper healing for return to function. If necessary, he may receive an injection to manage the pain but this won’t affect healing rates.

Considering both center Mitch Morse and wide receiver Cole Beasley both suffered sports hernias last season that required surgical intervention, natural curiosity would lead to concerns that his injury could develop into this. However, sports hernias occur due to a more forceful movement as a result of a change in direction. While the mechanisms of injury are similar, the severity varies and the duration of symptoms vary.

The difference between the sports hernia and the adductor strain is when pain is present. Pain is absent during rest with a sports hernia and comes back after resuming physical activity. With an adductor strain, pain reduces over time and function improves.

Basically, the sports hernia is more acute and becomes chronic whereas the adductor strain is acute but gets better with rehab. I have not found a correlation between adductor strains developing into a sports hernia but a sports hernia may present initially as an adductor strain. If Gaines continues to have issues upon returning, exploring for an initially missed sports hernia may be warranted.

Once someone has had a groin injury, the player is twice as likely to sustain a future groin injury. If the player has weak adductors, their likelihood of sustaining a new groin injury becomes four times greater.

Groin strains can become chronic if not rehabbed properly leading to frequent re-injury. Gaines most likely stays in shape in the offseason, it’s unlikely that he has prior weakness in the area. This leads to the previous documented groin injury from 2017 being the most likely cause of the current injury. Gaines will have to focus on proper rest, strengthening, and ensuring that he is fully healthy before returning to play to avoid re-injury risks associated with weak adductors.

Considering the injuries that Gaines has dealt with, questions arise whether he’ll make the team. His camp competition, Kevin Johnson, also has a lengthy injury history but has managed to stay healthy so far and may take Gaines’s job if he can’t recover. The coaching staff knows what Gaines brings to the table and he may still make the roster, but this injury will not help his chances. If he is able to come back and play, I question how effective he will be not just from the standpoint of his groin injury, but also his ability to stay on the field due the poor track record.

This is an untimely injury that really hurts Gaines in his quest to make the 53, but his presence on the field is evident and may ultimately save him. Other future injuries and personnel needs will eventually bring clarity to the position at the end of training camp. Hopefully there will be an answer to address to a weak spot on the defense going into 2019.