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2021 NFL Draft: Buffalo Bills OT Spencer Brown injury analysis

Several significant injuries, but little concern.

Reese’s Senior Bowl Photo by Don Juan Moore/Getty Images

Offensive tackle Spencer Brown comes to the Buffalo Bills from Northern Iowa with a lot of potential and several notable injuries. While both tackle positions are set for the next few years in Dion Dawkins and Daryl Williams, having solid depth at the position to account for injury or decline in play is vital. General manager Brandon Beane noted Brown’s potential and his ability to be a swing tackle as part of the reason they drafted him.

Brown does come to the Bills with several notable injuries that could hinder most careers. However, despite how concerning the injuries look, the research and context of when they occurred are favorable when looking at Brown’s long-term outlook. Below are Spencer Brown’s publicly known injuries.

Injury History

High School

2015 — Junior year: Broke his left femur while playing basketball in high school. While the article itself did not specify the left side, other articles from the same source went on to reference issues with his left knee in high school indicating that the femur fracture was on the left side.

Attempted to play baseball but had continued soreness in his knee while playing, revealing an osteochondral defect under his patella that required surgical repair. As a result, he missed the entirety of summer workouts, getting cleared days before football season.

During the football season, the same article details that Brown tore his meniscus. He finished the football season and played through the basketball season with the injury. Despite dealing with pain, he was able to garner first-team all-state honors in basketball before going under the knife once again to repair the meniscus in April of that year.


2016 — Freshman year: Redshirted as he was still recovering from his meniscus repair and gaining weight to transition from tight end in high school to offensive tackle. Reportedly, he gained 90 lbs, according to Dane Brugler of The Athletic.

2017 — Redshirt Freshman year: Appeared in five games before suffering a season-ending right knee injury. Specifically, he suffered an MCL tear along with damage to his patellar tendon. Based on the wording, it appears as though he required surgery to repair the damage in the area, as he was forced to miss spring workouts as he recovered.

2018 — Redshirt Sophomore year: Appeared in 13 games, did not suffer any publicly known injuries.

2019 — Redshirt Junior year: Appeared in 15 games, did not suffer any publicly known injuries.

2020 — Redshirt Senior year: Opt-out due to COVID-19 as a result of his school postponing the season. He declined to transfer to another school out of loyalty to Northern Iowa.

Bills Injury impact

Looking at Brown’s medical history, there are several notable red flags on the surface. However, looking at the timeline, missing crucial time for recruiting in the offseason while recovering from his injuries likely led to the lack of blue-chip schools either avoiding him or missing him altogether.

Breaking down each injury, it appears as though the femur fracture started the chain of events for Brown’s injury history. Due to the traumatic nature of a femur fracture, this likely led to the osteochondral defect under his kneecap, especially if the fracture was near the distal portion of the bone close to the knee. Basically, this is a tearing of the articular cartilage, which is the smooth outer portion of the bone that allows for movement between the bones. The kneecap, or patella, acts as a fulcrum for the knee to extend, increasing the leverage that the quadriceps can exert on the femur. The patella runs in the femoral condyle during normal movement.

Examples of osteochondral defects in the knee
Rehab My Patient

With the osteochondral defect, this was essentially a pothole within the cartilage. Anyone that lives in a colder climate knows that once a pothole develops, it grows in size and depth, leading to unsafe roads over time. Road crews would take cold patch asphalt to repair the hole in the interim until the road can be repaved. In the case of the human body, the body begins to lay down scar tissue to attempt to heal the area. However, the scar tissue is not as uniform as the original cartilage and strong, unable to take the stresses of the knee, leading to pain and swelling.

He had surgery to repair the defect and took the summer to rehabilitate and was cleared to play football by the fall. The outcomes for osteochondral defects are actually fairly good in younger populations in returning to sport and not having long-term issues. This would indicate that this is less likely to be a degenerative condition over time and would not cause many problems. Even 17 years later, patients who had the procedure still report less pain and swelling with indicating that this is a procedure that had sustained success.

Furthermore, cartilage lesions were found in 40-to-60 percent of NFL prospects during the NFL combine, indicating that this is a common issue that teams are used to treating. This supports that this is not a hugely concerning injury and that techniques to treat this injury are well-defined.

It’s possible that he returned from the osteochondral injury quickly, leading to temporarily decreased strength in the left knee, causing the meniscus tear. This is purely hypothetical, but the meniscus tear could have also been isolated due to a totally unrelated injury. He did play through the tear for some time before getting it repaired later that spring. Once again, Brown’s youth helps him avoid some of the issues that plague older players and people in general with degenerative knees.

Meniscus tears in children have higher rates of healing and due to the skeletal immaturity during adolescence, this can act as a buffer for long-term effects. Basically, the body can adapt to the injury with greater ease and recover more fully than if this happened when someone was older. The research also suggests that there are fewer long-term issues than the older population. It’s important to note that Brown had the meniscus repair versus meniscectomy, leading to decreased incidence of further degeneration of the knee joint with rates at 11 percent.

Example of mensicus tear and repair

It’s also important to note that he suffered these injuries when he was much lighter, around 225 lbs in high school. His ability to gain weight and not suffer an increase in injuries due to his skeletal immaturity adapting to the natural increase in muscle weight over adding weight to already matured bones.

Finally, the MCL injury with patellar damage in 2017 was the last concerning injury for Brown. Details are not available regarding how he injured the leg, but it was severe enough to require surgery. It’s rare to have a complete tear of the MCL, but possible. In most cases, the MCL can heal on its own without surgical repair. He likely required surgery on the patellar tendon as it may have been a partial tear. Thankfully, in the NFL, even those with a full patellar tendon rupture returned 80 percent of the time, indicating that this is an overall successful procedure regardless of age or level.

Examples of MCL injury severity grades

The sheer fact that Brown was able to stay healthy his two remaining years of college plus having a year off from football is promising. He won’t be immune from further injuries nor do I expect that his knees will be a major concern based on the injuries and procedures known. He may suffer further injuries unrelated to the prior ones or begin to develop osteoarthritis in either knee years from now.

The Bills continued their trend of picking players with traits and upside, most notably with a RAS score of 10, indicating supreme athletic ability. Brown fits into the trend of injury risk assessment, taking talent with injury concerns in the third round, for now, the fourth year in a row.

Despite what the injury history looks like, I like the potential of this pick. I am also not worried about the long-term implications as there have been several years between these injuries and now with healthy play demonstrated. This draft may not be addressing some of the other apparent needs on the team, but the Bills continue to address key positions to sustain success for years to come.