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Injury analysis: Bills’ roster considerations for Isaiah McKenzie

Will McKenzie move to short-term IR?

In part one of our discussion of Buffalo Bills WR Isaiah McKenzie’s recent shoulder injury, we provided an in-depth analysis about the specifics of the injury and potential timelines he could face in returning to action. In part two, we’ll look at the impact this injury has on the team’s roster and discuss the potential options facing head coach Sean McDermott and his coordinators.


Roster impact for Bills

The average time lost for an AC joint sprain is 9.8 days for NFL players and 11.61 days for the NCAA—just under two weeks. According to research, Grade I sprains take 2-4 weeks to heal and 4-6 weeks for a Grade II sprain. Now this does not mean that McKenzie could get right back to taking punishing hits over the middle right away and will be 100 percent at 9.8 days.

Healing is not a linear progression in that the more time passes, the better he is. If he attempts to rush and play through the damage, this could cause further pain and weakness in the area. The damaged ligaments need to heal back together while he begins to restore function. This includes addressing his range of motion, working on strengthening in various muscle groups such as the pectorals, deltoid, rotator cuff, trapezius, latissimus dorsi, among others.

Increasing strength also protects the area against future injury and prevents compensatory movements in moving the shoulder. In turn, this all helps to reduce the pain in the healing tissues and allow for further progression of rehab to eventually begin absorbing hits again.

Week 1 is on September 12; the injury occurred on August 24. This gives him 18 days to be ready for the regular season, just under three weeks’ time. Roster cut down day is August 31 at 4 p.m. EDT. The Bills have a number of options at their disposal for McKenzie including:

  • Place him on IR, ending his season with the Bills with the possibility of an injury settlement for him to go elsewhere.
  • Place him on the active roster during cut down day and then immediately move him to IR for a three-week stint, allowing him to come back in Week 4 against the Houston Texans on October 3.
  • Place him on the active roster and continue to rehab until Week 1 against the Pittsburgh Steelers.

Out of those options, the third option seems the most plausible. This allows the Bills to go with their preferred option at kick/punt returner, allowing them to fill roster spots elsewhere. McKenzie is in a contract year so there is no way he would go to IR and sit there all year, nor is this injury severe enough to warrant that.

This injury can suffer further damage with repeated hits, but generally, this won’t eventually require surgery, nor do they in general. It may just become more of a chronic injury until it is given the proper time to fully heal. So he could be slowed by it all year, but the team won’t let him take the hits until he is ready, reducing the possibility for further injury.

Even if he took an entire six weeks to recover from a Grade II by going to IR, this could put him to return Week 4. This could allow the team to move Marquez Stevenson to the roster, but overloading at wide receiver could prevent them from addressing other positional needs now and later on in the season.

If this were the regular season, I suspect McKenzie would miss one game and return with bracing and require a cortisone shot to manage the pain. Though if this were the case, I would be really concerned about ball security to that side for the following several weeks. Considering he already has some ball-handling concerns heading into the season, this injury doesn’t help.

As a fan base, we saw Tremaine Edmunds really struggle after suffering an AC joint sprain on his right shoulder in Week 1 against the New York Jets. He missed the following game and returned, but had a really hard time accepting hits to the area and tackling for the first half of the season. Josh Allen also suffered an AC joint sprain in his left non-throwing shoulder that forced him to wear bracing and affected his throwing motion the following weeks against the Tennessee Titans and Kansas City Chiefs.

Fortunately, McKenzie has the time and ability to get closer to completely healed rather than playing through the injury as Edmunds and Allen were forced to last year.

Bills’ roster decision

There is concern regarding keeping Stevenson as he is a draft pick, the team does like to hold onto their assets if possible, and there is a legitimate question whether they could get him to the practice squad. However, cutting him and moving him to the practice squad especially on cut down day is better than doing it later in hopes other teams don’t notice.

He was a sixth-round pick for a reason and he is coming off a right foot injury and head injury of his own. Right now, Stevenson appears to only have value in special teams whereas McKenzie has value in both the offense and special teams, lessening Stevenson’s value.

Looking at the information that is available, I believe the Bills will take the 3rd option in keeping McKenzie on the active roster and rehabbing until Week 1. He will either be fully healed or enough that he could get through the opening weeks with possible bracing and pain management until he is fully healed.

Initially playing special teams does limit his opportunities to get hurt compared to playing in the slot or on jet sweeps on offense. If they go that option, I don’t see him having an impact on the offense until they know he can absorb the type of hit that led to all this.

It’s unfortunate that a practice injury occurred, but the type of injury and time available to heal works in the Bills favor with roster decisions. Unless new information is revealed regarding the type of injury or severity, I expect McKenzie to remain on the active roster rehabbing until Week 1, allowing the Bills to maximize keeping talent elsewhere.