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Injury analysis: Buffalo Bills pass rusher Von Miller

Are there any injury downsides to signing Miller?

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NFL: JAN 23 NFC Divisional Round - Rams at Buccaneers Photo by Cliff Welch/Icon Sportswire via Getty Images

The Buffalo Bills nearly broke the internet Wednesday afternoon with the unexpected signing of veteran pass rusher Von Miller to a six-year, $120 million contract.

The former number-two overall pick comes to the Bills following a stellar career with the Denver Broncos and a brief stay with the Los Angeles Rams, collecting two Super Bowl rings along the way. Miller boasts a resume few can match around the league and even at age 33, still brings an element missing in the Bills’ pass rush attack.

In the league since 2011, Miller has suffered his fair share of injuries, but has been exceptionally productive. Below is Miller’s publicly known injury history.

Injury History

2011 Denver Broncos

Missed one game. On his way to Defensive Rookie of the Year, Miller missed one game due to a right thumb injury suffered against the San Diego Chargers in Week 12. Reports later indicated that he required surgery to correct for ligament damage a week later, forcing him to miss Week 13 against the Minnesota Vikings despite being listed as doubtful.

He was probable for the remainder of the season but at times visibly limited and unable to shed blockers or create pressure. He did wear a cast on the area to ensure that the surgical site was protected and that he could still play. With the knowledge he had the pins removed two days after the Broncos’ playoff loss to the New England Patriots mentioned in the links above, it’s likely that he suffered a UCL injury, also known as Skier’s thumb.

2012 Broncos

Missed zero games. Miller was probable with a hip injury suffered in Week 2, but suited up and played against the Houston Texans in Week 3. Later in the season, he suffered a hip pointer injury, side not specified, in Week 6 against the Atlanta Falcons. He also suffered an ankle injury, side not specified, in Week 9 against the Cincinnati Bengals.

2013 Broncos

Missed ten total games: seven regular season, three postseason. Miller had been suspended for the first six games of the season due to a substance abuse policy violation. The violation occurred as the result of Miller having a diluted sample of urine during a routine test. The sample collector attempted to assist in replacing the urine with someone else’s and it was flagged by another collector. Due to the diluted test being considered positive and the attempt to cover it up, the suspension was increased from four games to six games.

He later suffered a knee injury in Week 15 against the San Diego Chargers and was questionable heading into the Week 16 matchup against the Texans. Regrettably, Miller tore his right ACL in that game and was placed on injured reserve, missing the final regular-season game along with the entire playoffs where the Broncos ultimately lost to the Seattle Seahawks.

2014 Broncos

Missed zero games. After returning following his ACL surgery, Miller only suffered a groin injury in Week 2 against the Kansas City Chiefs, missing the last drive of the game. He was probable for the Week 3 matchup against the Seattle Seahawks but did not appear with a gameday designation for the remainder of the season.

2015 Broncos

Missed zero games. No publicly reported injuries requiring a game-day designation other than an illness prior to the Divisional Round game against the Pittsburgh Steelers.

2016 Broncos

Missed zero games. No publicly reported injuries requiring a game-day designation.

2017 Broncos

Missed zero games. No publicly reported injuries requiring a game-day designation.

2018 Broncos

Missed zero games. Miller suffered an ankle injury, side not specified, in Week 7 against the Arizona Cardinals, was questionable the following week but did not miss the game.

2019 Broncos

Missed one game. Miller suffered a left MCL knee sprain in Week 12 against the Buffalo Bills. He missed the following game against the Houston Texans, ending his 95-game starting streak.

2020 Broncos

Missed 16 games. Days prior to the start of the regular season, Miller suffered a left ankle injury that resulted in a peroneal tendon dislocation. According to reports, Miller went through practice on a routine drill and fell down due to the injured ankle. Tests revealed the dislocated peroneal tendon, which is one of two tendons that wrap around the outer portion of the ankle within a groove to evert the foot and plantarflex or point the foot down. These also act as stabilizers to prevent the ankle from rolling inward during ankle sprains.

Example of peroneal tendon dislocation

Miller either tore the tendon away from the bone or tore the retinaculum that helps keep the tendons in the groove, leading to the dislocation. This article at The Athletic does a fantastic job of describing in further detail what happened.

This required season-ending surgery and him missing the entire 2020 campaign.

2021 Broncos/Los Angeles Rams

Missed two games. Miller began the season with Denver, playing in seven games before suffering a left ankle injury in Week 7 against the Cleveland Browns. According to reports, there was concern that he re-injured the same ankle that cost him the 2020 season. However, MRI reports came back that while there was an injury, it was not as severe as the year prior. It’s also worth noting that the injury occurred to the inside portion of his ankle whereas the 2020 ankle injury was to the outside portion. He missed the Week 8 game and then was traded to the Rams.

He missed Week 9 against the Tennessee Titans to either heal or adjust before playing with the Rams. He did not appear on the injury report with a gameday designation as he helped Los Angeles win the Super Bowl.

Buffalo Bills Impact

What a signing! General manager Brandon Beane identified the shortcomings of last year’s team and did everything in his power to address any remaining weaknesses with this signing. I understand there are concerns regarding his age and the contract length, but Von Miller continues to produce at a high level no matter the season.

Miller has won everywhere he’s been and has shown the ability to be an effective leader in the locker room. Looking at his snap counts, he was routinely playing over 80% of the defensive snaps over multiple years, still producing at an elite level. Placed into the Buffalo Bills’ defensive line rotation may mean a reduction in snaps, and it may also allow him to stay fresher and potentially avoid injury. This could be a huge year for the team and Miller.

The only injury concern I have is the dislocated peroneal tendon. Considering that it was his left foot, I expect him to line up on the right side to avoid having to explode off the left foot to bend the edge. But other than that, he proved that last season he could return to form. Regrettably, I cannot find any information on the reinjury risk for an injury such as this. This is a fairly rare injury in itself but last year’s production puts most of my concerns to rest.

As for his other injuries, the thumb injury and ACL tear were so long ago, they won’t have much of an impact on his present skills and there is very little concern to reinjure those areas. He also does not have an extensive history of soft tissue injuries, which he should continue to avoid with less playing time and better recovery methods with the Bills’ training center.

Despite Miller’s age and length of the contract, which it sounds like the Bills can get away from in a few years, I love this signing. Performing this injury analysis only reinforced what kind of player the Bills are getting in Miller. Between his skill set and leadership in the locker room, this could be what propels the Buffalo Bills to their first Super Bowl Championship.