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USA Today Sports Media Group
USA Today Sports Media Group
Sport
Jimmy Liao MD

Lions vs Bills: Final injury report medical analysis plus injured reserve player update

Coming into the season, the Detroit Lions offense was expected to be the strength of this team. That is even more so now with the offense in excellent health coupled with a defense riddled with injury. This past week, Dan Campbell acknowledged that the offense would shoulder more responsibility and to expect the aggressive 4th-down decisions to continue.

With Taylor Decker’s return after missing two games, the Lions offensive starting unit is fully intact and most key reserves are healthy as well. The offense will need to put up points to stay ahead of a high-powered Bills offense which boasts the leading MVP candidate, Josh Allen, and will feature the return of two impact pass catchers in Dalton Kincaid and Keon Coleman.

The Lions defensive line trended sharply upward during the week with DJ Reader, Levi Onwuzurike, Josh Paschal, and Alim McNeill all rapidly progressing to the point that they are definitively in. The linebacker unit took a surprise hit with Trevor Nowaske’s midweek concussion.

The Bills defense will have a banged-up secondary with a starting CB out and both starting safeties nursing injuries with questionable status.



DETROIT LIONS

Out – Trevor Nowaske LB, (UL NP NP)

This backup LB played 64% of snaps last game. Presumably he got a concussion in Wednesday’s practice which will force him to miss this game.

At LB, Jack Campbell played 100% of snaps last game and expect that to continue. Ezekiel Turner (34%), Kwon Alexander (34%), David Long (32%), Jamal Adams (16%), and Ben Niemann (2%) are candidates to fill the void.


In – Alim McNeill DT, concussion (FP FP FP)

See my initial injury report analysis for the full timeline of his concussion. There was also concern for a non-concussion head or jaw issue. Very good news that everything has resolved quickly.


In – Taylor Decker OT, knee (FP FP FP)

A suspected right MCL and right high or medial ankle sprain on November 24 forced him to miss two games. With his return, the entire offensive starters are intact. Dan Skipper, who filled in admirably at LT, will return to his normal role as jumbo TE and 9th-string WR.


In – DJ Reader DT, shoulder (NP LP FP)

Reader hurt his left shoulder on Thanksgiving in a manner that is concerning for a shoulder subluxation and missed one game. While a subluxation is still a possibility, his quick return gives hope that it was just a mild shoulder strain.


In – Levi Onwuzurike DT, hamstring (LP LP FP)

A left hamstring strain on Thanksgiving caused him to miss one game. Hamstrings can easily take multiple weeks so it’s good to see that this one was mild.


In – Josh Paschal DE, knee (LP FP FP)

A right knee injury on Thanksgiving caused him to miss one game. Video did not suggest anything too concerning.


Injured reserve list update

Returning soon:

  • Alex Anzalone, left forearm fracture – Expect his 21-day practice window to open early next week with a possible return to play in week 17 (49ers) or week 18 (Vikings).
  • Kalif Raymond, left foot – Expected by the start of the playoffs. His 21-day practice window should open after next week’s Bears game.

Uncertain but hopeful to return soon:

  • Ennis Rakestraw, hamstring – Eligible to return next week vs the Bears. Keep an eye on if his 21-day practice window opens early next week. If it doesn’t open next week, that implies he is at least three more weeks away.
  • Ifeatu Melifonwu, left finger – Same situation as Rakestraw. Eligible to return next week vs the Bears. Hope for his 21-day practice window to open early next week. If it doesn’t open next week, that implies he is at least three more weeks away.

Early playoffs at best:

  • Jalen Reeves-Maybin, neck – He is eligible to return anytime but has not had his 21-day practice window opened yet. This implies he is at least 3 weeks away. At this point, his earliest projected return would be in the playoffs. Dan Campbell on December 9 corroborated a multi-week timeline stating he’s “better… There’s a chance we could get him in a few weeks.” While there are no details about his neck injury, this update is reassuring that it isn’t anything overly serious.

Late playoffs at best:

  • Aidan Hutchinson, left tib/fib fracture – Expecting very limited action in the Super Bowl although Jay Glazer reported a few days ago that the NFC championship game is a possibility. Currently nine weeks from injury, the bone should be close to healed at this point. Hutchinson has significant expected atrophy in his legs so it all depends on how quickly rehab goes.
  • John Cominsky, MCL surgery – Initial estimate projected a January return at best.
  • Derrick Barnes, right MCL/PCL surgery – Unlikely to be back.

Not expected to return:

  •  Malcolm Rodriguez, right ACL
  •  Marcus Davenport, left elbow
  •  Kyle Peko, left pec
  •  Mekhi Wingo, right knee

NFL IR PLAYOFF RULES

Lions can return as may IR players as they want in the playoffs as long as it doesn’t add up to more than 10 for the entire year (regular season + playoffs). So far, the Lions have returned three (Brodric Martin, Emmanuel Moseley, Ifeatu Melifonwu).



BUFFALO BILLS

Credit to @BangedUpBills for help with the analysis. The Bills had a walkthrough on Wednesday and a virtual meeting only on Thursday.

Out – Rasul Douglas CB, knee (NP NP NP)

This starting CB has not missed a game this year but will miss his first after hurting his left knee last game.

Questionable – Taylor Rapp S, neck/shoulder (NP NP LP)

Rapp hurt himself two weeks ago and was limited in the last game despite playing every snap. He may continue to try to play through but there are rumors that he will be out.

Questionable – Damar Hamlin S, back/ribs (FP NP LP)

This starting safety has played in every game this year logging close to 100% of snaps including 100% last game. Unless something significant happened during walkthroughs, he’ll likely play. He has 2 interceptions this year.

Questionable – Dalton Kincaid TE, knee (FP FP FP)

Expect this starting TE to play after missing the last three games due to a PCL. He is a very good receiver with 34 receptions for 356 yards this year.

Questionable – Dawuane Smoot DE, wrist (FP FP FP)

Smoot missed the last four games on IR with wrist surgery but is eligible to return on Sunday. He typically plays about 50% of snaps.

Questionable – Baylon Spector LB, calf (FP FP FP)

After missing four games on IR, Spector is eligible to return on Sunday. He has started multiple games this year.

Questionable – Casey Toohill DE, ribs (LP LP LP)

Toohill is a backup DE who plays about 25% of snaps.

Questionable – Quintin Morris TE, shoulder/groin (FP FP FP)

Morris is a backup who has 2 receptions for 16 yards this year.

Questionable – Tylan Grable OT, groin (FP FP FP)

Grable has not played since September 23.

In – Keon Coleman WR, wrist (FP FP FP)

This 2nd-round rookie will return after missing the last four games. He has 22 catches for 417 yards which is second on the team behind Khalil Shakir (735 yards).


Here is the full report:

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