Examining potential situations for Josh Allen's elbow injury

The best-case scenario for Allen is the injury is a day-to-day situation

Buffalo, N.Y. (WBEN/WGR 550) - Towards the end of Sunday afternoon's Buffalo Bills loss to the New York Jets at MetLife Stadium, quarterback Josh Allen went back to pass as he looked to put together a final game-tying or game-winning drive.

On a second down play, Allen dropped back and as he was attempting a throw down the field, Jets pass rusher Bryce Huff make contact with the quarterback's right throwing arm, forcing a fumble on the play. After a third down throw that fell incomplete, Allen was seen grabbing at his arm and elbow and grimacing in some pain.

The drive and the game ended on the very next play with an incomplete pass by Allen that traveled nearly 70 air yards, which was the longest throw recorded over the last six seasons.

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After the game, Allen addressed the media and was asked about his right elbow, saying there was some slight pain, "but we'll get through it."

During his meeting with the media on Monday, Bills head coach Sean McDermott further addressed Allen's elbow injury, saying his elbow is still under evaluation by the medical team, and he would provide a further update prior to Wednesday's practice in Orchard Park.

As Bills fans wait for a prognosis of Allen's throwing elbow, one medical professional provided his thoughts on the injury, saying the first area the team and other doctors are going to examine is the interior of his right elbow, which could be the biggest cause for concern.

"In order to get the throwing mechanics to work, first you need muscles and tendons that attach the muscles to the bones in order to be intact, in order to have the throwing mechanic work," said Dr. Jason Matuszak, Chief of Sports Medicine at Excelsior Orthopedics. "Those are something called the flexor pronator muscles on that part of the elbow, and that'll be the first area that they want to evaluate for, to make sure that the muscles and tendons are intact and that the motion is still working."

However, judging on the last throw of the game for Allen on Sunday, Dr. Matuszak believes that the muscles and tendons in the elbow are just fine.

The next angle doctors will be looking at with Allen's elbow is pertaining to his ulnar collateral ligament, or UCL, in his throwing arm to examine the extent of damage there.

"That's what actually gives our joints stability, and allows them to function in space," Dr. Matuszak said. "[It's] the elbow ligament that joins the two bones together from the forearm to the upper arm, and that's really important for making sure that the elbow remains stable, that the two bones are in relation to each other as the throwing mechanic is happening."

If a UCL is damaged in the throwing arm of a quarterback, Dr. Matuszak says it will affect the accuracy of passes being made, which could be an indicator going forward if Allen happens to be able to play. In order to tell if a player has suffered a torn UCL in their elbow, doctors will apply a stress test to see if there is still stability in that elbow.

The final factor that doctors will be examining in their tests leading up to the prognosis is for any injury to the ulnar nerve in the elbow.

"Most people will recognize this as being the 'funny bone' nerve, meaning that you know when you whack your elbow or your elbow gets hit and you get that zing, or that jolt down into your hand that comes out where your pinky and your ring finger are and it forces you to kind of shake out your arm, that's that 'funny bone' nerve, the ulnar nerve," Dr. Matuszak said.

When it comes to an injury relating to the ulnar nerve for athletes, Dr. Matuszak explains there are a couple of situations that may be a factor, especially in a case like Allen's injury.

"In a play like this, that's one of the things that we might see is where that nerve gets stretched. Another thing that we can see is that the ulnar nerve, in certain cases, can actually pop out of the groove that it usually sits in on the backside of the elbow," Dr. Matuszak said. "If it's just stretched and injured, that's a relatively minor injury. If it pops out of the groove, that can be a longer lasting thing."

According to Dr. Matuszak, the best-case scenario for Allen is the injury is a day-to-day situation, meaning he's managing the symptoms, getting treatments and he's still able to play. However, there is the chance that Allen can miss some time, similar to what he did when he suffered a sprained UCL back in 2018.

"A step below that would be a week or two, and then the more common type of thing would be in the 2-4 week range, if it was going to be something that caused him miss time at all."

Compared to Allen's right elbow injury back in his rookie season, Dr. Matuszak believes it was more from a trauma blow to the arm, which is a significantly greater force being put on a UCL and results in a higher grade injury. However, with Allen's arm being pulled back like it was on Sunday, Dr. Matuszack believes this would be less substantial trauma to that part of his elbow.

For Allen's sake, Dr. Matuszak is hoping that Allen's injury is nothing more than the ulnar nerve being pinched or banged up like someone banging their "funny bone" on the table. If it's a low-grade injury such as that, he says Allen should be back to his usual self within a few weeks.

If it's anything more than that like a moderate-grade injury, Dr. Matuszak adds Allen is likely going to be dealing with it for the bulk of the season, and managing it on a week-to-week basis.

Hear more of our conversation with Dr. Matuszak in the player below:

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