NFL Injury Report Week 4: Buffalo Bills vs New Orleans Saints
It’s Sunday in Orchard Park, and the Week 4 tilt between the Buffalo Bills and New Orleans Saints might not look like much on paper, but the storylines are stacking up like tailgate tables. The Bills are undefeated, the Saints are winless, and the only real drama might be whether Buffalo can keep its streak alive without tripping over its own injury list. Josh Allen is on an absolute heater right now, and we’re talking Zoolander-level hot. With the way he’s rolling, the only thing that seems capable of slowing him down is the availability of the guys around him.
Buffalo’s roster isn’t coming in fully intact. Star DT Ed Oliver and LB Matt Milano are already ruled OUT, two massive holes in the middle of Sean McDermott’s defense. During McDermott’s media session, he mentioned “It’s not clear where they’re going to be. They’re trending in the right direction, I don’t know for sure if they’ll be ready to go for next week’s game”. Offensive Tackle Spencer Brown and DE AJ Epenesa both carry QUESTIONABLE tags, and their status could swing things in the trenches. On the brighter side, rookie CB Maxwell Hairston was spotted ramping up drills on the sideline with trainers this week. He’s still on IR, but with his 21-day return window looming, the Bills may be inching closer to getting another young piece back in the secondary.
On the other side, the New Orleans Saints are desperate to find their footing after a tough start to the season. They’ll be shorthanded up front and on defense, with OL Dillon Radunz and DE Chase Young ruled OUT. Wide receiver Devaughn Vele is also listed as QUESTIONABLE, adding even more uncertainty to an offense that’s still searching for consistency.
OUT
DT Ed Oliver; This one’s a head-scratcher. Oliver held a full press conference two weeks ago after practice looking perfectly fine, then somehow rolled into the facility the next morning with a walking boot on his left ankle. Sean McDermott chalked it up to getting “stepped on” during practice, but the details don’t quite add up.
Adam Schefter reported it’s a multi-week injury, and considering the boot plus this timeline, the most logical diagnosis is a high ankle sprain. Those usually linger 4–6 weeks (BJSM, 2020).
So even though the Bills have kept him off IR, he is set to miss his third straight game. He has yet to practice since his injury, missing eight straight practices since September 10th. There is hope he will be back next week against the Patriots but it will be tough to get back based on how he was walking around last Thursday at the Dolphins game.
LB Matt Milano; Linebacker Matt Milano’s Week 2 matchup against the Jets came to an early end after a freak sequence late in the second quarter. Milano tripped, braced his fall with his arms, and injured his right pectoral muscle in the process. He was absent from practice the past two weeks and is set to miss his second straight game.
A pectoral injury can have a wide recovery range. According to a 2021 NFL study, roughly 45% of pec strains do not require surgery, with an average return-to-play timeline of 47 days. That said, outcomes can swing dramatically depending on whether the injury is classified as a Grade 1 or Grade 2 strain.
Bills fans may remember Milano has dealt with this exact issue before. In 2020, he suffered a pec strain that forced him to miss two games, briefly return, then ultimately land on injured reserve for four additional weeks. For comparison, fellow linebacker Terrel Bernard only missed two weeks with a pec strain last season — proof of just how variable this type of injury can be. Look for Milano to make a push to play next week, but likely will need another week of recovery due to his age and lengthy injury history.
QUESITONABLE
OT Spencer Brown; Right tackle Spencer Brown popped up on the injury report this week with a calf issue. Brown himself downplayed it a bit on One Bills Live, saying his calf “got a little weird” on him last week but that he was able to finish the game.
Still, the concern is real. He did not practice on Wednesday or Thursday and only returned in a limited capacity on Friday. Durability questions continue to follow him. Brown missed the start of training camp with a back injury, dealt with reported cramping in Week 1, and now faces this new calf problem. The lingering question is whether these issues are connected, with the calf perhaps tied to his back troubles. Time will tell if this is just a minor bump or part of a larger pattern the Bills will need to manage. I would not expect him to play, but return next week, especially after the effort in the stretching portion of practice on Friday.
DE AJ Epenesa; Epenesa has been limited all week with a left side pectoral injury. At first glance, the fact that he was able to practice in a limited capacity all week might seem unusual, as typically pec injuries (like the ones that sidelined Matt Milano and Terrel Bernard) are tough to work through. However, reports indicate this is a rare pec minor injury rather than the more common pec major.
The pec minor sits beneath the pec major, functioning primarily as a scapula stabilizer rather than a prime mover, which makes it a bit easier to rehab and play through. Still, asking him to return after just one week of recovery is a tall order. Expect the Bills to either deploy him on a strict snap count or hold him out entirely until Week 5.
Players on Injured Reserve
Outside of rookie defensive tackle DeWayne Carter, who remains out long-term, the Bills could soon be getting some reinforcements back. Three players; CB Maxwell Hairston, K Tyler Bass, and OT Tylan Grable, will all be eligible to have their 21-day practice windows opened next week.
CB Maxwell Hairston (Knee- LCL); On Wednesday, coach McDermott left some concern that Maxwell Hairston might not actually return this year.
However, Hairston then went on to show up for field drills progressing from very light exercises on Wednesday to cutting and sprinting on Thursday. This bodes well for activation to the 21-day practice window imminently.
K Tyler Bass (Left hip/groin); Tyler Bass has no timetable to return. The effectiveness of K Matt Prater makes you wonder if they will just drag this one out until he starts to falter.
OT Tylan Grable (Concussion)
DT DeWayne Carter (Achilles)
Returning from Suspension
Defensive end Michael Hoecht and defensive tackle Larry Ogunjobi are now permitted back in the facility and can begin practicing next week. However, both remain ineligible to play until Week 8 as they complete their six-week suspensions.
