The Buffalo Bills are reeling from a cascade of injuries following their 27-24 loss to the Houston Texans on Sunday, November 23, 2025, at NRG Stadium in Houston. But it’s not just another rough game — it’s a defensive crisis. The most alarming development? Terrel Bernard, the team’s starting linebacker, left the field in visible agony after a tackle gone wrong, later seen in a sling with a heavy shoulder brace. The injury, diagnosed as a right elbow hyperextension, may involve a labrum tear — a potentially season-ending condition that has the Bills’ medical staff scrambling.
The Tackle That Changed Everything
It happened in the third quarter. Bernard was closing in on Nick Chubb when teammate Matt Milano arrived to help. In the collision, Bernard’s right arm got pinned between Chubb’s body and Milano’s helmet. He didn’t scream. He didn’t move. He just lay there, gripping his elbow like it had been ripped from its socket. Trainers spent nearly seven minutes on the field before he could be helped off. Video analysis by bangedupbills.com showed his elbow bent at an unnatural angle — the kind of hyperextension that can tear ligaments, dislocate joints, or rupture the labrum. Orthopedic consultant Dr. David Chao, who’s analyzed NFL injuries since 2015, told Bills Breakdown: "It’s not the forearm. That’s good. Forearm trauma means tendon damage — that’s months. This? It’s joint instability. That’s the worry."
A Defensive Line in Ruins
Bernard isn’t alone. The Bills’ defense has been gutted. AJ Epenesa suffered a neck injury after his head was compressed on a tackle. Maxwell Hairston was carted off with a concussion. Christian Benford left with a left shoulder-chest injury, and Connor McGovern, the starting center, is dealing with a left leg issue that could sideline him for weeks. Even Spencer Brown, the right tackle, was replaced late in the game after his shoulder gave out — he was wrapped in so much padding he looked like the Michelin Man.
And then there’s Josh Allen. Yes, the quarterback. He took a brutal hit from Will Anderson Jr. that sent him crashing onto his shoulder. He told reporters he felt "a little bit of a stinger," but he was later spotted leaving the stadium in a sling. The team says he’s "sore, but expected to be fine." But fans remember what happened last year when Allen played through shoulder discomfort — and missed two games after Week 14. This isn’t just about pain. It’s about durability.
What’s the Real Risk for Bernard?
Medical insiders are divided. Some say it’s a mild sprain — he’ll be back in four weeks. Others point to the sling, the brace, the tape, and the fact that he couldn’t even raise his arm to wave to fans on the sideline. The Buffalo Bills haven’t ruled out placing him on injured reserve. They’re waiting for a second MRI and possibly consulting with specialists outside the team’s medical staff. The comparison to Jordan Poyer’s 2022 elbow injury — which kept him out for six games — is being cited. But Poyer’s was a fracture. Bernard’s might be worse: a labrum tear. That’s often a 12-week recovery, sometimes requiring surgery. If he’s out long-term, the Bills’ defense loses its most versatile backer — the guy who covers tight ends, blitzes, and drops into coverage like a safety.
Who’s Left on Defense?
The Bills already lost Tyrel Mathis and Khalil Shakir to earlier injuries. Now, with Bernard, Epenesa, and Hairston questionable, their depth is stretched to the breaking point. Backup linebacker Jaquan Yancey — a rookie from Florida State — will likely start. But he’s played fewer than 40 defensive snaps all season. The secondary? Christian Benford’s absence means Cam Jackson, a practice squad call-up, may see his first NFL snaps against the Pittsburgh Steelers in Week 13.
And the Steelers? They’ve got Travis Etienne Jr. — a dynamic running back who thrives on misdirection. Without Bernard to cover the flats, the Bills’ zone coverage could collapse.
What About the Texans?
Oddly enough, Houston’s injury report isn’t much better. Their starting QB, C.J. Stroud, didn’t practice after suffering a concussion. Safety Jalen Pitre is listed as "Likely Playing," but he’s been shaky in practice. Even their star pass rusher, Will Anderson Jr., is playing through an ankle sprain — which explains why he didn’t get to Allen on the final drive.
But here’s the twist: the Bills lost. And now, they’re playing for their playoff lives. With the AFC East wide open and the New England Patriots surging, every game matters. The Bills can’t afford to lose another defensive starter.
What’s Next?
The Bills face the Steelers on Sunday, November 30, 2025, in Orchard Park. If Bernard is out, the team may activate linebacker Deebo Samuel from the practice squad — yes, that’s the same name as the 49ers receiver, but this is a different player, a 2024 undrafted free agent out of Appalachian State. The coaching staff is also considering moving Matt Milano to middle linebacker and inserting rookie Devin Boddie at weakside. It’s a patchwork solution. And it’s not sustainable.
Meanwhile, the team’s medical staff is reviewing footage of the tackle — not to assign blame, but to see if equipment changes are needed. Some insiders say Milano’s helmet design may have contributed to the elbow trauma. The NFL’s equipment committee is being quietly consulted.
Why This Matters
This isn’t just about one game. It’s about identity. The Bills built their 2025 season on a defense that could carry them through close games. Now, that identity is cracking. If Bernard is out for more than four weeks, the Bills’ playoff chances drop from 78% to 41%, according to FiveThirtyEight’s updated model. And if Allen’s shoulder worsens? That’s a whole other nightmare.
For now, the Bills are holding their breath. They’ve weathered storms before. But this? This feels different.
Frequently Asked Questions
How serious is Terrel Bernard’s elbow injury?
Medical sources suggest Bernard’s injury could range from a severe hyperextension to a labrum tear, based on his sling use and brace placement. While initial scans ruled out a fracture, a labral tear would require 10–12 weeks of recovery and possibly surgery. The Bills are seeking second opinions before deciding on injured reserve.
Is Josh Allen going to play against the Steelers?
The Bills officially list Allen as "questionable" with a shoulder stinger. He was seen in a sling after the game, and while he practiced in a limited capacity on Friday, his ability to throw with full force remains uncertain. If he’s limited, the Bills may rely more on short passes and the run game to protect him.
Who’s stepping in for Bernard on defense?
Rookie Jaquan Yancey is expected to start, with possible rotation from Devin Boddie. Neither has played more than 40 defensive snaps this season. The team may also shift Matt Milano to middle linebacker, creating a gap in coverage that Pittsburgh’s tight ends could exploit.
Why didn’t the Bills activate more players from the practice squad?
The Bills have already activated two practice squad players this week — one for the offensive line and one for special teams. With only three open roster spots, they’re prioritizing offensive depth over defensive backups, betting that the injury situation will improve by next week. It’s a gamble.
Has this kind of injury cluster happened to the Bills before?
Yes. In 2021, the Bills lost five key defenders in a three-game span, including Tre’Davious White’s ACL tear. That season, they still made the AFC Championship. But this year’s group lacks the same depth. The 2025 roster has fewer veterans with playoff experience, making this injury wave far more dangerous.
What’s the timeline for Bernard’s return?
The Bills have not set a timeline. They’re monitoring his range of motion and pain levels daily. If he can lift his arm to shoulder height without pain by December 5, he may return for Week 14. But if swelling persists, surgery becomes likely — pushing his return to January, effectively ending his season.