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Buffalo Bills quarterback Josh Allen is an NFL MVP candidate, the leader of one of the best teams in football, and arguably the best quarterback in the league in 2022. Unfortunately, at the end of the Bills’ Week 9 loss to the New York Jets, Allen suffered an elbow injury, and the team is now evaluating his status moving forward.

The scary piece for Bills fans is that the injury may be an ulnar collateral ligament (UCL) injury, which is a ligament on the inner side of the elbow. The last time Allen missed an NFL game was in his rookie year with a UCL injury. That season, he missed four games. However, UCL injuries are also the type of injuries that often affects baseball pitchers and is fixed with the infamous Tommy John surgery.

The diagnosis of Allen’s elbow injury is still unclear. Maybe he misses Week 10 to give his elbow a little rest. Maybe he will miss four games again like he did in 2018. Or maybe it’s more serious, and Allen ends up out for the year.

In these cases, here’s what happens to the Bills, and the NFL as a whole, if the QB misses a week, a month, or a year because of this Josh Allen injury.

The Josh Allen elbow injury costs him a week

If Josh Allen only misses one week, the first thing that will happen is that the National Weather Service will register a massive collective sigh of relief coming from Western New York. Allen missing any time isn’t great, but it is a minor bump in the road in the grand scheme of things.

If this happens, Case Keenum steps into the spotlight and takes over for the Bills’ Week 10 matchup with the 7-1 Minnesota Vikings.

From here, one of two things happens.

One is that Keenum could win the game and go down in history with beloved Bills backup quarterbacks like Frank Reich and Doug Flutie. Getting a win without Allen is possible based on the excellent Bills roster, even against a tough opponent like the Vikings.

The other scenario is that the Bills lose. This isn’t a death knoll — especially because it’s against an NFC opponent — but it’s certainly not ideal. After losing to the Jets and Miami Dolphins in the AFC East, both teams could surpass Buffalo in the division standings. The Dolphins would do it by going 7-3, and the Jets (on a Week 10 bye) would move into a 6-3 tie and own the head-to-head tiebreaker.

However, if the Bills did take the L and then battle back in the division and conference as the year went along, they’d still have a leg up in the No. 1 seed race with their wins over the Kansas City Chiefs and Tennessee Titans.

Allen could miss a month, like in his rookie season

A Josh Allen injury update that says he’s out a month becomes seriously problematic for the Buffalo Bills and changes the entire 2022 NFL season.

On an individual level, Josh Allen’s MVP campaign is over if he misses four games. That’s certainly the least of Allen and Bills fans’ worries, but it is worth noting as Allen continues to build his resume as a generational QB.

On a team level, Case Keenum now starts vs. the Minnesota Vikings, Cleveland Browns, Detroit Lions, and New England Patriots. Keenum went 2-0 as a starter last season with the Browns but has never won more than three games in a row, which he did in 2018 with the Vikings and in 2016 with the Los Angeles Rams.

The Keenum Effect on the Bills is a sliding scale based on how the team performs with the backup in charge. A 3-1 record likely keeps the division and conference in play. A 2-2 mark preserves the playoff hopes but almost ensures a Wild Card game. If Keenum goes 1-3 or 0-4, Buffalo’s playoff hopes will come into question.  

The silver lining here is that even if the team goes 0-4 with Allen out for a month, the superstar would come back with five games (vs. Jets, Dolphins, Chicago Bears, Cincinnati Bengals, Patriots) left to play. And if he’s back to 100% healthy, running the table and finishing 11-6 isn’t out of the question.

This scenario will be nerve-wracking for Bills fans and give the team little margin for error down the stretch, but missing four games to let the Josh Allen elbow injury completely heal is still far better than the alternative.

The worst-case scenario

The Buffalo Bills quarterback Josh Allen elbow injury coudl be a problem for the team and the NFL.
Josh Allen | Rich Graessle/Icon Sportswire via Getty Images

Is Josh Allen Already the Best QB in Bills History?

Josh Allen going out for the remainder of the 2022 NFL season falls somewhere on the gut-punch scale between last season’s “13-seconds” loss to the Chiefs and Scott Norwood’s “Wide Right” in the 1990 Super Bowl.

Without Allen, maybe the Bills have enough momentum with a 6-2 start to squeak into the playoffs. However, the team is no longer a Super Bowl contender.

The MVP Award goes to Jalen Hurts or Patrick Mahomes or Lamar Jackson, or maybe even Geno Smith. If Mahomes or Jackson win the award, it will one day give them an extra chip in the greatest QB of the generation arguments over Allen.

That’s of little concern to Bills fans in this scenario, though.

With Allen out for the year, the Dolphins or the Jets take the AFC East, possibly usurping the Bills as the next dominant AFC East team after two decades of Patriots supremacy. It also gives the Titans, Baltimore Ravens, and Bengals more Super Bowl hope and makes the Chiefs the prohibitive AFC favorite.

In summation, if the Josh Allen elbow injury ends his 2022 season prematurely, it’s bad for the NFL — which is hurting for elite QBs this season — and absolutely crushing to the Buffalo Bills.

Here’s hoping we haven’t seen the last of Allen in 2022.