Over the last two years, Dalton Kincaid became one of the best collegiate tight ends at Utah. This is despite only playing a year of high school football followed by two years at FCS level San Diego. 

Appearing in 55 collegiate games and leading all FBS tight ends with 890 yards this season, Kincaid ended his season abruptly due to a back injury. While any injury will be poked and prodded at during the draft process, there is always the potential for one injury leading to another. 

Below is Dalton Kincaid’s publicly reported injury history along with any concerns if he were to be drafted by the Buffalo Bills. 

2022

Right shoulder injury, missed 1 game. 

While scoring a touchdown in the third quarter against Washington State, Kincaid suffered a right shoulder injury. He landed on the right side, slowly getting up and walking off with trainers. He was later reported as day-to-day. 

Dalton Kincaid scores for Utah, but hurts his shoulder. It’s safe to say Utah has caught the injury bug this season.

pic.twitter.com/yd6ldcOrIV

— Brendan Moore (@bmoorecfb) October 28, 2022

He missed the next game and observing the mechanism of injury, it is possible he sustained an AC joint sprain. 

Back fracture, missed 1 game. 

Kincaid suffered a back injury after he fell and had a Colorado defender land on him. You can see the play below. 

pic.twitter.com/ySsbpnQhrs

— justice for tortuguita (@zacharyengberg) March 1, 2023

He played the following week in the Pac-12 Championship game before further testing showed that he had a “small fracture”, forcing him out of the Rose Bowl. Based on the sudden, forceful flexion of the legs and lower body, there is a concern for a compression fracture in the lower thoracic or lumbar vertebral body.

He was cleared to work out on March 20th but did not test Utah’s Pro Day and was unable to test at the NFL Combine.

Reading his brief injury history, there could be a concern about the back injury affecting his draft stock. To understand the injury, a review of the anatomy is necessary. 

4 burning questions facing the Bills ahead of the 2023 NFL Draft

Anatomy

The thoracic and lumbar vertebrae are comprised of twelve and five vertebrae in the lower back that lie below the cervical vertebrae and above the sacrum. Each section of vertebrae in the human spine is designed differently based on the function necessary at that level. The thoracic vertebrae are smaller and shaped differently from the lumbar vertebrae, but do have similar structures and articulate with the ribs. The lumbar vertebrae have a thicker vertebral body along with the pedicles and lamina, which create a cage around the spinal cord that passes through. This area also supports the upper body in staying upright during standing and walking. 

Surrounding the support structure is the spine, transverse process, and superior and inferior articular processes. These allow for articulation between the vertebrae and serve as attachment points for ligaments and tendons in the back. When articulated with other vertebrae, they also create openings for the spinal nerves to pass through and into various portions of the body. 

Compression fracture 

Looking at the back fracture that Kincaid suffered, it’s possible he suffered a compression fracture based on the mechanism of injury observed above. Compression fractures in the thoracic or lumbar region are falls that result in an axial load on the vertebrae. This is a force that pushes the top down or bottom up. Think of someone landing on their tailbone and that sudden forceful compression fractures the vertebral body. These can also happen with sudden or overloaded flexion, extension, or rotation of the area.

There are three types of compression fractures: wedge, crush, and burst fractures. Wedge and crush fractures are the most stable fractures whereas burst fractures are exactly what the name implies, the bone bursts apart. These are unstable and can cause many problems.

He likely suffered a wedge fracture to the area as this is when the anterior portion of the vertebral body is damaged, known as the superior end plate. These happen 62 percent of the time. A crush fracture happens when both the superior and inferior end plates are damaged, but these are less common at 6 percent. According to research, the highest likelihood of area for these fractures to occur is T12-L2 with 60-75 percent of compression fractures occurring here. 

Once team physicians knew that there was no vertebral loss height or instability within the bone that required surgery, then healing can take place. Most compression fractures take between two-to-three months to fully heal. It appeared as though Kincaid took about that amount of time, eventually cleared for all activities roughly four months after the original injury in March. 

Other possible fractures

There is a possibility that he suffered a pars interarticularis fracture as those are also considered minor. This is the area between the superior and inferior articular processes within the vertebrae. 

These fractures are seen often at L5, much lower than the compression fractures mentioned above. These types of injuries happen acutely or insidiously in adolescence as a result of repeated lumbar extension or rotation. Considering the tight end position does incorporate those movements, this can’t be ruled out looking from the outside. 

Instability within the vertebrae due to the fracture would cause spondylolisthesis. This is slippage of one vertebra over the other with increasing levels of severity that can cause weakness and pain down the legs. These can be managed conservatively and healed on their own, but surgery may be indicated with severe slippage. 

However, the mechanism of injury doesn’t fit what we see on film. If he did have this issue, this could be more of a concern, but without any additional information, it remains speculation. 

Finally, other possibilities include transverse, articular, or spinous process fractures but these would not result in a long healing time. This is evident with Tony Romo, Jameis Winston, and Derek Carr who all dealt with some variations of these. 

It’s worth highlighting that Romo did also suffer a compression fracture in the preseason that contributed to the end of his NFL career. He was projected to miss six-to-ten weeks, ultimately missing ten weeks before returning as a backup QB to Dak Prescott. 

NFL Outlook

While Kincaid’s shoulder injury did cost him one game due to the likely AC joint sprain, it is not concerning. This is a very common injury amongst all football players that do cost players time following the hit but does not tend to linger. 

The biggest concern is the back fracture and understanding the type of fracture does reduce the level of concern. Players with pre-existing lumbar injury diagnoses have been shown to have a shorter career length (4.0 vs 4.3 years), fewer games played (46.5 vs 50.8), and started (28.1 vs 30.6). This can lead to a lower draft position as result. However, the majority of those athletes in the study had either disc herniation, spondylolysis, spondylolisthesis, or fusion. The possibility for spondylolisthesis is there, but unlikely.

Kincaid doesn’t fall into any of those injury concerns thankfully. 

Buffalo Bills Outlook

Nothing in the literature indicates that there are any risks moving forward. This appears to be a one-off injury that should not affect his health. These types of injuries typically do not scare the Bills in the first two rounds of the draft. 

Kincaid is projected as a first-round prospect that may fall to the Bills; it would be hard for them to pass on his skill set if available. The only reason they would not select him is if they only draft players with RAS scores from pre-draft testing. Looking back through 2017 when Sean McDermott was hired, the Bills have never selected a player without a RAS score. This shouldn’t disqualify Kincaid from the Bills selecting him, but it would be a first for this regime. 

He could possibly drop to the second round but will likely not be there by the time the Bills are ready to pick again, barring a significant trade-up. He may be a prospect that’s selected if he is truly the best player available on the board for Buffalo. The Bills need offensive playmakers and giving Josh Allen another weapon at tight end will not only help address the future but also the present.