Josh Allen injury impact: Top 3 ways Bills offense will change if Case Keenum starts at quarterback

Invoices quarterback Josh Allen missed practice Thursday and had a limited session Friday as he treats a right elbow injury to the ulnar collateral ligament and related nerves. He is listed as doubtful for Week 10, and veteran substitute Case Keenum would start on Sunday against the Minnesota Vikings if he is unable to go.

There is no replacement for Allen if he misses a time frame. He’s been the MVP favorite for most of the season and embodies the phrase “one man band” better than anyone in the league right now. He leads the Bills in rushing and has the fifth-most yards (passing and rushing) by any player in eight games since the AFL-NFL merger in 1970. He is the source of 23 of the Bills’ 25 touchdowns this season, the highest rate (92%) in the NFL.

Below is a look at the total yards (passing and rushing) in eight games – since 1970.

Bills head coach Sean McDermott has seen the best and worst of backup quarterback situations, and luckily Case Keenum is a little more Jeff Garcia and a lot less Nathan Peterman. When Donovan McNabb was injured in 2006 with McDermott as Eagles‘ defensive coordinator, Garcia took over and Philadelphia won its last five games to qualify for the playoffs. A little different from 2017, when Peterman threw five first-half picks in his first career start. A year later, when Allen missed the only five games of his career, Buffalo started three different quarterbacks (Peterman, Derek Anderson, Matt Barkley) and went 1-4.

There’s reason Bills Mafia is confident that Keenum could keep the seat warm for Allen. It would be the best supporting cast Keenum has played with since 2017 with the Vikings, when Minnesota had capable wide receivers and No. 1 scoring defense, just like this Buffalo team. Keenum went 11-3 that season, finished seventh in passer ratings, and helped lead Minnesota to the NFC Championship. He can hold down the fort, but he can’t get within close range of Josh Allen.

Here are the three biggest changes you can expect:

1. Trade the long game for an intermediate action

Don’t expect a re-enactment of the Minneapolis Miracle, though Keenum would reunite with Stefon Diggs and take on his old team. Keenum hasn’t had a single completion for more than 20 yards on the ground in two starts with the Browns last season. This ball thrown to an open Odell Beckham Jr. on a double movement shows its limits:

Allen is 14 of 24 for 618 yards and six touchdowns on throws over 25 yards this season — all league-best marks. He can make throws that only a small handful of people in the world can, like the seed he threw into the smallest of windows at Dawson Knox for the game-winning touchdown against Kansas City earlier this year.

Keenum should be useful in the middle passing game. He ranks above the league average in completion percentage on throws from 11-20 yards since 2017, and below average on short and deep throws.

Less than 10 aerial meters



11-20 aerial meters



21+ airyards



This touchdown pass to Jarvis Landry last year is a good example of game design that works for Keenum – play action with a deep cross that he hits in stride for a score:

2. Conservative on third try

The Bills could miss Allen the most on third down. Buffalo leads the NFL in third-down conversion rate (52%) this year and has the third-best third-and-long rate (38%).

We know Keenum won’t crush defenders on crucial downs like Allen, who is tied for second on third down conversions this season. Allen has also embraced the gunslinger mentality on third down, where he has the longest average passing length in those situations this season (minimum 50 attempts).

Allen has a 127.0 passer rating on third down passes to first down scorer this season. Keenum has a 66.0 rating in those situations since 2017, one of the worst ratings in the NFL.

That could mean more action for Bills punter Sam Martin. Buffalo has 15 punts this year, the fewest in the NFL, a stat I’m sure they use as a badge of honor.

3. No improvement

Buffalo also won’t be able to rely on Allen’s improvisational skills to make big plays. Allen leads the NFL with 9.0 yards per attempt when under pressure this season. He has a better passer rating when under pressure (96.0) than Tom Brady on all plays (90.5).

His runaway deep ball to Diggs in Week 1 is a pitch Keenum doesn’t have in the arsenal:

One thing Keenum will have at his disposal is the aforementioned Diggs. Keenum actually has similar numbers to Diggs in his career as Allen. And Keenum was pitching at Diggs before he became a superstar and was Adam Thielen’s No. 2 option at Minnesota.

Percentage complete



Yards Per Attempt



Passer ranking



It would be easy to assume Buffalo will go more ground game without Allen, but I’m not so sure. The Bills have one of the worst running blocking units in football and they rank fourth in the Rush EPA this year. The Bills are throwing one of the highest rates in the league and sometimes a check pass is like a run. That’s why Buffalo traded for Nyheim Hines, who could get more involved.

Either way, let’s hope Allen can play despite an injury that could threaten an MVP campaign and Super Bowl run. Football wouldn’t be as fun without him.

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