Bills dominate, while Dolphins face uncertainty after Tua's injury

MIAMI GARDENS, Fla. — The Buffalo Bills rolled to yet another victory over the Miami Dolphins on Thursday night, using three first-half touchdown runs by James Cook and two interceptions by Ja’Marcus Ingram to blast the Dolphins 31-10 at Hard Rock Stadium.

The loss wasn’t Miami’s biggest concern, though, as quarterback Tua Tagovailoa suffered a concussion late in the third quarter. Tagovailoa was immediately ruled out after a night in which he threw three interceptions — one of which Ingram returned for a third-quarter touchdown. Now the Dolphins face an uncertain future as they evaluate Tagovailoa, who has had concussion issues in the past.

Here are the most important things to know from Thursday night for both teams:

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For so much of Josh Allen‘s career, he has been the main supplier of Bills rushing touchdowns. That wasn’t the case on Thursday night in a statement AFC East win.

As Allen dealt with an injury to his left hand suffered on a touchdown run — or leap, more specifically — in Week 1, Cook had a career night. His three touchdowns helped the Bills to a decisive victory over the Dolphins. In one game, Cook matched his rushing touchdown total from both last season and the season prior (two in each).

Cook’s first touchdown came on the first drive of the game — following the first of two interceptions by Ingram — on a 17-yard touchdown pass by Allen. The second was a 1-yard rushing score in the second quarter and the third came on Buffalo’s very next offensive play. Cook darted 49 yards untouched into the end zone to put the Bills up 24-7. Since ESPN began tracking yards before contact in 2006, Cook is the seventh player with an untouched rushing touchdown of 49 yards or more.

The team finished with 108 yards on the ground, with Cook accounting for most with 11 attempts for 78 yards and one reception.

Offensive coordinator Joe Brady continues to put an emphasis on running the ball, while Allen finished the game completing 13 of 19 passes for 139 yards and one touchdown.

It’s a new cast of characters around Allen in the wide receivers room, but this offense has shown early that it can put up points and take advantage of opportunities.

Most surprising performance: The Bills have found success with defensive backups in the past, but Ingram has made an absolute statement through the first two games. Coach Sean McDermott said Ingram would have been a healthy scratch in Week 1 if defensive end Dawuane Smoot wasn’t injured, but instead Ingram played in the dime package after nickel corner Taron Johnson injured his forearm and Cam Lewis shifted to nickel and defended the game-ending play. Against the Dolphins, Ingram — an undrafted free agent from the University of Buffalo in 2022 who spent the previous two seasons on the practice squad — put on a show with two interceptions, including a pick-six. Even when Johnson returns, Ingram should be given even more opportunities.

Pivotal play: Up 10-7, on third-and-12 from the Miami 34-yard line, Allen waited in the pocket, then ran out to his right and uncorked a 33-yard throw across his body to running back Ty Johnson. The impressive throw set up a 1-yard rushing touchdown by Cook on the next play, giving the Bills a double-digit lead they never reliquinished.

Describe the game in two words: Statement maker. If there was any doubt the AFC East still runs through Buffalo, New York, it was eliminated with this decisive win on the road. The Bills are 20-5 vs. the division since 2020 and, Allen’s record vs. the Dolphins is 12-2. Thursday also marked the Bills’ fifth-straight win, including in the postseason, over Miami.

Promising trend: The defense limited big plays. Tagovailoa went 0-of-4 on passes 15 yards downfield and 2-of-8 on throws 10 yards downfield. In Week 1, Cardinals quarterback Kyler Murray went 0-of-6 on passes of 10 or more air yards. — Alaina Getzenberg

Next game: vs. Jacksonville Jaguars (7:30 p.m. ET, Monday, Sept. 23)

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A nightmare.

There’s no other way to describe the Dolphins’ loss to the Bills.

Not only did they lose for the 10th time in their past 11 matchups with their AFC East rival, but they potentially lost their quarterback for an undetermined amount of time. Tagovailoa suffered a concussion late in the third quarter, after a hit to the helmet kept him on the ground for several minutes while players kneeled around him.

He was able to walk off the field and eventually into the locker room under his own power. Besides a collective gasp as Tagovailoa writhed on the ground after the hit, Dolphins and Bills fans alike were left stunned in an eerily quiet Hard Rock Stadium.

Tagovailoa’s concussion history — two diagnosed concussions during the 2022 season — will likely mean he and the team will be monitored over the next 10 days with intense scrutiny. What happens if he clears the NFL’s concussion protocol in time for Miami’s game against the Seattle Seahawks in Week 3? Would 10 days be enough for the Dolphins to feel playing their franchise quarterback after yet another head injury?

Perhaps the Dolphins shut him down for longer, perhaps a stint on injured reserve? Even longer than that? At the risk of sounding overly dramatic, nothing is off the table as the Dolphins’ 2024 season has taken a grave turn.

Troubling trend: For the second time in as many weeks, the Dolphins offense laid an egg in the first half. Tagovailoa threw his first interception of the season on Miami’s opening drive and threw his second two drives later. This could double as the biggest hole in the Dolphins’ game plan because on both interceptions, Tagovailoa was targeting receivers he isn’t used to throwing to — Grant DuBose and Robbie Chosen. The only thing keeping the crowd from going home at halftime was a 78-yard performance from running back De’Von Achane. Miami did just about everything wrong that it possibly could in a game against a team that it couldn’t afford to make mistakes against.

Describe the game in two words: Utter disaster. The blowout loss was painful enough for the Dolphins to endure, but Tagovailoa suffering the third diagnosed concussion of his career potentially puts the remainder of this season in jeopardy. Considering the events of the 2022 season, the team will likely be placed under a microscope as it decides how to handle its franchise quarterback.

Prediction for next week: The lone bright spot of Thursday’s loss was Achane’s performance. He assumed a featured role in Raheem Mostert‘s absence, compiling 96 yards on 22 carries and Miami’s only touchdown. Regardless of Mostert’s health next week, expect Achane to be heavily featured in Week 3 against the Seahawks — especially if Tagovailoa doesn’t play. — Marcel Louis-Jacques

Next game: at Seattle Seahawks (4:05 p.m. ET, Sunday, Sept. 22)