ORCHARD PARK, N.Y. -- Rarely have 70,000 people in a football stadium been quieter than those at New Era Field Sunday when LeSean McCoy was laying on the turf, helmet off, face twisted in pain, grabbing at his right knee.
"I had the same concerns that every single Bills fan that lives here in western New York," coach Rex Ryan said. "We had to hold our breath."
McCoy has been the Bills' offense this season, especially during the last four games, all Buffalo victories. But late in the second quarter Sunday, he twisted awkwardly after catching a pass and then getting hit by San Francisco linebacker Nick Bellore. McCoy went down, stayed down, and there were gasps in the stadium as the training staff attended to him.
After some anxious moments it turned out he was fine, cleared to play in the third quarter, and he finished off a 140-yard, three-touchdown performance in Buffalo's 45-16 blowout of the 49ers.
"You know, it could've been something bad," McCoy said. "But I feel fine. There were a few plays running on it where it was feeling kind of gimpy, but as the game got on, the adrenaline was pumping, and I was fine."
McCoy has rushed for 470 yards during the Bills' four-game winning streak, and he now leads the league in yards per carry at 5.6. McCoy trails only Dallas rookie Ezekiel Elliott in yards (703 to 587), but the Bills have now surpassed the Cowboys as the No. 1 rushing offense in the league, averaging 166.1 yards per game, including 211.8 the last four games.
"We have confidence when it comes to running the football, and Shady proves us right," said Bills left guard Richie Incognito, who admitted his heart sunk when McCoy was down on the field. "When you have a talented guy like him, you feed him. He makes big plays happen. He's a dynamic runner, probably one of the best one-on-one guys I've seen in space as far as making people miss and setting up jukes and getting yards after contact. We want to get him one-on-one with corners, one-on-one with safeties. He'll make that guy miss and gain big yards."
McCoy's first year in Buffalo was somewhat of a disappointment as he was nagged by injuries and gained 895 yards while rushing for just three touchdowns in 13 games. He had three touchdowns against the 49ers alone, and now has six for the season. Since the firing of offensive coordinator Greg Roman, McCoy looks like a different back as new coordinator Anthony Lynn has simplified the run calls, but also added a few new wrinkles that have greatly helped McCoy.
There have been more between the tackles runs where the offensive line opens a crack and McCoy makes one cut and goes. The Bills have used some college-style option, and they have also used some wildcat formations. McCoy scored once on an option pitch, one on a wildcat play, and once on a quick hitter up the middle against the 49ers.
"If you want to give any game balls out, you need to give it to the offensive line," McCoy said. "They whooped them up and down the field. I mean, they made my job real easy."
Last year, McCoy never seemed to adjust to his surprising trade from Philadelphia to Buffalo. People started wondering whether the Bills made a mistake trading for, and then investing heavily in, a then 27-year-old running back with some serious mileage on his tires. All that did was motivate McCoy for 2016.
"Ever since my rookie year I've never really been doubted," he said. "So to hear people say that, it can definitely drive you. There's training. There are things I did mentally. Overall though, that's not the big picture. The big picture is winning. If I get 30 yards and we win, I'm not going to be pissed."
Without injured wideout Sammy Watkins, the Bills have virtually no passing game, so the burden on McCoy has been tremendous, and so far, he has excelled even though opposing defenses know he's getting the ball.
"I think they were 31st in the league against the run, so we thought we were going to have a chance to be successful running the football, obviously," Ryan said. "And we did have a great plan. Anthony, (offensive line coach Aaron) Kromer, all those guys did a great job of putting a plan together. And then our players went out and did a great job of executing, more importantly. I know it's boring football, but we just want to win, whether that means we're going to put it up 30 or 40 times a game or just run the football.
"Obviously, I'd prefer to run. There's no question about that. Maybe that's the old school in me, but I still think you run the ball to win games."
REPORT CARD VS. 49ERS:
PASSING OFFENSE: C-minus -- The Bills have been very fortunate throughout their four-game winning streak that they haven't needed their passing game, because they don't have one. Without Sammy Watkins, the Bills threaten no one with their wide receivers as Robert Woods and Marquise Goodwin just aren't creating separation, and that's a tough thing because Tyrod Taylor remains an inaccurate downfield passer. Taylor threw for 179 yards and the Bills will again rank last in the NFL in passing heading into Week 7. Newcomer Justin Hunter looks like he can help as he now has two catches and both have gone for touchdowns, including a 30-yarder against the 49ers. Tight end Charles Clay's 52 receiving yards led the team.
RUSHING OFFENSE: A-plus - LeSean McCoy looks like the McCoy who played in Philadelphia and was one of the NFL's best running backs. He has regained that status with another big day, 140 yards and three touchdowns as the Bills rushed for 312 yards as a team. That was their fifth-highest total in franchise history and most since 1992. The offensive has done a great job the last few weeks of creating gaps between the tackles, and McCoy's biggest plays have been quick hitters up the middle. But he's also making a ton of yards by cutting back or bouncing to the outside. Taylor contributed to the huge total with 68 yards, some of those on designed runs, and Mike Gillislee chipped in a 44-yard touchdown run.
PASS DEFENSE: A-minus - Colin Kaepernick still can't hit the broad side of a barn, as the saying goes. He was 13 of 29 for 187 yards, and his only big play, a 53-yard touchdown to Torrey Smith, came when the Bills botched a coverage and he was left wide open. Cornerbacks Stephon Gilmore and Ronald Darby gave up very little to San Francisco's pedestrian group of receivers. The Bills sacked Kaepernick three times for 20 yards, they broke up five passes, and the only thing they didn't do was pick him off. Lorenzo Alexander recorded a sack for the sixth consecutive game.
RUSH DEFENSE: B-plus -- Carlos Hyde was held in check as he managed just 52 yards on 14 carries. Kaepernick provided some anxious moments with his tremendous running skill and he rushed for 66 yards including one 29-yarder scamper. On one of the biggest sequences of the game late in the third, the Bills stuffed Mike Davis twice on third- and fourth-and-1, creating a turnover on downs when the score was 17-13. From there, the Bills scored four plays later and tacked on three more touchdowns in the fourth quarter. It was a huge point in the game. Linebackers Preston Brown and Zach Brown combined for 16 tackles.
SPECIAL TEAMS: A-minus -- For the second week in a row the kicking teams created a turnover. This time it was Nickell Robey-Coleman forcing a fumble on a fourth-quarter kickoff which was recovered by Jonathan Meeks, setting up a Buffalo touchdown. On a gusty day, Dan Carpenter made a 40-yard field goal and all six of his extra points, and he also produced four touchbacks on eight kickoffs. Colton Schmidt averaged 40 yards net and dropped one punt at the 5-yard-line. Brandon Tate had 16 punt return yards, but never got a chance to return a kickoff. That was fine with the Bills as they started five possessions at their 25.
COACHING: A -- The Bills have won four consecutive games for the first time since 2008, and Rex Ryan deserves some credit. He has this team's full attention and they are buying in. The offensive run game plan was creative and the Bills executed flawlessly against a defense that was susceptible to the run as they the 49ers ranked 31st. It was nice to see offensive coordinator Anthony Lynn not over-think too much. On defense, the Bills limited the 49ers to one touchdown, that coming on a busted coverage. San Francisco made only two trips into the red zone and managed a lone field goal.