But if he does play, you have to start him.
The Bills running back left the field early in Sunday's 24-14 win over the Browns in what appeared to be excruciating pain. Later, we found out that he injured his shoulder, and according to CBSSports.com's Will Brinson, Spiller appears to be dealing with a sprained AC joint rather than a separated shoulder.
That's good news; Brinson reports that such an injury would only rule him out for 1-to-2 weeks.
But there's also the possibility that he could miss even less time than that and could play on Sunday at home against New England.
Word has it that Spiller is recovering from this shoulder injury much faster than anticipated. According to Pro Football Talk's Mike Florio, Spiller "could return to practice this week" and "is healing faster than expected."
You don't want to be on the sideline for these types of games. Hopefully by [Thursday] we'll have a better understanding.
So he clearly hasn't been ruled out yet.
The Bills' situation becomes murkier when you consider the fact that running back Fred Jackson is also dealing with a knee injury. That, originally, is what opened the door for Spiller to step in and do some damage over the last couple of weeks, rushing for 292 yards and three touchdowns in two games against the Jets and the Chiefs.
If Jackson is still unable to go for this weekend—he returned to practice on Wednesday, according to CBSSports.com, but he's still listed as questionable—that leaves the Bills' rushing attack largely in the hands of Tashard Choice and Johnny White.
That means that, given the rampant injuries that have afflicted this backfield, if Spiller is good to go, the Bills could use him—particularly given the implications surrounding Sunday's game.
As of now, the Bills are somewhat shockingly 2-1. If they win this weekend, they have a golden opportunity to put the Patriots—the consensus favorites to win the AFC East—in a big, big hole. In order to take down New England, though, they're going to need all hands on deck—especially one of their strongest backfield assets.
If Spiller returns to practice this week, he could very well get into Sunday's game. And if he gets into Sunday's game—given how important he's been to this Bills offense over the last couple of weeks—he can very much be expected to make an impact.
Basically, if he's around this weekend, he should be starting.