Sports Injury Hall of Fame: Peyton Manning

“The Sherrif”

In 1998, Peyton Manning, son of NFL legend Archie Manning, was the star quarterback of the SEC Champion University of Tennessee Volunteers. Shortly thereafter, he was the number one NFL draft pick for The Indiana Colts. For 12 years, Peyton Manning served as the quarterback for the Colts.

On this road, he was met with roadblock after roadblock. In 2006, during a game against the Washington Redskins, he suffered a horrible neck injury that would nag at him for the remainder of his career. This injury lead him to suffer from a herniated disc in his neck that would progressively worsen as the years went on.

Despite his injury, the 2006-2007 season would prove to be his greatest up to that point. On February 4^th, 2007, at Superbowl 41, Peyton led the Colts to defeat the Chicago Bears 29-17. The world was his oyster.

In 2009, during a game against the Miami Dolphins, Monday Night Football commentator Jon Gruden referred to Peyton Manning as “The Sheriff” based on his dominating and intimidating presence at away games, and how he would “lay down the law” in opposing stadiums.

What is a herniated disk?

The spinal cord is comprised of individual bones known as vertebrae. They are separated by discs of intervertebral cartilage. There are 29 vertebrae in the human spine, which is then separated into 4 sections: the cervical spine (neck/upper back), the thoracic spine (mid-back), lumbar spine (lower back), and sacrum (the tailbone).

Between these vertebrae are intravertebral disks. The disks help to allow the spinal column to flex and bend, and they absorb shock when jumping, running, and walking. They are filled with a viscous material known as the nucleus pulposus. Surrounding the nucleus pulposus is the annulus fibrosus, which is a cartilage-fiber ring that keeps the intravertebral disk unscathed when force is applied to the spine. Over time, the disks effectiveness can lessen and might be displaced.

Also known as a slipped disk, ruptured disk, protruding disk, or a bulging disk, a herniated disk develops when a vertebral disk tears, leaks, or becomes inflamed. This pushes against its outer ring, which puts pressure on the spine and spinal nerves. This leads to weakness, pain, and numbness in the back, neck, or legs. Herniated disks will often heal by themselves within 6 weeks, but they can linger and worsen if not properly treated.

Symptoms associated with a herniated disc can include:

Pain localized to one side of the body
Sharp pain, weakness, or numbness in the leg, hip, calf, sole of the foot, or buttocks. These symptoms usually indicate that the herniated disc is in the lumbar spine.
Pain while moving the neck or shoulders. This pain might radiate to the upper arm, elbow, forearm, hands, and fingers. These symptoms usually indicate that the herniated disc is in the neck or upper back.
Slow or missing muscle reflexes
Muscle weakness
Back pain
Numbness and tingling in the legs and feet

Common reasons for suffering from herniated disks include:

Getting older
Traumatic injuries, which may occur during car accidents, falls, sports injuries, etc.
Intense bending or twisting
Improperly lifting heavy items

Common treatment methods can include:

Bad Luck

After his victory against the Bears, Manning, the Colts, and the rest of the NFL would struggle to maintain their spot as Tom Brady and the New England Patriots dominated the sport for the next 15 years. Peyton Manning would go down in history as one of Tom’s greatest rivals.

In 2011, after his herniated disk got to its’ worst point, he underwent C3-C4 spinal fusion surgery. He missed the entire 2011 season.

Spinal Fusion Surgery

Spinal fusion surgery is a procedure that involves multiple vertebrae being grafted together and held in place with metal plates, screws, and rods. During the surgery, bone grafting material is placed between the disks, and eventually this material fuses with the pre-existing bone during surgery. Spinal fusion surgery limits motion between vertebrae and inhibits nerves, ligaments, and muscles from stretching. It is often sought as a last resort when movement is the primary cause of the patient’s pain.

Spinal fusion surgery will naturally end up limiting flexibility in the spine, but the majority of surgeries only involve very small subdivisions at a time.

There are two methods of performing spinal fusion surgery:

Anterior: This is when the surgery is performed from the front of the spine.
Posterior: This is when the surgery is performed from the back of the spine.

The primary actor in spinal fusion surgery is undoubtedly the bone grafting material. Bone grafts are harvested from other sources of bone. The bone is then processed into powder or carefully shaped implants. Common sources of bone graft material include:

Allograft: Bone graft material sourced from the cadaver of a tissue/organ donor.
Autograft: Sourced from a different part of the patient’s skeleton, most commonly from the pelvis.
Bone Morphogenic protein: DNA components extracted from bone. BMP promotes bone growth by stimulating the bones and their stem cells. This process is known as osteogenesis.
Synthetic products: Comprised of man-made materials. These products are usually comprised of biocompatible polymers, glass, collagen, and ceramics. They serve as a scaffold-like structures to help maintain stability and are inevitably replaced with new bone that grows naturally from the patient.

Potential complications of spinal fusion surgery include:

Pain management and rehabilitation are essential to the aftercare of spinal fusion surgery. Usual procedures may include:

Medications such as acetaminophen and non-steroidal anti-inflammatory drugs (such as naproxen). Opioids are commonly used after spinal fusion surgery as well, but in many cases are inadvisable due to the risk of dependency and overdose.
Limits on activity. Strain after spinal fusion surgery could undo all the hard work and resources that went into the surgery. The spine must be properly aligned so it can heal. As strength returns, patients may begin to gradually increase activities.
Physical therapy is commonly started between 6 weeks and 3 months after spinal fusion surgery, but it may be sooner or later depending on what the treating provider says.
Maintaining a healthy lifestyle and refraining from smoking and drinking will help the spine properly heal faster.

Disregarded

When he was sidelined for the year, he was traded away to the Denver Broncos. While he was nursing his wounds, The Indianapolis Colts, the team he had made into champions, sold him away like he was a defective antique.

This put a chip on Peyton’s shoulder. He was out to prove that he wasn’t just some flash in the pan, a broken toy for the National Football League, but one of the best to ever do it. If he won the Superbowl while he was on the Broncos, he would be the first quarterback to become champion on two different teams.

Redevelopment

While he was nursing his injury, Manning had to relearn how to release the ball on time so it would go to his target.

Peyton’s college friend Todd Helton, then of the MLB’s Colorado Rockies, invited him to a private workout session, and saw his struggles . “He had nothing. But I knew he’d come back and be Peyton Manning again because nobody else works that hard.”

“It’s hard to explain but I kind of lost awareness of my arm in space. When you had the same throwing motion for so long — golfers talk about repeating their swing, well, quarterbacks repeat too. But I couldn’t repeat. That was scary. Just discouraging.”

While he was no longer in pain, the spinal fusion surgery left him weak.

Manning credits his recovery to his work with his old college offensive coordinator from The University of Tennessee, Duke University’s Head Coach David Cutcliffe. “[I] could barely throw a dart” said Manning. He had to relearn how to play football entirely. They worked in secret due to Manning’s doubts and insecurities surrounding his injury. They would have to work around Cutcliffe’s schedule as a collegiate coach, either starting at the break of dawn or around midnight.

“I started back with the basics. I worked with David Cutcliffe, and we went back to ground zero with everything I did. So I think my fundamentals got sharper, and that could be a reason why this is happening now. But I don’t know.”

“When he saw himself getting back to his normal, when he could get the ball into his arm slot, and felt it, God, that was fun to see,” Cutcliffe stated.

For the finale of his training regimen, Manning and Cutcliffe recreated every play of the 2009-2010 season Superbowl game, in which the Colts played against the Saints. Manning threw every single pass that he had made in that game, down to the smallest details: which receiver positions were being blocked, where the ball was placed on the field, referee calls, etc.

In an interview with the NFL Network, Coach Cutcliffe stated that “I don’t think I’ve ever won a game that I felt any better — after what he accomplished — in this ball game that nobody watched.”

Silencing Doubt

During his 2013 season with Denver, Manning would throw 55 touchdowns in a single season, which today is the all-time record for most touchdowns in a season by a quarterback. During his 4 seasons with the team, Manning would lead the Broncos to win four AFC west titles and 2 conference championships. There was only one thing left to do as Manning neared retirement age: One more Superbowl.

On November 8^th, 2015, as what would become his final season was coming to a close, Peyton developed plantar fasciitis. The injury occurred in a game against, who else, the Indianapolis Colts. He had been nursing a minor tear in his fascia for the majority of the preceding season, but it had worsened significantly during that game.

Plantar Fasciitis

Plantar Fasciitis is one of the leading causes of heel and foot pain. It occurs when the plantar fascia (the tissue on the bottom of the foot that runs from the heel to the toes) becomes inflamed or is torn. It is usually compared to stabbing pain, which is intensified and exacerbated with continued movement and pressure.

The plantar fascia is the primary support system for your feet as they make contact with the ground, and are essential to walking, jumping, running, and playing sports.

Symptoms include

Heel pain with pressure
Pain on the arch of the foot
Foot stiffness
Achilles tendon tightness
Heel swelling
Worsening pain over time
Intense foot pain in the morning that decreases as the fascia is stretched with walking
Consistent and constant aching

Common treatment methods include:

RICE: Rest, Ice, Compression, Elevation. One of the most prominent treatment methods for foot injuries, RICE has been the standard since 1978. That being said, ice has recently been recommended for only the initial stages, and motion and pressure on the injury will eventually help it heal at a normal rate, as too much rest may delay the healing process.
Stretching.
NSAIDs: Non-steroidal inflammatory drugs such as aspirin, ibuprofen, and naproxen will help a patient deal with pain and inflammation.
Corticosteroid injections: Also known as cortisone or steroids. These injections are meant to resemble the effects of cortisol, a hormone produced by our adrenal glands that decrease inflammation and pain.

Sweet Victory

Despite his injury, Peyton Manning was able to help lead the Broncos to the first-place seed in the AFC. After eliminating the Pittsburgh Steelers, Manning would have one final opportunity to face his greatest nemeses, Tom Brady and the New England Patriots. They would win 20-18, with the victory being determined by a single field goal. Manning had overcome his rival by a single hair and was on to face the Carolina Panthers in the Superbowl 50.

The stage was set. On February 7^th, 2016, at Levi’s Stadium in San Francisco, California, Peyton and the Broncos would handedly defeat the Panthers 24-10. Confetti rained as Peyton looked solemn and introspective. He knew his retirement was inevitable. He would announce his retirement shortly after, on March 7^th, 2016. On August 8^th, 2021, Peyton would be inducted into the NFL hall of fame.

The Legend

In Peyton Manning’s nearly 20-year career, he was able to defy the odds and set the standards of what a quarterback can do. In his career, he was able to pass for an incredible 71,940 yards and help deliver 539 touchdowns. He was the first quarterback to ever win the championship on two teams. Moreover, he won the MVP award a record 5 times, more than anyone else in the history of the sport. Peyton Manning is one of the greatest quarterbacks in NFL history, and his story acts as a shining beacon to any athlete fighting grueling injuries.

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