Specialist: Injury, time cast doubt on Peyton comeback

One of the NFL's best and most durable QBs ever faces an uncertain road back. (US Presswire)

It was on Monday morning when Indianapolis owner Jim Irsay, while speaking at a Super Bowl-related event, told a group of people he didn't expect quarterback Peyton Manning to return for this season. Irsay's words, it's fair to say, sent a mild degree of panic throughout the Colts and NFL.

Irsay later clarified his remarks on Twitter: "I didn't say Peyton out 4season FOR SURE, keeping him on ActiveRoster n taking it month by month/Outside chance of return n December possible."

Irsay's clarification came too late. The damage was done. It reignited speculation throughout football that Manning's injury remains far worse than the Colts are saying despite the team reiterating it expects Manning back this year.

The more time passes without Manning on the field, the larger the concerns grow that not only is Manning's 2011 season in jeopardy but his overall future, according to a medical expert consulted by CBSSports.com.

It should be made clear the Colts say Manning will return to football. Manning says he will return. The specialists Manning has consulted say the same.

Yet Benjamin Wedro, a trauma physician and teacher whose specialties include athletic injuries, believes the number of Manning surgeries (three), the time that has elapsed since those surgeries and the fact Manning has sought more unconventional treatment like stem-cell therapy all add up to reasonable concern about the quarterback's long-term future.

"I'm on the outside looking in and I obviously haven't examined him but based on the available information you have to be concerned he may never play again," Wedro said.

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Wedro reiterated his beliefs are speculative and stressed these types of injuries can be extremely unpredictable. Manning could heal very quickly or take a great deal longer. No one knows for certain.

"There's information out there that when you add it all up we may be looking at a situation that is worse than we know," he said. "The Colts are keeping a tight lid on some things and that's fair. Peyton is a private citizen, but if I was Manning or the Colts, I'd be very worried."

Wedro also raised an interesting issue that has rarely been discussed in the media. The danger to Manning isn't that he might take a shot to his injured neck and suffer paralysis (though that is always a concern for Manning or any player). Wedro said the biggest concern for Manning is his long-term health.

"The issue it seems to me is quality of life," said Wedro. "There's weakness in that arm right now. If he plays and there's further injury or problems will he be able to use that arm fully in the future? My guess is he's probably had many conversations with his doctors and family about this.

"That's one of the big issues. You see older players with bad knees and shoulders hobbling around. The injury to his neck could lead to issues with use of his arm or worse. He could be hampered for life, not with paralysis but just degenerative use of it."

In response to the latest Irsay tweet and now increasing speculation about the timetable of Manning's return, the Colts re-released their statement from earlier this month in which the team says it will have no further updates on Manning's status in the near future.

The Colts also have another problem. They can't say now if Manning would be gone for the season even if they wanted to. It would be tactically unsound. Hall of Famer Michael Irvin told USA Today the Colts team would fall into an abyss if Manning were placed on injured reserve now and lost for the year. He remains a beacon of hope in a season that for now has very little.

"They've got to make the other guys think, 'We're still playing,' or the whole team will shut it down," Irvin said. "Hope will dictate effort. If you think you've got a chance, you'll put more effort out. No hope, no effort. Once you make an announcement on Peyton [being out for the year], all hope is gone."

While the Colts and Manning have released limited information, what we know is that this past offseason Manning had his second surgery for degeneration of his cervical spine. The healing progressed slowly and Manning's cervical bones in his neck pushed against the spine. This led to a loss of strength in the arms and hands. Of course, a quarterback losing arm strength is not good.

It was reported by Fox Sports that Manning went to Europe for stem-cell treatment before a third surgery. He has since had that third operation, and while doctors and the Colts say Manning will return either this year or next, there remains no guarantee. Wedro remains hopeful but skeptical.

The reason Wedro is concerned about Manning's quality of life is that neurological damage is highly unpredictable and can last years or longer.

Manning is a fierce competitor, and like many NFL players have for generations, he may not be thinking about 20 years down the line. He may see his Colts struggling and want to get in there as soon as possible. But as Wedro explained this isn't about competition or desire, it's about science.

And for the moment it's possible the science is against Manning.