Merril Hoge Comments On Nerve Damage

[presto123]

I heard on an ESPN segment last night that Hoge has had nerve damage in the past and it took a full 2 YEARS so get back to close to normal. I know each case is different but I think there's a real possibility that even if Peyton does make it all the way back at some point that it could even be the season after next. I've said that in other threads as well. The Colts simply can't afford to wait that long. Unless he's throwing 60 yard passes by March 8 I'm pretty sure what the Colts will do. If it comes down to that I really hope Peyton can resume his career at some point but I still think he's a little ways off from full recovery. He absolutely dodges any questions that try to pinpoint exactly where his throwing and accuracy are right now.

[wercolts]

Begging the question again, why do so many people believe another team signing him is a foregone conclusion. Who's signing an expensive 36 year old maybe, and why doesn't it make sense for the team he's currently on to take the same risk. Money is not the answer, that can and always has been manageable for every organization with half a brain, and by their own admission is not a factor to either party involved.

[tonychen]

This is why people are saying Irsay has already made the decision. It is a long period of time for the recovery and if they are not sure about Manning's healthy at this point, there is almost no way they can know it by March. Even September could be kinda early to tell, not to mention Manning will not be tested in severe game conditions until a real football season begins. So actually this is not a decision related to Manning's health indeed.

[presto123]

Begging the question again, why do so many people believe another team signing him is a foregone conclusion. Who's signing an expensive 36 year old maybe?

How expensive he is would depend on Manning since it would be a new contract. Maybe he would sign a real short term deal for way less money to prove himself or something that is incentive based. That would make the most sense.

[LUVTHESHOE]

Begging the question again, why do so many people believe another team signing him is a foregone conclusion. Who's signing an expensive 36 year old maybe, and why doesn't it make sense for the team he's currently on to take the same risk. Money is not the answer, that can and always has been manageable for every organization with half a brain, and by their own admission is not a factor to either party involved.

I think most people on here believe he will still be playing into his 60's and then JI should just sign the franchise over to him. I love PM, BUT SOME OF THIS IS GETTING SILLY, I brought this up on another post, but you dont se PM OFFERING TO TAKE ANY KIND OF A PAY CUT.

[LUVTHESHOE]

How expensive he is would depend on Manning since it would be a new contract. Maybe he would sign a real short term deal for way less money to prove himself or something that is incentive based. That would make the most sense.

Thank you!!!!!!!!!!!!

[sbtwenty]

Not sure if this has been posted or not...if it has been please merge......NFL.com had this article posted today @ 1330.

"I haven't watched him the last few weeks, but I did see him at the end of the season," Vinatieri said during the interview. "He was developing nicely. Was he quite all the way back yet? No, probably not. Not to his standards.

"But he definitely is not that far off."

i couldn't paste the link itself......but it is on nfl.com

just to be clear....I'm on board for waht is best for the Colts.....hopefully with a healthy Manning, but if not then whoever we draft!

GO COLTS!!

I just seen that there was another thread on this....my fault....mods can you merge please

[John Dee]

This is why people are saying Irsay has already made the decision. It is a long period of time for the recovery and if they are not sure about Manning's healthy at this point, there is almost no way they can know it by March. Even September could be kinda early to tell, not to mention Manning will not be tested in severe game conditions until a real football season begins. So actually this is not a decision related to Manning's health indeed.

Exactly... I have said it time and time again, a nerve can come back in a matter of a couple of months or it can take up to 3 years. The longer time goes by the greater the probability of the nerve NOT coming back slowly grows....

And "not that far off" when in the context of a nerve healing can be a matter of a year or two.

[KyFan18]

Exactly... I have said it time and time again, a nerve can come back in a matter of a couple of months or it can take up to 3 years. The longer time goes by the greater the probability of the nerve NOT coming back slowly grows....

And "not that far off" when in the context of a nerve healing can be a matter of a year or two.

Thank you, Doctor Dee.

[ColtsBlueFL]

The question becomes, what teams can afford to wait on Peyton 's health before making a bid for him if he is released? First off, it has to be teams that need a QB. But some of those teams current QB is a FA and might move on while said team waits for the word on Manning's heath: IE SF 49'ers and A. Smith. Seems Redskins (Grossman) and Dolphins (Moore) could wait or give their QB one more year at it. What other team can afford to wait until July, August or whenever it becomes apparent Peyton is healthy enough to go after? And I assure you, Peyton will not do a Vet Min contract that is incentive laden. If healthy, he will most likely command pay commensurate to his proven capability, or close to it. If not healthy, who will even take a chance?

[Coffeedrinker]

Why do people jump on everything other people, who are not involved in Manning's rehab or involved in paying him, say regarding the issue and ignore what Manning and Irsay say about it?

[Fx Stryker]

It probably depends on the nerve. Does anyone know what nerve is injured in Peyton's arm? I know I heard people say that is a fast healing nerve, compared to others.

[Warhorse]

It probably depends on the nerve. Does anyone know what nerve is injured in Peyton's arm? I know I heard people say that is a fast healing nerve, compared to others.

Hey, you've got some nerve.

[MLawRunner]

It probably depends on the nerve. Does anyone know what nerve is injured in Peyton's arm? I know I heard people say that is a fast healing nerve, compared to others.

The nerve that was damaged was in his neck (hence the three neck surgeries), which is affecting his arm strength. I do not believe any nerve as actually damaged in his arm - though I could not tell you what nerve per se was injured in his neck.

[WoolMagnet]

Why do people jump on everything other people, who are not involved in Manning's rehab or involved in paying him, say regarding the issue and ignore what Manning and Irsay say about it?

I talked to a buddy of mine who runs into Irsay from time to time and golfs with him.

He saw Irsay at a wedding a week or so ago and Irsay told him some stuff.

i won't go into details but he said expect "word" a week or so after the Super Bowl.

Apparently Irsay is waiting until after the SB to do anything as to not detract from the event.

Take it for what its worth.

Don't shoot the messenger.

[ACollie17]

It also has to be taken into account that Hoge was a running back. That may mean it could have taken two years to get back to normal for a running back to play (much more risk of re-injury because of all the hits to the head/neck area), Not necessarily a QB.

[nsurg]

Nerve regeneration is variable, and the length of the nerve has some relevance. The C7 nerve to the triceps is a relatively short distance, so typically recovery of substantial strength, if it occurs at all, is seen within the first few months. Anecdotal results from a given person do not apply. Manning's nerve was injured in April, approximately 10 months ago, by what I have read in the press. I have not seen patients go 10 months after this problem with poor improvement that later improved. I'm not happy to say this regarding manning.

[Fx Stryker]

The nerve that was damaged was in his neck (hence the three neck surgeries), which is affecting his arm strength. I do not believe any nerve as actually damaged in his arm - though I could not tell you what nerve per se was injured in his neck.

I know it's in the neck, but, correct me if I'm wrong, that is the nerve that affects the triceps.

[Coffeedrinker]

I talked to a buddy of mine who runs into Irsay from time to time and golfs with him.

He saw Irsay at a wedding a week or so ago and Irsay told him some stuff.

i won't go into details but he said expect "word" a week or so after the Super Bowl.

Apparently Irsay is waiting until after the SB to do anything as to not detract from the event.

Take it for what its worth.

Don't shoot the messenger.

**Bang**

JK. No offense to you or your friend, I will believe word is coming down when word comes down.

[WoolMagnet]

**Bang**

JK. No offense to you or your friend, I will believe word is coming down when word comes down.

As would I.

[Fx Stryker]

Nerve regeneration is variable, and the length of the nerve has some relevance. The C7 nerve to the triceps is a relatively short distance, so typically recovery of substantial strength, if it occurs at all, is seen within the first few months. Anecdotal results from a given person do not apply. Manning's nerve was injured in April, approximately 10 months ago, by what I have read in the press. I have not seen patients go 10 months after this problem with poor improvement that later improved. I'm not happy to say this regarding manning.

It was injured in April, but wasn't it relieved until after the fusion? So that was what? Six months ago?

[Tony Sullivan]

Nerve regeneration is variable, and the length of the nerve has some relevance. The C7 nerve to the triceps is a relatively short distance, so typically recovery of substantial strength, if it occurs at all, is seen within the first few months.

Anecdotal results from a given person do not

apply. Manning's nerve was injured in April,

approximately 10 months ago, by what I have

read in the press. I have not seen patients go

10 months after this problem with poor improvement that later improved. I'm not happy

to say this regarding manning.

How do you know he's had "poor" improvement? Would you expect someone to be able to throw 70 yards within 6 months of their last procedure?

[Coffeedrinker]

It was injured in April, but wasn't it relieved until after the fusion? So that was what? Six months ago?

I belive you are correct. I'm not a surgeon but I got this tidbit from spine-health.com

Postoperative Care Following Spine Surgery for a Cervical Herniated Disc

For anterior surgery, there usually is not a great deal of postoperative pain. The surgery is done through a small incision in the front of the neck, and the spine can be accessed in between tissue planes that do not require cutting. This type of surgery usually can be done either outpatient (going home the same day as surgery) or with one overnight stay in the hospital.

The pain in the arm usually goes away fairly quickly, although it may take weeks to months for the arm weakness and numbness to subside. It is not uncommon to have some neck pain for a while.

Postoperatively, most spine surgeons prescribe a neck brace, although the type of brace and length of usage is variable. Also, most spine surgeons will ask their patients to limit their activities postoperatively, although the amount of restrictions and the length of time tend to vary. Ask your spine surgeon before the surgery what his or her usual protocol is regarding postoperative care.

Weeks or months and this is just talking about the pain. For an elite athlete to get back into elite athletic condition I would imagine it takes months. When I was in the army and broke my hip, I was on crutches for 6 months. After that 6 months, while I could do all the PT, it took me another couple of months to get back to the level I was before the injury.

Based on recent comments from Manning, it sounds like he's at that stage now... working to get back to his pre-surgery level of fitness. The body responds quickly to good things like exercise but it does not respond immediately.

[Fx Stryker]

I belive you are correct. I'm not a surgeon but I got this tidbit from spine-health.com

Weeks or months and this is just talking about the pain. For an elite athlete to get back into elite athletic condition I would imagine it takes months. When I was in the army and broke my hip, I was on crutches for 6 months. After that 6 months, while I could do all the PT, it took me another couple of months to get back to the level I was before the injury.

Based on recent comments from Manning, it sounds like he's at that stage now... working to get back to his pre-surgery level of fitness. The body responds quickly to good things like exercise but it does not respond immediately.

Let's hope so. We all want Manning in 2012.

[nsurg]

It was injured in April, but wasn't it relieved until after the fusion? So that was what? Six months ago?

...

It's very hard to glean any medical details from the press... I've pretty much tried to piece things together by reading articles from espn and what is linked on the board, putting more weight on detailed articles.

Both surgeries he had done were very common and straightforward. I would be shocked if the decompression in april (perhaps it was may?) was anything less than excellent. I think nerve decompression started then. My feeling, and that of surgeons I have spoken with (who are simply forming opinions as well, without direct knowledge), is that he had enough joint decompressed with the surgery that his spine was a bit unstable, leading to pain. The trick of a non-fusion surgery is to remove enough joint that the nerve has space, but not so much that the joint fails.... it's judgement on the surgeon's part and thus could theoretically fail on both objectives (though rarely). The nerve didn't recover, so he had fusion to create additional space for the nerve and stabilize the presumed hypermobile joint.

It really doesn't matter when nerve decompression "started" though. If he wasn't fully decompressed until august, that's still not good news--means the nerve was actively compressed for months, which also portends a poor prognosis. Conversely, if it was perfectly decompressed in the april (may?) surgery, he hasn't apparently shown improvement over 10 months which is depressing.

I assume he's throwing "poorly" as I've stated (I have no idea) simply because he has every reason in the world to show off for the media if he's anything approaching good, right? But yes, it's an assumption, and I don't know.

Medicine, even at its finest, is about opinions, science, and experience. There is not a single cut and paste article which gives us an answer. Irsay said in his interview that no qb in the history of football has ever had a similar injury, which means weakness of the dominant arm triceps due to a c7 nerve compression on that side.

I don't think he's done improving, but it is a reasonable assumption that most of his improvement has already occurred and may be possible the nerve will improve no further. He still has some portions of the nerve working, which we may assume knowing that he can throw at all, so perhaps the muscle fascicles that are innervated currently can hypertrophy further and become "good enough". But how much can that occur? Nobody can grow new muscle fibers, they simply enlarge or atrophy, so some will be gone for good.

Again, my opinion. I'd love to be wrong, but as I've stated all along the good news should have come in January when he was "fused" and allowed to be vigorous with his neck. To not have power at this time is discouraging.

Some of you may also note that about half the neurosurgeons in the country, if not more, will happily state that they are an expert/innovator/authority on any given field given the opportunity to do so in the press. Good for elective referrals, they might hope. Read between the lines and look for bias.

My personal motivation in this is just to give some info--I guess it drives me nuts to read misinformation, anecdotal results of random people, and blathering doctors seeking to get their names in the national press. I'd love to see him play. I'd prefer to remain somewhat anonymous because I simply don't care to have an internet presence about this... sorry for my username, but I chose it years ago on the old board and transitioned over, thought it was subtle then and something simple to remember.

This could be worse, we could be drooling over jamarcus russell at the number one pick years ago, right?

[John Dee]

Thank you, Doctor Dee.

Not a doctor but i have had nerve damage to my lower left leg from the knee down (drop foot) and Bell Palsy to the right side of my face. My nerve in my left leg only came back at about 20% and that happened at the 6 month mark, no progress occured prior or after that. The Palsy I got Very LUCKY with... the nerve came back 100% in 3 months.

I'm no doctor but I guarantee you I know far more than most on the topic.

[JoKeR]

I talked to a buddy of mine who runs into Irsay from time to time and golfs with him.

He saw Irsay at a wedding a week or so ago and Irsay told him some stuff.

i won't go into details but he said expect "word" a week or so after the Super Bowl.

Apparently Irsay is waiting until after the SB to do anything as to not detract from the event.

Take it for what its worth.

Don't shoot the messenger.

What word? Or was he just saying a answer will come about a week after the SB.

[WoolMagnet]

What word? Or was he just saying a answer will come about a week after the SB.

Not sure what "word" means.

We heard Irsay will talk to manning next week.

Maybe if they arrive at a conclusion it will be released but i had no details on what "word" actually meant.

This "medically cleared" info released today clouds the issue but I don't think it really improves the situation as "medically cleared" to play has nothing to do with the nerve damage (the over-riding current issue).

Unfortunately, it still doesn't look that positive in respect to the nerve issue which apparently hasn't improved that much.

I'm still keeping my fingers crossed.