The Indianapolis Colts released a statement this morning announcing that star quarterback Peyton Manning will be held out of practice. This news comes as questions had been swirling about whether the team’s quarterback would miss the season opener. Manning has made 227 consecutive starts.

I am reluctant to write about this situation for a couple of reasons. As always with my Famous Athletes and Breaking News posts, these columns are somewhat speculative, in that I take information reported in the media and try to explain the injury, surgery, and rehab in basic language for people interested in their favorite players. This is not inside medical information, and the information reported in the media is often incomplete. And in this case, the Colts have really kept this injury quiet, so there isn’t much concrete information for me to read. Also, I am not a spine surgeon and do not treat neck and back injuries typically, as there are specialists better at those injuries than me. Having said that, let me try to offer at least a little insight on what might be going on with him.

Manning underwent surgery May 23 in Chicago on his neck. According to Colts owner Jim Irsay at the time, “They (surgeons) removed part of a (bulging) disc, which is a very non-invasive procedure.” Manning had previously undergone a similar neck operation in March 2010. Recovery from the surgery this May has been said to be slower than both doctors and Manning himself expected. Manning has been quoted as suggesting that the inability for him to work with the team’s trainers during the lockout might have contributed to the slow progress.

The Colts removed Manning from the Physically Unable to Perform list on August 29, clearing him to practice and making him eligible to play in the Week 1 opener against the Houston Texans. In the Colts’ statement today, the team acknowledges that Manning is being evaluated by several neurosurgeons who have been involved in his care throughout this process. The team notes that Manning has developed soreness in his back, and ESPN’s Chris Mortensen tweeted this morning, “Colts will confirm Manning’s re-evaluation but also doctors advise no practice this wk. Doubtful. Triceps weakness. Back sore, etc.”

Now again, I am just speculating, but neck and back soreness and if true, triceps weakness, suggests that it is possible that there is continued inflammation around the nerve root in his neck. The surgery to remove all or part of the disc would have tried to remove pressure on the nerve root as it exits the bones in the neck before providing sensory and motor function to the arm, hands, and fingers. Triceps weakness suggests inflammation or continued weakness of the seventh cervical nerve root.

It sounds like multiple surgeons are involved trying to determine the source of Manning’s discomfort and come up with remedies. Despite some speculation suggesting the need for another surgery, there has been no official confirmation or denial of any particular treatments. If no persistent disc material is pressing on a nerve root, the options likely will be nonoperative. Options would seem to include steroid medications (anti-inflammatory, not anabolic – such as a Medrol Dose Pack), nonsteroidal anti-inflammatory medications, steroid injections into the area around the nerve root in the neck, continued physical therapy and modalities, and giving the injury more time.

If Manning is not back for Sunday’s opener, which the Colts announced is “doubtful”, then the team seems prepared to move ahead with backup quarterbacks Curtis Painter and newly-signed Kerry Collins, who joins the team after coming out of retirement.