Injury to nervous system doesn't mean end of an NFL career

ENGLEWOOD, COLO. -- As Peyton Manning approaches the NFL's all-time record for touchdown passes, just two away from tying Brett Favre's record of 508, it could be argued that none of his previous 506 touchdowns mattered as much as No. 400.

There wasn't anything flashy about No. 400 – it traveled maybe 10 yards, a quick screen pass to the left to beat a blitzing Pittsburgh Steelers defense, that receiver Demaryius Thomas caught and ran 71 yards to the end zone in the first game of the 2012 season.

No, No. 400 might not have been the prettiest pass of Manning's career, but it was a seminal moment in his career: It was his first touchdown after undergoing spinal fusion surgery, after missing the entire 2011 season, after being released by the Indianapolis Colts and signing with the Broncos.

It's almost hard to remember now, 107 Broncos touchdowns, one MVP award and one AFC championship later, that there was legitimate concern heading into the 2012 season if Manning would be able to play again.

This Sunday, three of the NFL's best teams, including the Broncos, will be led by over-30 quarterbacks who have overcome significant back or nervous system issues.

With Manning on the verge of becoming the NFL's all-time touchdown king, he has helped change perception that a neck, back or nerve issue could be a career-ending injury for NFL quarterbacks.

"I think certainly maybe that has changed a little bit whereas before you thought, 'That's the end of it' and whatnot," Manning said. "I do think that it does show that it is possible to return from those types of injuries."

Dallas Cowboys quarterback Tony Romo had surgery late last year to repair a herniated disc. His recovery kept him out of the Cowboys offseason and has him on a limited practice schedule, but he has the Cowboys at 5-1 and is completing 68.6% of his passes – the third-best percentage among starting quarterbacks – and has thrown 11 touchdowns to only five interceptions.

The Cowboys continue to list Romo on their weekly injury report with a back issue, but really, the back hasn't been an issue, including when he endured a brutal hit early in Sunday's win at Seattle. As Romo struggled to climb off the CenturyLink Field turf, the immediate question was about his back. But no, Romo said later, it was just a painful blow to the ribs.

"Our quarterback play was -- I sure think our quarterback play [Sunday] was the difference, really," Cowboys owner Jerry Jones said.

In Arizona, Carson Palmer missed three games in a month while dealing with a lingering nerve issue in his right shoulder. He took a hit in the Cardinals' season opener, and afterwards, his arm went numb. He had trouble gripping the ball, and he couldn't throw. It took flying to Denver to work with a nerve specialist – a doctor employed by the Broncos who has treated Manning – before getting the breakthrough he needed to get his nerves firing again.

He returned last week to throw for 250 yards and a pair of touchdowns against Washington, and will face his former team, the Oakland Raiders, on Sunday.

"It's not like a hamstring pull where it's a certain week that you'll be healed, I'm going to be in the woods until I'm out of the woods, and I don't know what day that is, what week that is, what month it is," Palmer said. "I just have to stick with my protocol and continue to progress every day, I guess."

Manning spoke with Palmer briefly after the Cardinals played the Broncos two weeks ago (one of the three games Palmer missed) and talked to Romo about his recovery when their teams met in the preseason in August, as Manning has become a sounding board in recent years for athletes and non-athletes alike who need surgery on their backs or necks.

"I think it's such a unique situation per player. It's not one of those where it's the ACL and you can go, 'This is how every ACL is rehabbed.' It's unique and I'm not sure you can say all of them have something in common except that it is unknown," Manning said.

But what Manning has done is provide a blueprint for making a comeback, and it has carried beyond just the NFL.

Dr. Vikas Patel, the chief of orthopedic spine surgery at University of Colorado Hospital in Denver, said many of his patients have found inspiration in Manning's recovery.

"The perception is, 'Wow, if he can get back to playing pro sports then I can get back to my life,'" Patel said. "Having [Manning's] profile definitely changes the perspective. People in general are becoming more educated."