Giants Quarterback Eli Manning & Injurious Plantar Fasciitis

Eli Manning. In October 2009, American football quarterback for the New York Giants Eli Manning, 28, was diagnosed with Plantar Fasciitis in his right foot, an injurious condition of the plantar fascia, which is the wide thick connective tissue supporting the arch of the foot- it runs from the heel to just short of the toes. Manning's Plantar Fasciitis is focused in the heel. His symptoms are irritation, inflammation, bruising, and pain.

Manning continues to deal with the worsening condition of the plantar fascia- as he has done for most of his sixth season in football. Observers have seen him compensating for the pain in his right heel with a limp. This indicates he has put stress on other parts of the right foot- in this case, the cuboid bone. ESPN's Adam Shefter reports that a recent MRI on Manning's right foot showed a stress reaction in the cuboid- the chunky bone located between the large calcaneus (heel bone) and the long fifth metatarsal bone, which leads to the phalanx bones of the little toe. This means the cuboid is damaged in some way and is thus susceptible to a stress fracture- a hairline crack caused by repeated wear-and-tear- which could halt Manning's 2009 season.

The Giants' Effort. To try to prevent a stress fracture, the Giants- most likely led by team physician Russell Warren- are urging Manning to stay off his feet as much as possible. But the star quarterback reportedly doesn't notice the pain when he's practicing or playing football. The Giants' prevention campaign includes having Manning wear extra-supportive shoes. And having him use a bone stimulator on the injured foot. A bone stimulator is typically used on a stress fracture and less typically on a stress reaction.

Manning & Me. My personal experience with the perennial Plantar Fasciitis somewhat parallels Eli Manning's. His diagnosis and mine were both in October- in 2009 and 2006 respectively. His Plantar Fasciitis is in the right foot and involves the cuboid bone. The same facts are true for me, but with two differences- 1. Plantar Fasciitis thus far affects Manning's heel, whereas it affects my entire foot. 2. His cuboid bone is susceptible to a fracture, whereas an X-ray showed my cuboid already with a fracture, which had healed. Incidentally, the X-ray also showed a bone spur on my heel, another Plantar Fasciitis symptom.

Although not a football player like Manning, I was in top physical shape in 2006 from lifting weights. My job involved running about on my feet for nine hours a day, doing heavy lifting and stooping- all of which put undue stress on my feet and caused Plantar Fasciitis in my right foot because of the old fracture. I eventually sought medical treatment.

Initial Treatment for Plantar Fasciitis. Doctors doled out anti-inflammatory drugs to relieve the inflammation and pain. I didn't take the drugs because they are inhibitors of healing and have possible side effects- and because they can't cure Plantar Fasciitis. Hence, I endured the pins-and-needles pain, which although tolerable, coursed throughout my entire right foot, causing me to sometimes limp. An orthopedic surgeon provided me with custom orthotics- orthopedic shoe inserts- as well as a night splint to wear for ten minutes every night. And he sent me to Back 2 Health Physical Therapy, in West Hollywood, where I then lived.

Physical Therapy. Ian A. Novotny PT DPT, a knowledgeable and talented Physical Therapist, treated my right foot with the following methods: electric stimulation, ultrasound, ice packs, massage, and PT exercises- all directed to the inflamed painful areas of the foot. Although Plantar Fasciitis is a lifetime condition, the PT treatments successfully controlled it to the extent that inflammation and pain were reduced to near-nothing- even though I attended only two sessions a week rather than the prescribed three.

Because of the PT, my right foot began to feel normal- as long as I didn't put undue stress on it. The moment I tried to carry a heavy box at workplace or simply stoop, I could feel painful pressure on my right foot. The plantar fascia seemed to be stretching apart and the pins and needles returned. Hence, I adhered to doctor-prescribed work restrictions as best I could. I also had home restrictions. Mr. Novotny recommended that I not engage in cardiovascular exercises that stress the feet- such as running, dancing, aerobics, etc. He suggested swimming, instead.

PT End. My PT sessions ended in August 2007 when I moved from California. Had I at least continued the PT exercises taught by Mr. Novotny, I would possibly be symptom-free today. He and I had discussed how continuing them would keep the Plantar Fasciitis symptoms at bay. But as most patients don't keep up PT exercises on their own after professional PT ends, neither did I (due to declining conditions from other injuries). Thus, the symptoms are back- though with less pain since I no longer have the physically-demanding job that caused and aggravated the condition.

Prognosis for Manning. How will Plantar Fasciitis- from which complete recovery is impossible- affect Eli Manning's career? All known treatments can only control, not cure. The last resort of surgery holds the risk of nerve damage, infection, splitting of the plantar fascia, and failure to lessen the pain. My best guess is that Eli Manning will play football until the Plantar Fasciitis hinders his ability to play well. Yet, given the circumstances of his pain and limp, his ability to play well may decline sooner than later.

From a layman's viewpoint, Manning's best hope may lie in taking PT treatments, which will at least counteract the increasing damage to his right foot. Then, he can alternate playing football with getting medical treatment- a process that entails a repetitive symbiosis of 'destroy and repair'.

Manning Now. As of December 6, 2009, Eli Manning is still going strong. The NFL recorded that he threw for 241 yards, 2 TDs, and an INT in the Giants 31-24 win vs. Cowboys.

* To visit Back 2 Health Physical Therapy website, click here.

_{Sources: Sources: http://sports.espn.go.com/nfl/news/; Blog network: NFL Nation; en.wikipedia.org; personal experience}