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Manning had surgery in May to correct a bulging disc in his neck, but it didn’t solve his problems. Prior to a third surgery in September, he took a private plane to an unknown hospital in an unnamed country, Fox’s Jay Glazer reported in a pregame show Sunday (clip below). The procedure is not available in the United States.

In an email, a Colts spokesman said the team's only comment was head coach Jim Caldwell's "no comment" during a Monday press conference. Caldwell said the team would not discuss Manning's medical issues.

That means details are scarce, but Fox's report said this was not a procedure involving embryonic stem cells. It's likely Manning underwent a procedure involving induced pluripotent stem cells, or iPS cells, which can be reprogrammed to become any type of cell. Glazer said he was informed that doctors cultured some of Manning's own fat cells and injected them into his neck, where they would ideally help regenerate damaged tissue. Researchers showed back in 2009 that fat cells could easily be turned into iPS cells, and do so much more quickly than the other common iPS cell progenitor, skin cells.

In any event, the fat-stem-cell procedure was insufficient, leading to Manning’s third neck surgery Sept. 8. The anterior fusion of two neck vertebrae was a success, but the future Hall-of-Famer will be sidelined for two to three months, likely missing the entire regular season.

Sports analysts said the stem cell procedure was evidence that Manning really wants to get back on the field this year (he's missed, like, one snap in his career prior to last week). It could also mean that his injury was more serious than some people thought. But let us pose another theory: It’s also evidence American stem cell therapy is still lagging. Researchers at Stanford started working with fat-derived iPS cells in 2009 — so why is a marquee NFL quarterback flying overseas for this therapy?

So-called stem cell tourism is nothing new, of course; risk-takers of wealthy and/or desperate stripes have been doing it for some time. And the reasons for American reluctance regarding stem cell procedures are many and varied. But when high-profile people like Peyton Manning start leaving this country for treatment that could be done at home, it’s a good opportunity to ask bigger questions than the quarterback’s personal motivations.

Glazer's Edge: Peyton's Stem Cells

[via ESPN]

What makes Narrative Science different than previous attempts at computer-generated news briefs is that this software has the ability to make inferences and actually provide an angle for a story, the New York Times reports. In the realm of sports, it learns the meaning of terms like “come from behind” and “team effort” and leads the article with the aspect of the game it deems most important. This keeps it from being a plug-and-chug fact regurgitator and actually adds some variety to the articles it's writing. The example article posted in the Times led with the sentence “Wisconsin jumped out to an early lead and never looked back in a 51-17 win over UNLV on Thursday at Camp Randall Stadium.” Not bad, for a computer.

Most of Narrative Science's 20 customers aren't talking, but the Times was able to confirm that the Big Ten Network has been using the software since the spring of 2010 to generate recaps of sports games. Use of the software helped grow their web traffic for football games by 40 percent between the 2009 and 2010 seasons. And it's cheap – each 500 word article currently only costs $10. If Narrative Science keeps improving their software, lowly human writers may have some competition.

[The New York Times]

Pistorius, at 24 years old, has had his share of difficulties in competing with able-bodied athletes. His prosthetics were at one time declared to represent an unfair advantage over the athletes using the flesh-and-blood legs they were born with, rather than the space-age sproing-y Cheetah legs Pistorus uses, though he was eventually cleared for Olympic competition.

Pistorius isn't a favorite at the World Championships--his qualifying time, a personal-best 45.07 seconds, was just barely fast enough to earn him a ticket to the games in Daegu, South Korea--but he calls it "the highest-profile and most prestigious able-bodied event which I have ever competed in."

We've previously called for a league of exclusively performance-enhanced athletes, but it sounds like Pistorius is thrilled just to compete with the best able-bodied sprinters in the world.

[BBC]

The use of performance enhancers in sports is inevitable. Celebrating it instead of banning it would make competition safer, more honest, and more fun

It’s only natural that when we discover our heroes have injected chemicals into their veins for a competitive edge (and I’m not saying Lance has, only that it’s looking increasingly difficult for him to prove that he hasn’t) we find them tainted and strip them of medals and put an asterisk by their names. Doping is ugly for fans but it goes beyond betrayal. Performance enhancers turn a contest between athletes into a competition among scientists and engineers. This is the best argument against enhancers. It’s also the best argument for them.

Let’s pretend, for a minute, that a separate league exists. Let’s call it the Asterisk League or, better, the League of Extraordinary Medicine. Drugs are legal but regulated. Athletes get educated about the risks, long term and short, of everything they introduce into—or onto—their bodies. Fans know exactly who is taking what and tracking their performance accordingly. Labs and scientists are inexorably linked to athletes’ rise and fall. Chemist versus chemist doesn’t sound like it would make great television, but the field would quickly advance to the point were records were broken daily and feats of crazy strength became the norm. Chemist versus chemist would become superhuman versus superhuman. Broadcasts could include expert scientists in the booth describing the limits of the human body and how these chemical enhancements get around that, or don’t. The League of Extraordinary Medicine is more honest, its regulation more sensible, since outlawing drugs just does not work—we’ve got a forever War on Drugs to prove it. And our tests for drugs still aren’t very good.

Through this openness the league creates an environment where cutting-edge science is discussed daily, and celebrated, alongside athletic triumph. Better still: legitimizing enhancement would make the enhancements better. More drugs hit the market, more treatments become available, and this would trickle down to non-athletes. Would all this openness and advancement foster a more honest, inviting, even wholesome environment? Maybe. Creating a separate league where drugs are legal would, without a doubt, make competition safer for athletes. Matthew Herper, who has covered science and health (and, by extension, athletes and drugs) for a decade at Forbes, says as much.

“To me, the most obvious solution has always been to legalize those drugs that work, and to experimentally monitor new entrants, including dietary supplements, for both efficacy and safety. Biological improvement would be treated much as athletic equipment like baseball bats and running shoes. This could improve both athlete’s performance and their health, and would be a lot better than having everybody trying whatever additive they can sneak, attempting to stay ahead of drug tests, and trusting anecdotes as a way of measuring safety and efficacy.”

But perhaps most importantly, by keeping advances off the field, we’re holding back possibilities. A few years ago I visited Hugh Herr, the director of biomechatronics at MIT’s Media Lab, who had just invented a robotic ankle that would soon revolutionize prosthetics. We ended up discussing the ankle a little bit, but mostly we talked about science in sports. Herr is an athlete. As a young man he was a world-class rock climber. A week before my visit, he had been busy trying to convince the International Association of Athletics Federations to allow South African runner Oscar Pistorius to compete in the Olympics. Pistorius has no legs below his knees and runs using Cheetah Flex-Foot carbon fiber limbs which, arguably, gives him an unfair advantage. Herr is also a double amputee, and walks and climbs using prosthetics. That day in his lab, while he showed me his improved ankle and described his work with veterans, Herr told me that he sees no reason why we can’t make “disabled” people stronger and faster than the rest of us. In fact, we already are: just look at Pistorius. The IAAF agreed and, weeks later, decided to ban the South African from competition.

One of the best arguments for pushing, even uncomfortably, the boundaries of science and the human form was voiced by Joe Rosen, a controversial plastic surgeon. Rosen (the subject of a profile in Harper’s) sees endless possibilities when the human form and science meet. But this makes people very uncomfortable. A colleague asked: “If a patient came to you and said, ‘I want to you to give me wings,’...would you actually do it?”

“Who here doesn’t try to send their children to the best schools, in the hopes of altering them?” Rosen responded. “Who here objects to a Palm Pilot, a thing we clasp to our bodies, with which we receive rapid electronic signals? Who here doesn’t surround themselves with a metal shell and travel at death defying speeds? We have always altered ourselves, for beauty or for power, and so long as we are not causing harm what makes us think we should stop?”

Stem cell treatments like this are of dubious clinical efficacy but are not banned by Major League Baseball. However, they are part of a growing grey area in professional sports wherein athletes receive questionable treatments that don’t violate the rules outright but may or may not offer them a competitive advantage.

In Colon’s case, the treatment was carried out in the Dominican Republic--not because the treatment is illegal in the States (it’s not) but because Colon lives there--by Dominican doctors and a Florida surgeon named Joseph Purita, whose regenerative medicine clinic has treated several other professional athletes. And though his office does offer human growth hormone (or HGH) treatment, he says he didn’t provide it to Colon or any of the other athletes (HGH treatments would definitely run afoul of Major League rules).

Purita’s procedure involved removing stem cells from Colon’s fat and bone marrow and injecting them into his elbow and shoulder to repair ligament and rotator cuff damage. It’s a procedure that hasn’t been put through rigorous clinical reviews, and other physicians say there’s no conclusive evidence that it works. The MLB, fighting a constant uphill battle to stay current regulating new performance enhancing drugs and supplements, doesn’t even have an official opinion--much less a rule--on such treatments derived from one’s own stem cells. They told the NYT they are looking into Colon’s case.

For his part Colon is 2-1 and throwing like he was years ago, topping 93 miles per hour with regularity. His ERA is a respectable 3.81. And if stats told the whole story, it would be easy enough to deduce that these stem cell therapies have given a 37-year-old pitcher a younger man’s arm.

Whether or not that’s so is up for debate, and surely there will be one. Can someone’s own cells be considered a performance enhancer? Can leagues and athletic bodies effectively test for such therapies? Was it the procedure, or Colon’s season off from the majors, that really repaired his arm; that is, do such therapies even make a difference?

If you’re into baseball, stem cell therapies, or medical controversies click through to the NYT piece below, it’s a good read on an increasingly weighty topic in sports and medicine alike.

[NYT]

The robot, assembled over the last six weeks by Penn robotics engineers, is throwing the ceremonial pitch as part of Science Day festivities. It is essentially patched together from a Segway, a third support wheel in the rear, and a three-jointed throwing arm on top. A pneumatic cylinder driven by compressed CO2 delivers the pitching power, and an onboard computer controls velocity and trajectory.

When you think about it, that all adds up to a pretty desirable arm for your pitching corps. As long as you don’t run short of compressed air, pitchbot can go the distance, pitching consistently and accurately straight through the late innings en route to a complete game. Unfortunately, its velocity tops out at about 40 miles an hour, but that’s by design--the league didn’t want the robot out there hurling 100-plus mile per hour projectiles.

Of course, given all the hype surrounding the Phillies starting rotation this year, too much has been invested to replace Lee, Roy Halladay, or any of the others on staff there. Members of that mediocre Phillies bullpen, however, might want to take notes.

[AP]