Suddenly last summer, I developed tendinitis in my right wrist. It hurt when I played tennis. It hurt when I played squash. It hurt when I shook hands. It hurt when I paid off bets.
Now, the ordinary cure for tendinitis goes something like this: heat it, wrap it, give it plenty of rest and take Geritol twice a day. The main thing is rest. Which is fine, except that I need my right hand to write, type, shake hands and eat. In other words, to live. And I wasn't willing to give up tennis. So I went on suffering.
Then I heard about an Arlington, Va. doctor named Robert P. Nirschl. He was recommended to me as the "compleat" tennis doctor, a man who takes your measurements by examining your grip size and your weight by putting your racket on a scale.
His credentials were indeed impressive: assistant professor of orthopedic surgery at Georgetown University School of Medicine, chairman of the committee on medical aspects of sports for the Medical Society of Virginia, author of more than a dozen papers on sports injuries and physician to numerous tennis pros. Robert P. Nirschl should be able to keep me on the courts.
His presence was reassuring: younger looking than his 42 years, trim, handsome, athletic, with a fine sweep of brown hair and a freckled face that reddens a bit when he smiles. He began the examination by observing, "Looks like you've got the old politician's malady. They get it from arm-twisting, hand-shaking and back-slapping."
I was given some wrist tests and X rays. Then Nirschl started to do his number. "Touch your toes with your knees straight," he said. "That's all right—Tom Okker couldn't either. Now try to scratch your back with your right hand."
With a final flourish, Nirschl pulled out a tape and measured my right hand from the second crease of the palm to the tip of the ring finger. It measured 4⅝". "I discovered that this correlates to grip size," he said. Among tennis people this may be Nirschl's most noted innovation, of which he can claim many.
His treatments for tennis injuries break down into four categories: relief from inflammation by means of elevation, heat, ice, pills, shots and braces; changes in equipment and strokes; exercises; and, should all else fail, surgery. The first and fourth measures—minor therapy and surgery—are familiar to most doctors, although Nirschl generally shuns the scalpel. It is his uses of seemingly nonmedical ideas that make him a bona fide tennis doctor, as opposed to a doctor who treats tennis injuries.
One of Nirschl's firmest beliefs is that injured parts must be rebuilt as well as rehabilitated or they will atrophy from disuse. "There's a lot of mythology about getting musclebound," he said as he showed me to a room in which he keeps Nautilus weight-lifting machines. "When I was growing up in the '40s and '50s, anyone who lifted weights was ostracized. But if properly administered, weight lifting can improve both strength and flexibility."
Nirschl insists on weights for most of his patients, whether they are young men or 80-year-old women recovering from broken hips. And lest one assume that the exercises deal with injured parts alone, he said, "We make the mistake of zeroing in on one part of the body when others also are involved. If you hurt your knee, your arms and shoulders will have to work much harder to compensate." Nirschl had me try touching my toes and scratching my back to determine if ligaments and joints elsewhere had affected my wrist. He found my overall coordination average, which was a relief to me. I never earned enough letters to spell the word "jock."