Virginia Hospital Center is now VHC Health™- Read More | Download the Virginia Hospital Center App -Read More

Published on August 26, 2019

Arlington Magazine: Arthur Ashe vs. the Amateurs

Written by: Matt Blitz

In the late 1960's, Robert Nirschl felt pain in his elbow after a game of tennis. As an orthopedic surgeon, he knew something wasn’t right. He went searching for answers in several prestigious orthopedic journals, but found none.

“They basically said, ‘We’ve never seen a tennis player with an [elbow] problem,’ ” says the McLean resident, now 85. “It was clear that these guys didn’t know anything.”

So he conducted his own research. Securing permission to film the U.S. Davis Cup team during its 1970 finals against West Germany, Nirschl was able to record and analyze the strokes of world-class players, including tennis legend Arthur Ashe. Then he took his camera to Tuckahoe Recreation Club in McLean and Washington Golf and Country Club in Arlington.

“It was pretty funny because [the country club players] would say, ‘The doctor is coming to film us playing. He must think we are really good,’ ” Nirschl recalls. “No, I was filming them because they were really bad.”

In comparing the swings of pros and amateurs, he realized why some ended up experiencing the pain that would become colloquially known as “tennis elbow.” It was a problem of bad mechanics and muscle imbalances. And here’s the revolutionary part: The surgeon’s recommended course of treatment didn’t involve surgery.

The son of a dentist, Nirschl grew up in suburban Milwaukee as a player and lover of sports. In high school he lettered in football, basketball and tennis. He remembers visiting his grandmother in Green Bay and watching the NFL’s Packers practice in a public park across the street from her house.

“That would be like watching the Redskins practice in Bluemont Park in Arlington,” he says.

He attended Holy Cross in Worcester, Massachusetts, followed by Marquette Medical College back in Wisconsin (where he met his wife, Mary Ann), and completed his orthopedic residency in 1963 at the Mayo Clinic in Rochester, Minnesota. During the early years of the Vietnam War, he served in the U.S. Navy as a surgeon. Stationed in New York City, he treated people who had been injured overseas.

“I had like 80 patients at one time who were military injured,” he recalls. “It was an experience.”

In 1965, he got a job at Georgetown University Medical Center and moved his family to the D.C. area.

Five years later he was analyzing his own tennis film footage and dissecting the elbows of cadavers, in part to understand his own aches and pains. Though he had pioneered groundbreaking surgeries—in 1967 he was one of the first in the world to publish a patella-bone technique for ACL reconstruction of the knee—he concluded that surgery should be a last resort for fixing “tennis elbow,” a condition in which muscles and tendons become damaged due to repetitive movements and overuse.

“Tennis players strengthen the front part of their shoulder but weaken the back part,” Nirschl explains. “The imposed demands of the sport create muscle imbalances which invite injury.”

And in most cases, that injury can be fixed by avoiding overuse while rebuilding those weakened muscle groups via supplemental workouts and physical therapy. “The body changes based on the sport,” he says. “So, you need to change with it.”

Nirschl’s unorthodox methods weren’t accepted by the medical community right away. “In 1974, I’m in the parking lot of [Virginia Hospital Center, then known as Arlington Hospital],” he recalls, “and a couple of doctors come up to me to tell me my [ideas] were all hokum and that I knew nothing.”

But in the years that followed, he would go on to treat professional athletes of every ilk, from tennis stars and MLB pitchers to NFL quarterbacks. For 35 years he served as the team doctor for Bishop O’Connell High School (all of his kids went there) and, in 1981, he was appointed to the President’s Council on Physical Fitness and Sports. He remembers meeting Ronald Reagan. “It was all about encouraging proper fitness in the schools.”

Today, Nirschl continues to consult with patients out of his practice at Virginia Hospital Center. He and Mary Ann, his wife of 61 years, still live in the McLean house they bought in 1970. They have three children, 11 grandchildren (several of whom have gone into medicine) and two great-grandchildren. “I’m so proud of them,” he says.

Another point of pride? Having helped countless patients realize that complicated, stressful and expensive surgery is not necessarily the answer to every sports injury. To this day, he says, patients still come into his office thinking that they need an operation. “I talk about 50 percent of folks out of surgery,” he says. “They save money and get a good result.”

Matt Blitz is a local journalist who writes for various national and regional publications. He lives on Columbia Pike with his wife and cat.