Give the Man a Big Hand By being an impatient patient, Patrick Ewing forged a remarkable comeback

The injury to his shooting hand that New York Knicks center
Patrick Ewing sustained while breaking a fall at Milwaukee on
Dec. 20--a dislocation of the right lunate bone, one of eight
small bones in the wrist--rarely occurs on the basketball court.
However, it happens often enough among the general populace, in
football and in falls or automobile accidents, that doctors can
construct a pretty grim prognosis for the patient with average
care and motivation: a rehabilitation period of at least six
months and a permanent 20% to 30% loss in range of motion. But
last Thursday, only 4 1/2 months after injuring himself, Ewing
was back on the court, defying normal medical estimates and
averaging 15.3 points in three games of the Knicks' Eastern
Conference semifinal series with the Indiana Pacers, which the
Pacers led 3-1 after a victory on Sunday.

Had Ewing's recovery been similar to a normal patient's, it
would have meant the end of his season and perhaps his career.
"Because it was Patrick's shooting hand, our biggest worry from
the start was whether he'd regain full motion," says Knicks team
doctor Norman Scott. "A lot of lay people might not need full
motion; they might function at 75 percent motion. He couldn't."

Fortunately, Ewing had three things working for him that the
average Joe doesn't: high motivation (his bread and butter,
after all, lies in the full flick of his wrist), an absence of
other work obligations, and a team of medical professionals
devoted to his recovery. Within eight hours of his tumble in
Milwaukee, Ewing had already undergone a 1 1/2-hour operation in
New York by hand surgeons Charles Melone and Susan Craig Scott
(Norman's wife). Their quick relocation of the lunate and repair
of the surrounding ligaments, which had been torn, spared Ewing
tissue swelling and nerve damage.

A few days after the surgery Ewing started an aggressive
conditioning regimen with Knicks strength coach Greg Brittenham
to keep himself generally in shape. Once his above-the-elbow
cast came off on Feb. 15 (it was replaced by a light plastic
wrist splint), Ewing added modified upper-body workouts and
range-of-motion exercises for his wrist with team trainer Mike
Saunders and New York-based physical therapist Karen Lockhart.
"That was four hours a day, easy, just at the [Knicks' practice]
facility," says Brittenham. "Even on the plane and bus, Patrick
was always working on his grip strength or range of motion. He
always had Silly Putty in his pocket. So he really probably
spent eight to 10 hours a day on his rehab. He gave 100 percent
from Day One. There was no question in his mind that he could
come back."

No obstacle fazed Ewing. While traveling with the Knicks during
the early phases of rehab, he and Brittenham would seek out a
gym or health club while the rest of New York's players were at
a shootaround. It couldn't be just any gym. "We always had to
find a place that had a ladder we could set up next to the stair
machine so Patrick could keep his arm elevated while he worked
out," says Brittenham. "That wasn't always easy, but we never
missed a workout."

Once the wrist cast came off and Ewing could start running the
floor, Brittenham concentrated on working Ewing's left side,
throwing passes to his left hand, forcing him to dribble and
shoot layups with it. "It's called cross-transfer training,"
says Brittenham. "The idea is that if you train the left side of
the body, there might be a transfer to the right side. I saw
some real benefits in Patrick not being able to use that right
hand."

Fragile though Ewing's right hand was, Norman Scott knew it had
a future when Ewing's wrist registered a 65% range of motion a
mere month after the cast came off. "As soon as we saw that, it
allayed a lot of our apprehension," says Scott. "It was our
first glimmering that he might force us into making a decision
about playing him this year."

Ewing's return to action with almost full range of motion and
strength last week "was a real testament to Patrick's motivation
and medical team," says Pacers team doctor Sandford Kunkel. "It
gives hope to future athletes faced with this injury."

But what hope does the guy who approximates Ewing's injury by,
say, falling from a scaffolding have for regaining full range of
motion when faced with a need for highly specialized surgery,
time-consuming rehab and, perhaps most daunting of all, the
draconian tightfistedness of the typical modern health-care
organization? "You had better be a hell of a motivated person,"
says Norman Scott, "because you're going to have to take charge
of your own treatment. Doctors will be handcuffed in what they
can prescribe. The injury is substantial enough, but when you
have to fight the system as well.... I'd venture that most
people would say, 'The hell with it.'"

COLOR ILLUSTRATION: JARED SCHNEIDMAN DESIGN ALL IN THE WRIST Surgeons limited damage by quickly putting Ewing's lunate (yellow) in place and repairing ligaments (black). [Diagram of x-ray image of wrist with lunate and ligaments marked]