Monday, June 6, 2022

Explained: Rafael Nadal's chronic foot injury that has plagued his career

Rafael Nadal made history on Sunday as he became the first men's tennis player to win 22 Grand Slam titles. He got to the milestone with a record-extending 14th French Open title after beating Casper Ruud in the final.

While celebrating the milestone on the court and at the press conference, a considerable amount of time was spent by the Spanish star talking about the chronic foot injury that has plagued him throughout his career. He spoke about trying new methods to get relief and if that doesn't happen his tennis future could be in doubt.

“It’s obvious that with the circumstances that I am playing (in),” Nadal said, “I can’t and I don’t want to keep going.”

What is the injury that has troubled Nadal forever?

Nadal suffers from Mueller-Weiss Syndrome, it's a rare degenerative condition that affects bones in the feet and causes chronic pain. The injury forced him to miss a large chunk of action last year. This syndrome affects the navicular bone on the back of the foot, between the talus and cuneiform bones.

"This bone is subject to significant stresses and, for reasons that we don't understand, loses its vascularization and necrosis takes place," said Professor Didier Mainard, the president of the French association of foot surgery and head of orthopaedic surgery at Nancy Hospital in northeast France, explained to news agency AFP.

A lack of vascularisation means the bone loses its blood supply. In the most serious cases and "in people who put a lot of strain on their feet, the bone will disintegrate, flatten, it can fragment and this can evolve into osteoarthritis with a shortening of the plantar arch," the professor explained. Mueller-Weiss syndrome can affect only one foot but more often both. Nadal has it in just one foot, the left.

Since when is Nadal suffering from this injury?

Nadal has suffered from a chronic foot injury for over one and half decades now. He was diagnosed with it in 2005, the same year he won his first Grand Slam title. “It’s the same injury I’ve been having since 2005,” Nadal had said last year after the injury forced him to pull out of US Open.

“In that moment, the doctors were very negative about my future career, but honestly, I’ve been able to have a career that I never dreamed about so I am confident I will recover again, and if the foot is better, I am confident that my tennis and my mentality will be there again soon.”

How did he manage to play in French Open with the injury?

In May this year, just ahead of the French Open, Nadal's foot injury flared up again as he was knocked out from the Last 16 of the Italian Open.

“I had my foot again with a lot of pain. I am a player living with an injury - it is nothing new. It’s something that is there. Unfortunately, my day-by-day is difficult, honestly. Even like this, I am trying hard... it can be frustrating that a lot of days I can’t practice the proper way,” Nadal had said back then.

The recurrence of the injury put Nadal's French Open participation in doubt but the star athlete was ready to stretch his limit to bear the pain. After the Grand Slam title win, Nadal said that he brought his doctor along with him to Paris and played after taking multiple anesthesia injections to numb the pain. I had my doctor here with me. I don’t know how to say in English the thing that we did, but we played with no feeling in the foot, with a [pain-killing] injection on the nerve. The foot was asleep, and that’s why I was able to play,” Nadal told Eurosport after the final.

What's next for Nadal?

After winning the French Open, Nadal said that he would not want to miss Wimbledon, which begins on 27 June. However, he added he will not play the tournament by taking injections. Nadal also said that he is going to try a new method that includes burning "the nerve a little bit" to help his foot. If that doesn't work then the surgery could be an option.

“So that’s the thing that we are planning to do the next week. It’s going to be a radiofrequency injection on the nerve to try to burn the nerve a little bit and create the impact that I have now on the nerve for a long period of time.

“That’s what we are going to try. If that works, I’m going to keep going. If not then it’s going to be another story. And then I’ll ask myself if I am ready to do a major thing, a major surgery that doesn’t guarantee me to be able to be competitive again take a long time to be back."

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