Rafa Nadal defied his own expectations by claiming an astonishing 14th Roland Garros title when he swept Casper Ruud aside on the Parisian clay. Nadal is rarely bet against on clay, a surface on which he has win ratio of over 90%, but the Spanish great readily acknowledged during the French Open that every game is potentially his last due to a chronic foot problem that has dogged him for several years.
Nadal suffers from Müller-Weiss syndrome, which he was diagnosed with in 2005, the same year he won his first French Open. Last year, he was forced to pull out of the US Open and missed the rest of the season to undergo treatment and Nadal himself admits it is a day-to-day process, with the aim of his team and medical advisers being to prolong his career for as long as possible while avoiding surgery. “Honestly, I have been suffering much more than I should with my foot for a year and I need to take some time... to find a solution to this problem or at least improve it in order to continue to have options for the next few years,” Nadal said at the time. However, he returned in style at the beginning of 2022, adding another Australian Open to his Grand Slam collection to take him to 21 overall, one ahead of Roger Federer and Novak Djokovic in the all-time stakes.
Nadal: “We have known for quite a few years that this is incurable”
Speaking to AS and L’Equipe in Melbourne after the Australian Open, Nadal said: “We have known for quite a few years that this is incurable, so anything that we tried would just be trying to lessen the pain, just enough for me to keep playing. It is the same thing that I have done throughout my career, even though, obviously, everything has a degenerative factor, as logic would dictate.”
Going into the French Open, Nadal was very frank about his foot issue and unsure if he would be able to stand the rigors of a two-week Grand Slam tournament, but once again the Spaniard played through health issues to triumph, picking off Djokovic along the way and being spared what was shaping up to be an epic, and potentially a very, very long encounter against Alex Zverev in the semi-finals, after the world number three rolled his ankle in the second set and was forced to leave the stadium on crutches.
After his Paris success, which has placed Nadal on a calendar year slam for the first time in his career, the world number four travelled to Barcelona for treatement on his foot with a view to making it to Wimbledon. Working with his long-term doctor, Spanish Tennis Federation physician Ángel Ruiz-Cotorro, Nadal underwent a course of pulsed radiotherapy treatment, which transmits impulses to the nerves in the area of the injury to lessen the feeling of pain without affecting mobility. In warm-up matches on grass against Stan Wawrinka and Félix Auger-Aliassime Nadal looked comfortable and said in his pre-Wimbledon press conference that he felt his warm-up games had gone well and that his goal was to be competitive.
Nadal faces Ricardas Berankis in the second round at Wimbledon on Thursday after seeing off Argentina’s Francisco Cerúndolo in four sets in his opener, and is projected to meet Djokovic against in the final.
Müller-Weiss syndrome explained
Speaking to L’Equipe last September after Nadal announced he would not be playing at Flushing Meadows, Gilbert Versier, the former head of the orthopaedic department at Vincennes military hospital, explained the origins of Muller-Weiss syndrome.
“It usually affects people who have flat feet. It’s congenital. In some people, the arch of the foot is more pronounced - in other words, there is a greater distance between the sole of the foot and the floor. Others have a fallen arch when the insole loses its curvature and those people tend to be more susceptible to this kind of pathology. It causes the navicular bone to become compressed which eventually develops necrosis. Basically, the bone dies, it loses its vascularization,” Versier said.
“A stress fracture could also be the cause - when bones don’t heal properly. When the fracture occurs at the point where vascularization no longer reaches it, the area where the blood vessels are which could result in a necrosis. But it is a very rare pathology, and its origins are not very clear. It’s not a pathology which necessarily evolves very quickly. Deterioration happens over time and is quite painful, but usually osteoarthritis takes a long time to develop. We have seen these kinds of conditions in women over the age of 50. It is not something we tend to see in young people,” he added.
FAQs
According to the American Journal of Roentgenology (radiology), Mueller-Weiss syndrome is a “rare disease that refers to spontaneous adult-onset tarsal navicular osteonecrosis.” In other words: The bone in the middle of the top of the foot — and its surrounding cartilage — suddenly loses vascularization and just dies.
What causes Mueller-Weiss syndrome? ›
The most popular theory is that MWD is caused by decreased blood supply to the navicular bone of the foot. Decreased blood supply has many potential underlying causes including nutritional deficiency, smoking, alcohol, corticosteroid use, rheumatologic disorders, hematologic disorders and metabolic disorders.
Does Rafael Nadal have Mueller-Weiss syndrome? ›
It connects the ankle to the bones of the foot and has significant function in maintaining the foot's arch and the dynamic biomechanics of walking. The first time fans were able to see how Muller- Weiss Syndrome affected Nadal was during the 2005 Madrid Masters.
Does Nadal have a degenerative disease? ›
Rafael Nadal suffers from Mueller-Weiss Syndrome, it's a rare degenerative condition that affects bones in the feet and causes chronic pain.
What is the surgery for Mueller-Weiss syndrome? ›
Both triple fusion and TNC arthrodesis are reasonable methods for the treatment of Mueller-Weiss disease if properly used. It is crucial to use radiological assessment to evaluate the involved joints preoperatively and then chose the appropriate method to treat different patients.
How painful is Mueller-Weiss syndrome? ›
Mueller-Weiss syndrome is a rare condition that causes severe arch pain on the inside of your mid- and hindfoot.
Is Mueller-Weiss syndrome treatable? ›
Mueller-Weiss disease (MWD), which involves dorsolateral fragmentation and collapse of the navicular, leads to functional misalignment and painful deformities. The successful treatment of MWD hinges on a detailed and through assessment of the patient to establish the modality of treatment that best suits the patient.
What is Nadal's stomach problem? ›
It has now been reported in the Spanish press that medical tests revealed he suffered a seven-millimetre tear in one of his abdominal muscles during the match. According to Cadena Ser, Nadal appeared at the All England Tennis Club at 2pm on Thursday, and minutes later, he began training to prepare for the semi-final.
What sickness does Nadal have? ›
Muller Weiss syndrome in the left foot.
The truth is that, specifically, this last pathology was one of the first to manifest itself and one of those that has been tormenting the Balearic Islands for the longest time, which he assures almost made him retire at the beginning of his career.
What is Rafa Nadal's medical condition? ›
While the tennis world only really became conscious of Mueller-Weiss syndrome in 2022 when Rafael Nadal started talking about it, it is something he has been aware of for years. He was actually diagnosed with the problem aged just 19, which was three years into his professional career.
That is because in the mid 2010s, he was showing signs of male pattern baldness, a common type of alopecia which affects 85% of men before the age of 50 [1]. Then, after 2016, he seems to have recovered his hair fullness, only to start thinning again a few years later.
Who has Mueller-Weiss syndrome? ›
Mueller–Weiss syndrome, also known as Mueller–Weiss disease, is a rare idiopathic degenerative disease of the adult navicular bone characterized by progressive collapse and fragmentation, leading to mid- and hindfoot pain and deformity. It is most commonly seen in females, ages 40–60.
What surgeries did Nadal have? ›
The surgery consisted of cleaning the fibrotic and degenerated areas of the tendon both proximal and distal, as well as stitching it to adequately reinforce it. An old injury to the labrum of his left hip was also fixed, which will help the tendon evolve better.
What are the symptoms of Weiss syndrome? ›
The condition may be asymptomatic in mild cases. In 85% of cases, the presenting symptom is hematemesis. The amount of blood is variable; ranging from blood-streaked mucus to massive bright red bleeding. In case of severe bleeding, other symptoms such as melena, dizziness, or syncope can be manifested.
What is Mueller-Weiss syndrome an uncommon cause of midfoot pain? ›
Mueller–Weiss syndrome (MWS), or spontaneous osteonecrosis of the tarsal navicular in adults, is a rare cause of chronic medial midfoot pain. MWS has been described in orthopedic, podiatric, and radiologic literature without consensus agreement on its pathophysiology and treatment.
What is the difference between Mueller-Weiss syndrome and Kohler's disease? ›
These two disorders differ in epidemiology, clinical features and imaging. Köhler's disease affects children 3-to-7 years old and is usually asymptomatic. The scaphoid appears hypoplastic at X-ray. MWD affects adults with pain and progressive navicular deformity.
Is Mueller-Weiss syndrome a disability? ›
Depending on the severity there may be a hindfoot varus with a flat arch. Delay in diagnosis is particularly problematic; early diagnosis is critical. It is frequently misdiagnosed, increasing the level and length of pain and disability for affected patients.
How is navicular disease transmitted? ›
This disease is believed to be genetic but can occur due to the conformation of the distal limbs. Structure associated with Navicular syndrome includes excessively long toes, under-run heels, and a “broken back” hoof-pastern axis.
What is the most common cause of Mallory-Weiss syndrome? ›
Heavy alcohol ingestion is considered to be one of the most important predisposing factors as about 50% to 70% of the patients diagnosed with Mallory-Weiss syndrome have a history of the same.
What are the symptoms of the Weiss disease? ›
Mallory-Weiss syndrome is most commonly characterized by abdominal pain, a history of severe vomiting, vomiting of blood (hematemesis), and the strong involuntary effort to vomit (retching). The blood is often clotted and has the appearance of “coffee grounds”. The stools may be as dark as tar (melenic).
