DOCTOR ON CALL
Injuries associated with tennis, like tendonitis of the knee, are often due to the “sudden acceleration, deceleration, jumping, and bending movements in this sport,” says Timothy Hosea, MD, a sports medicine orthopaedic surgeon and a spokesperson for the American Academy of Orthopaedic Surgeons. Hosea says that accumulative motions lead to overuse injuries, especially to the ankles and knees, and he suspects that Rafael Nadal’s tendonitis was caused by overuse and exasperated by his intense style of play.

Rafael Nadal achieved a world No. 1 ranking, despite tendonitis. Does this indicate that his condition wasn’t severe, or did he simply play through the pain?
Tendonitis is a progressive process. An athlete at this level is highly motivated and determined to win matches. He may have had some pain but brushed away the aches while playing and practicing. The tendonitis finally progressed to the point where he couldn’t tolerate it anymore.

How might his condition affect his ability to compete?
Tendonitis in both knees could be a blessing in disguise because he’ll now have to give his knees the attention they need to rest and rehabilitate.

Is there any indication that Nadal’s tendonitis is due to a predisposed condition?
Not knowing Nadal, that is impossible to say, however, to reach a No.1 World ranking demands a tremendous effort, physically and mentally. I would believe his tendonitis is because of over-use, not genetics.

What recommendations can you offer Nadal regarding treatment?
The treatment protocol is straight forward. Primarily, he needs to rest, cross train, stretch, use various physical therapy modalities and let time and the healing process take its course.

If Nadal continues to play tennis without allowing his tendonitis to heal, what would be his best and worst case scenario for his tennis career?
The worst case scenario is not being able to play, which would be very detrimental to his career. There is no best case scenario.