The difficulty of coming back from serious tennis injuries

It wasn’t long before Alexander Zverev only to realize that his situation was dire.

After hours of scintillating shots, Zverev and Rafael Nadal were on the verge of starting a second tiebreaker in their semifinals at last year’s French Open.

But suddenly Zverev ran wide for a forehand, rolled his right ankle on its side and let out a roar. He stumbled to the ground, red clay caked to the back of his black sleeveless top, and took his ankle in his hands.

“I immediately knew I was done because my ankle was actually three times the size of normal,” Zverev said over the phone about the injury that took him out of tennis for the rest of 2022 and brought out his ATP No. 2 ranking . the top 20. “It was not a nice feeling.”

Zverev is not the first player to be forced into a long-term layoff due to a serious injury.

His opponent that day, Nadal, has not played a tour match since he injured the psoas muscle between his lower abdomen and upper right thigh during the Australian Open in January. After repeated attempts to rehabilitate from the injury over the past four months, Nadal — who also suffered from chronic foot pain, a broken rib and a torn abdominal muscle over the past 18 months — pulled out of the French Open on May 18. 14-time Roland Garros champion and has played the tournament every year since 2005. He also indicated that he does not intend to play Wimbledon and that 2024 will likely be his last year on the professional tour.

Emma Raducanu, who won the 2021 United States Open, has been injured regularly ever since and recently had surgery on both her wrists and an ankle. Andy Murray, a Wimbledon and US Open champion, announced before the 2019 Australian Open that he would retire after the tournament, only to come back, playing first doubles and then returning to singles after successful hip resurfacing surgery .

Bianca Andreescu, who beat Serena Williams to win the 2019 US Open, has suffered injuries to her adductor, ankle, foot, back and right shoulder that left her wondering if she should stop competing. And Stan Wawrinka, a three-time main champion, was considering retirement after multiple surgeries on his knee and ankle. Wawrinka, once number 3 in the world rankings, is now fighting to stay in the top 100.

Injuries, surgeries and rehabilitation are dreaded words in every athlete’s vocabulary. For professional tennis players, who are not protected by the extensive rehabilitation coverage of a team sport, but are instead treated as independent contractors, returning to the ATP and WTA Tours can be physically, mentally and even financially grueling.

“From the moment I started, I had never had an injury and I played every day at high intensity,” Dominic Thiem said by phone. Thiem, who defeated Zverev to win the 2020 US Open, suffered a debilitating wrist injury in June 2021 and was sidelined for months. Thiem, once No. 3, lost seven straight matches when he returned to the ATP Tour for the first time, and his ranking plummeted to No. 352, forcing him to play lower-level Challenger tournaments.

“In the event of an injury, the entire system comes to a standstill,” says Thiem, who is now just inside the top 100. “You can’t do your job and you don’t have a clear plan anymore. After I came back, it was like never before. You have to adjust your expectations, but that is very hard, because all these years you have set yourself a certain standard, not only of the tournaments you play, but also how you feel on the ball. In fact, everything changes.”

The process of returning from a layoff can be as difficult as the injury itself. Re-accustoming to the rigors of constant travel and the pressures of playing matches at all hours of the day and night, along with worrying about the possibility of new injuries, can affect a player’s recovery.

Andreescu knows that. Plagued with back problems for much of 2022, she finally began to recover at the Miami Open in March. But during her fourth-round match against Ekaterina Alexandrova, Andreescu tumbled onto the court, clutching her left leg and screaming in pain.

“I’ve never felt such pain,” Andreescu said on the phone as she prepared to return to the tour in Madrid three weeks later. “The next morning I knew what was happening, but I just hoped I woke up from a bad dream. Then I felt the pain and knew this was real.”

Andreescu has rehabilitated her body many times before, but she also believes that the mind-body connection is just as important.

“I believe everything starts in the head and we create our own stress and in a sense our own injuries,” she said. “Weird accidents can happen, but if you can get your mind right, it’s easier to bounce back from those injuries.”

The WTA takes injury prevention and rehabilitation seriously. The tour has programming and staff specifically dedicated to the physical and psychological well-being of athletes. According to Carole Doherty, the WTA’s senior vice president of sports science and medicine, all players receive comprehensive medical care, with services such as cardiology, dermatologist checkups, bone density studies, and nutrition and hydration advice.

When a WTA player is injured or pregnant for at least eight consecutive weeks, she can apply for a Special ranking, which means that upon her return she will be ranked where she left off and can compete in eight tournaments over a 52-week period with that ranking. The ATP has a similar protocol called Protected Ranking.

Becky Ahlgren Bedics, vice president of mental health and performance for the WTA, is well aware of the psychological toll an injury can take.

“Injuries take you out of training and competition and force you to regroup and prioritize your life differently,” says Bedics, who is encouraging players off the tour to delete WTA rankings from their phones so they don’t see where they are up to. compared to their peers. “It’s hard for an athlete whose only thought is, ‘How can I come back, and what happens if I don’t?'”

Bedics and her mental health team are encouraging players to meet their expectations when they return to play.

“There are so many stressors in this game, including financial ones,” Bedics added. “Our athletes are typically very young and won’t be doing this again for the next 50 years. Sometimes they support their family. So what we’re helping them with is listening to ‘what is’, not ‘what if’. We want them to look forward, but also look back to see how far they’ve come.”

Daria Saville understands the play-for-pay nature of tennis. She has repeatedly suffered from Achilles tendon and plantar fasciitis since 2016. She had surgery after the 2021 Australian Open, which kept her out of play for nearly a year. When she tore her anterior cruciate ligament during her competition in Tokyo last September, she had to have another operation.

“Every time I get injured I think about my life and wonder what it will be like without tennis,” says Saville, who also had ACL surgery in 2013. “Life isn’t that hard on tour. Everything is done for you, so you don’t have to think too much. The worst thing that can happen is you play badly and lose a game.”

Fortunately, Saville’s financial burden has been eased by the support she receives from her national federation, Tennis Australia, which pays for her physiotherapist and strength and conditioning coaches. She also receives pep talks from her coach, former tour player Nicole Pratt.

When Thiem thinks back to his wrist injury, he links it to when he won the US Open. After reaching that goal, Thiem said, he suddenly lost his passion and motivation to play, prompting him to practice at a reduced intensity, which ultimately led to the injury. Trying to come back was difficult.

“I can’t forget,” Thiem said, “that all the time I wasn’t playing, the other players were playing, practicing and improving and getting ahead of me. That makes it even harder to come back.”