Injuries Explained: Vol. 1: Rafael Nadal

July 14, 2022

After a grueling 5 set match to advance to the quarterfinals, Rafael Nadal announced in a press conference he would be withdrawing from Wimbledon due to an abdominal muscle injury.  The following day, testing results showed a 7-mm tear of the abdominals.

7-mm seems so miniscule, so why did Nadal pull out of the tournament?

Let’s first think about the job of the abdominals: forced inspiration/expiration, rotation of the torso, flexion of the torso, maintenance of intra-abdominal pressure. Now, let’s consider all of the motions required to complete 1 point in tennis: the back swing, running, the swing, the follow through, running from baseline to the net. Once we break it down we can fully understand that the abdominals are constantly firing throughout an entire match of tennis.

What does this mean for Rafa moving forward?

The #3 ATP ranked athlete is opting for conservative treatment at this time, however more invasive steps may be taken at a later date. Due to the size of the tear and the athlete’s ability to play through thus far, conservative treatment should be effective.  

What is conservative treatment for this injury?

Like many soft tissue injuries, rest and deloading the injured tissues is the first step.  Once the pain levels have decreased with activities completed throughout the day (i.e. breathing, dressing, etc.) PT is typically started.  A patient’s treatment session will focus on normalizing range of motion in all directions, breathing retraining, and strengthening of the entire body to promote return to previous activity level/sport.  

What is surgical intervention & PT for this injury?

Surgery entails sewing the torn fibers back together, typically through microscopic surgery.  Following surgery, PT begins with protective the incision and a walking program.  Once the scars have closed and healed, scar mobility and limiting scar tissue build up are emphasized. From there, progressively stressing the abdominal musculature and followed by return to sport/work training depending on the patient’s goals

What is the timeframe for an injury like this?

Like many questions in PT, it truly depends on many things such as size of tear, length of injury, and compliance with PT.  A “typical” timeframe for an injury the size of Nadal’s is ~6-8 weeks.  However, if conservative treatment and Rafa undergoes surgical intervention, recovery could take 12-20 weeks.  That being said, for a high level athlete recovery is typically a little quicker due to accessibility to the highest level of care, and availability to train and recover daily.  As of right now, Nadal and his medical team are expecting him to play in the U.S Open in August.

Link to Nadal’s press conference: