It is a degenerative disease from which there is no cure. Surgeries are often not conclusive and for athletes it would mean safe withdrawal
The injury to Nadal’s left foot that is putting Paris’ Rolland Garros at risk and that last night tormented the Spanish player on the Centrale del Foro Italico is now a chronic problem. It is called syndrome of Muller-Weiss: it’s a dysplasia of the tarsal scaphoid, deformity of one of the bones located in the central part of the foot, essential for its mobility. The disorder is listed as one rare, degenerative, difficult to cure and often inoperable disease. Nadal will have to live with it all his life, well beyond when he decides to hang up the racket. Patients suffer from significant and progressive pain accompanied by bone deformity which can eventually lead to osteoarthritis
The unknown causes: hypotheses only
«The disease is not frequent, it affects mainly subjects between 40 and 60 yearswith net female prevalence. The disease probably has an onset in pediatric age, is asymptomatic and usually occurs in adulthood “explains Dr. Umberto Alfieri Montrasio, Head of the Foot and Ankle Surgery Unit of the IRCSS Galeazzi Orthopedic Institute in Milan. Nadal represents a rarity in the rarity because the first signs date back to when he was 18 and he is a man.
The pathology was first described in 1927, however since then the causes are still unknown. «We have a series of hypotheses – says the orropedico – and one of these is that the scaphoid bone goes into necrosis due to lack of vascularization due to primitive or post-trauma causes; others speak of an abnormal process of ossification of the scaphoid in pediatric age and someone else argues that it is a malformation of the scaphoid that subsequently undergoes this pathology. Finally, not recent Spanish studies speak of possible food shortages. The issue is much debated and has not yet found an answer ».
The scaphoid in the midfoot is a fundamental bone because it has various joints and if he gets sick it causes pain when walking. “The downside is that this pathology is often asymptomatic: those who suffer from it carry it with them without particular problems” adds Alfieri Montrasio. Unfortunately this is not the case with Rafa Nadal who has lived with it for about 15 years. “Despite not having x-rays, if Nadal suffers from Muller-Weiss and still wins tournaments we can only bow to superman” comments the doctor
The treatments
One of the big problems with this syndrome is that its diagnosis is possible only when the disease is in a very advanced stageand the treatment is mainly conservativeof compromise, precisely because the cause is not yet clear: suitable shoes, special insoles, possibly physiotherapy.
“Surgical treatments often don’t give great results and go to sacrifice other joints between theastragalusthe bone that allows the foot to articulate with the leg, or between the cuneiform. Some surgeons propose to remove, at least partially, the malformed part of the scaphoid, but removing a fundamental bone for the biomechanics of the foot does not lead to exciting results ». If you operate, the foot would stop adapting to the ground and it would be impossible to run. «And this is a big problem for an elite athlete. If Nadal had chosen to undergo surgery, he would undoubtedly have had to stop playing because bone is fundamental in the biomechanics of the foot »underlines Alberto Alfieri Montrasio. Hence the tennis player’s choice to «bear the pain until my head tells me enough. If I don’t take anti-inflammatories, I’m lame. “
The course
The first signs of the problem occurred in Shanghai in 2005 and Nadal himself told the press the first symptoms: “After the last game I woke up and limped: I had a small scaphoid disease which, being thinner, broke in half . Since then a lump has formed in that area ». The athlete, as he himself confessed, used a very aggressive footbed which deflects the fulcrum of the left foot. For some time the strategy worked, but since it is a chronic and degenerative pathology, destined to worsen over time, in 2021 the tennis player was forced to a new stop with rest and physiotherapy. And yesterday once again he went back to talking about the pain that has afflicted him for a lifetime. For him the desire to play and win has always been more powerful than the acute suffering that has tormented him for so many years.
May 13, 2022 (change May 13, 2022 | 15:18)
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