Rafael Nadal is gunning for his 22nd Grand Slam title, having reached the final of the 2022 French Open, despite struggling with Mueller-Weiss Syndrome and being in a fair amount of pain for a considerable part of at least one year.

This is a rare degenerative condition which impacts the bones in one’s feet. The 36-year-old has to battle Caspar Ruud, who’s aiming for his first Grand Slam, as well as his medical condition out on the clay court. 

The syndrome impacts the navicular bone on the back of the foot, between the talus and cuneiform bones. 

“This bone is subject to significant stresses and, for reasons that we don’t understand, loses its vascularization and necrosis takes place” Professor Didier Mainard, the president of the French association of foot surgery and head of orthopaedic surgery at Nancy Hospital in northeast France, told France 24. 

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Without vascularization, the bone loses its blood supply. 

The professor further explained serious cases, saying, “in people who put a lot of strain on their feet, the bone will disintegrate, flatten, it can fragment and this can evolve into osteoarthritis with a shortening of the plantar arch”. 

While the Mueller-Weiss syndrome can only affect one foot, it mostly impacts both. However, the Spaniard only has it in his left foot. 

The condition develops without pain in the early stages, which makes it harder to detect. Being overweight, having a stress fracture or having flat feet, increase risks of the condition developing. 

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When the pain becomes too much to bear, surgery is often performed to hold the joint, formed by the navicular bone and the three cuneiform bones, in place. 

If Nadal undergoes the operative procedure, he would likely step back from professional tennis. Mainard said, “Doing sport at a high level after such an operation seems difficult to me”.