As a former professional tennis player, I’m always excited to see the world’s best players competing for a major championship.

Unfortunately, as New York prepares to welcome many of the greatest in the game today for the U.S. Open, the defending men’s champion won’t be in the ranks.  Rafael Nadal just announced that a he is withdrawing from the championship due to a right wrist injury. Nadal is a left-handed player, but he uses both hands for his backhand, like the famed Jimmy Connors.

This is a shame on several fronts, not the least of which being that Nadal is a player in his prime, winning four tournaments in 2014 including his record ninth French Open. He is tied with Pete Sampras for having the second-most major titles in the history of men’s tennis – 14.

It’s possible to tape the wrist and keep playing in certain team sports (soccer for example) but the wrist is critical in a sport like tennis. In Nadal’s case, he apparently hurt his wrist so severely during practice on his home court in Spain that doctors advised him to wear a cast for two to three weeks.

It’s unlikely Nadal suffered a traumatic injury. More likely, he’s dealing with one or more bone stress fractures due to overuse – essentially a Repetitive Stress (or Strain) Injury.  Ligament sprains and cartilage tears also may be contributing to his pain. As a world-class athlete preparing for the hard court tennis season, Nadal likely put himself on a more rigorous practice schedule.

Our bodies react to this kind of increased demand by strengthening the bone and muscle in areas of higher stress. If the rate of practice and play outpaces the body’s ability to cope, however, then stress fractures are likely.  Quite simply, if you play too hard too fast, something has got to give.

The wrist is a special case because it’s the slimmest part of the human body. There are eight bones in the wrist, supported by fragile tendons (compared with other tendons in the body). When a tennis player strikes the ball, it’s not just the force of the arm that generates powerful strokes. The hand and wrist are the end of the whip that is lashing out from kinetic forces starting at the feet, knees, thighs and turn of the waist.

For us mere mortals, it’s important to remember to exercise and stretch the muscles in and around the wrist if we are going to be playing sports like tennis regularly. Isolating the muscles by flexing and stretching the hands up, down and side to side is one simple suggested set of exercises. Another is to work on your dribble – just dribble a basketball (or exercise ball) on the floor and then against the wall at about eye level for 30 seconds (or longer) will fatigue the muscles. If you are on the tennis court regularly, you should be doing these exercises, but not right before you plan to play as you’ll find your strokes are significantly weaker than normal.

The good news for Nadal is that surgery is probably not going to be required for this kind of injury in the wrist, although stress fractures of the foot or hip are more likely to require going under the knife. Rest and recuperation will help Nadal return to the court, but not in time for an appearance on the courts at Flushing Meadows.

Dr. Annette “Dr. Z” Zaharoff heads the Non-Surgical Center of Texas, focusing on non-surgical alternatives to relieve pain and repair injuries. A former professional tennis player who competed in the WTC circuit, Dr. Zaharoff remains actively involved with the US Tennis Association. Learn more about her at