In January 2022, the tennis player from Spain, Rafael Nadal became the 1st player to gain 21 grand slam tennis competitions by winning the Australian Open. He had been 2 sets down to Daniil Medvedev from Russia in the final and came back to victory 5 sets to 2. The thing that was so remarkable about the win might be that he previously had a serious foot injury becoming a 4 month lay off from tennis in 2021 and also the 2 weeks ahead of his arrival down in Australia for the Open he was not well with COVID-19 for a couple of weeks.

Nadal

The foot injury that Nadal has was a condition known as Müeller-Weiss Syndrome or disease. It is a pretty uncommon spontaneous necrosis or loss of supply of blood for the navicular bone in the arch of the foot. It was first described back in 1927 and is also from time to time known as Brailsford Disease. The reason for this condition isn’t known as it is not obvious just what does hinder the blood supply to several areas of the bone. This navicular bone is an essential part in the top of the arch of the foot and it is exposed to lots of force, particularly in sports activities like tennis. Women are more likely to be impacted more than males.

The signs and symptoms of Müeller-Weiss Syndrome or disease typically start out as a mild ache in the mid-foot that will get gradually more painful over time if treatment is not began. A medical professional may often find the pain sensation to the part of the bone. You can find rather specific changes to the navicular bone on x-ray which include alterations to the density and shape of the navicular. The look on the x-ray can often be used to classify the stage of the problem.

The main approach to the treatment is normally to restrict activities so that the strain is reduced on the bone. Alternative activities such as going swimming and also riding a bike can be used rather than weightbearing exercises. Weightbearing movements might slowly and gradually be added as the signs and symptoms improve. Foot supports are often used early to support the arch of the foot and lower the strain on the bones which support the arch of the foot. If the pain is particularly bad, then a walking brace needs to be utilized to reduce even more the stress on the mid-foot (arch) of the foot. As the pain improves, the foot orthotics should be used for the long term to hold those stresses lower. If these approaches will not help then there are some surgery alternatives in case the pain is severe. There are a number of different operative approaches which have been made use of such as drilling of the bone, removal of the fragments of the bone along with a synthesis with the joints around the navicular bone. There’s no ‘gold standard’ procedure for the surgical procedures and the results of each strategy is frequently mixed which is why a good test of the conventional methods will be required before considering surgery. As Rafael Nadal’s case of Müeller-Weiss Syndrome shows that the prospects with the disorder could be good if detected early and proper therapy applied.

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