Rafael Nadal announces his retirement after 22 Grand Slams. Since he was 18, this legendary tennis player has been affected by a rare syndrome: Muller-Weiss syndrome. What is this pathology? We take stock with Dr. Cyrille Cazeau, orthopedic surgeon.
Tennis legend Rafael Nadal bows out
Tennis icon Rafael Nadal confirmed his retirement in an emotional video released on October 10. At 38, after winning 22 Grand Slam titles, the king of clay will end his career after the Davis Cup in November. Roger Federer and Novak Djokovic paid tribute to him, celebrating an athlete who left his mark on the sport with his dedication and fighting spirit. Nadal, an exemplary figure, leaves an unrivaled sporting legacy that already inspires millions of young players.
Rafael Nadal has been suffering for several years from a rare syndrome in his left foot, called Muller-Weiss syndrome or osteonecrosis . This rare disease is serious because it causes a deformation of the navicular bone of the foot and eventually generates severe pain .
Risk factors include flat feet, obesity or even an episode of malnutrition, such as anorexia, among others.
What is Muller-Weiss syndrome?
Muller-Weiss syndrome or osteonecrosis , is a " pathology caused by a bone that dies , here the navicular bone, which is located in the foot " explained Dr. Cazeau, during a previous interview. " The bone becomes deformed, which leads to premature degeneration of the joints with which it is in contact, because due to the deformation, the joint fitting is no longer done correctly and this generates pain" .
This loss of joint harmony mainly affects the navicular bone and the neighboring bone, which is called the talus. " The cause is a small artery that becomes blocked and triggers this poor vascularization that precedes necrosis, that is to say the death of the bone. This phenomenon is probably of genetic origin, we don't really know" the specialist continues.
What symptoms?
The disease progresses silently in the early stages. " Pain usually occurs later and is triggered by bone deformation, but is irregular," our expert tells us. Swelling can also occur.
Diagnosis of Muller-Weiss syndrome
Before considering surgery on a patient, it is important to ensure that this is indeed the syndrome. As Dr. Cazeau explains, this syndrome " can be confused with a stress fracture of the navicular bone, due to repeated stress. This should be considered because Muller-Weiss syndrome remains rare ." The diagnosis is confirmed by an X-ray of the foot in a standing position.
Treatments for Muller-Weiss syndrome
Anti-inflammatories
Regarding treatments, they consist of masking the pain with medication or infiltration, which is the direct injection of an anti-inflammatory into the injured joint of the foot.
Orthopedics
Orthopedics helps reduce mechanical stress on the foot by making custom-made orthopedic insoles. Rest is also recommended.
Surgery
If a patient has to undergo surgery, the impact will be on the adaptability of their foot to the ground: " When we operate on this syndrome, we have to block the navicular bone with that of the talus. The problem is that they work with another pair which are the cuboid and calcaneal bones, the heel bone. If we choose to operate, we have to intervene on the "two pairs or nothing " explains the specialist.
He added that this operation is incompatible with practicing high-level sport. " A recovery time of about three months is required, with physiotherapy. For an athlete like Nadal, whether or not to undergo this operation is a real question that he must think about, because it affects his professional future ."