When Carlos Alcaraz walked off the court at Rod Laver Arena in January, he was on top of the world.
At 22, he had just completed the career Grand Slam, beating all-time great Novak Djokovic in the Australian Open final to claim his seventh major title.
A few months earlier he had decimated his rival Jannik Sinner in the US Open final in what was one of most the impressive performances of his illustrious career to date.
But the Spaniard has now missed the French Open and Wimbledon, going 114 days without playing a competitive match due to a wrist injury he suffered in April.
After returning to training, he has now withdrawn from the upcoming Cincinnati Open, and with the US Open less than a month away, Alcaraz’s ability to defend his title is in serious doubt.
So, why exactly is Alcaraz’s injury proving so troublesome, and how problematic can wrist issues be for tennis players in the long run?
How bad is Alcaraz’s injury and how common are wrist issues?
Alcaraz has been suffering from tenosynovitis – a painful inflammation of the fluid-filled sheath that surrounds the tendon on the inside of the wrist.
Tenosynovitis is typically caused by repetitive movements like gripping and swinging a tennis racket, and can lead to swelling and ongoing tenderness.
Minor cases can take weeks to recover, mostly managed by rest, but more severe issues can require significant physiotherapy and potentially even surgery, with recovery taking up to a year.
Alcaraz has not undergone surgery, but his latest withdrawal will take him to over four months out injured, and for a portion of that he was unable to use a racquet at all.
Wrist injuries are particularly worrisome for tennis players. The joint plays a key role in every contact between the racquet and ball – the way the wrist rolls through a shot helps generate power, and its dexterity is vital for delicate touches like drop shots, which are a key part of Alcaraz’s all-court game.
The lack of muscle surrounding the bones and tendons in the wrists also makes rebuilding strength difficult, meaning the length of absences can be difficult to predict.
“It’s really hard to cope with”, says CiCi Bellis, a former world number 35 who retired aged 22 after suffering from recurring wrist injuries.
“The wrist is one of the places you fear hurting the most. With lower body injuries you can still be on court swinging but with the wrist it’s so tough mentally because you can’t. I definitely had distrust in the joint when coming back.
“Time is the biggest healer from a rehab standpoint and building back your confidence.
“For somebody like Alcaraz who has maybe the best forehand in the world, the wrist is so core to his game and he plays with a lot of spin using the wrist a lot. It’s one of the biggest parts of his body he relies on.”