In mid-May, Rafael Nadal lost a game in the last 16 of the Italian Open. It wasn’t so much the fact that he lost it (although it was his earliest exit from the tournament since 2008), it was how he lost it. By the end of the game, he was visually limping and in pain.
Nadal suffers from Mueller-Weiss syndrome – a rare under-diagnosed degenerative condition that affects bones in the foot and can cause chronic foot pain. This was very bad news; not only did it seem to suggest that Nadal, 36, may be forced to retire, but his favorite tournament was also coming up. Nadal had won the Roland Garros, one of the four Grand Slam tennis tournaments, a record-breaking 13 times, losing it just 4 times since 2004. Nadal, a quintessential fighter, wanted to give it another go.
He played the Roland Garros, using regular injections to numb the pain in his foot. It was a grueling, scorching road to victory, but in the end, he managed to win. Along the way, he managed to defeat Novak Djokovic. Along with Nadal and Roger Federer, Djokovic is part of the “big three” — three tennis players that have dominated the past two decades in tennis and almost without a doubt, the best three tennis players in history. The three are neck and neck in terms of most Grand Slam tournaments won, with Nadal having a slight edge thanks to the recent Roland Garros win.
But now, Wimbledon’s up. The anaesthesia injections are unsustainable, so Nadal had to employ a different medical procedure to numb the pain: radiofrequency ablation.
Killing nerves
Radiofrequency ablation (RFA), uses radio waves to create a current that doesn’t affect the skin but heats a small area of tissue. The technique can be used to attack tumors, nodules, or other growths in the body. It can also be used against chronic pain — by targeting nerves.
During the procedure, a hollow needle is inserted into the targeted nerve. An electrode is inserted into the top of the needle, and through this electrode, radio waves are sent. These radio waves only hit the targeted tissue, leaving nearby tissues intact and unaffected.
When deployed for this purpose, radiofrequency ablation destroys a part of the nerve, essentially stopping it from sending pain signals to the brain. It’s like a permanent anaesthetic, but instead of numbing the pain pathway, you discontinue it.
“We seek to maintain it permanently. If it works, we’ll take the sensitivity out of the sensitive part of the foot. And there is another important thing: with distance blocks it has been shown that I can play.”
“The objective is clear: to make a radiofrequency in the nerve to try to achieve the sensation that I have when I play with my foot asleep,” Nadal told the ATP Tour. Radiofrequency ablation is around 70% effective for several months, and the procedure can be repeated if needed.
Nadal and his team say they’ve explored many different options, and at the end of the day, this was the only one left. It’s not the first time a high-profile player relied on this procedure, which is usually reserved for the over 60. Tiger Woods also relied on it when he was suffering from chronic back pain. Woods, also in contention for the “GOAT” title in his sport, ended up firing his coach because he didn’t know how to train him after the procedure. No one did — it was a venture in the unknown. But as Woods won the Masters in 2019, his first Major title for 11 years, it showed everyone that what was once thought impossible was now possible. This is good news for Nadal, but there’s no guarantee that the procedure will work just as well for him.
Wimbledon’s just started, and Nadal won his first game, in part thanks to the procedure. But there are few guarantees.
“Well, it is obvious that if I am here, it’s because things are going better. If not, I would not be here,” Nadal said. “So quite happy about the things, how [they] evolved. I can’t be super happy because I don’t know what can happen.
“First of all, I can walk normal most of the days, almost every single day. That’s for me the main issue. When I wake up, I don’t have this pain that I was having for the last year and a half. So quite happy about that.”
Of course, even if it works, the procedure does nothing about the injury itself — it’s just a way to deal with the pain. But even so, it’s enabling one of the greatest athletes of all time to give it another shot and do the best thing he knows how to do: fight.
