Nadal press conference - Hoffa's Syndrome or Hofitis

http://www.bupa.co.uk/running/injury-prevention-and-recovery/injuries/hoffas-syndrome/

A friend of mine just sent me a message saying that at the press conference in Manacor today, Nadal revealed that he is suffering from Hoffa's syndrome - the fatty soft tissue separates the patellar tendon from the shin bone, causing inflamation and great pain. So far the only published interview on the web is in Spanish, but there are bound to be more comprehensive reports by the end of the day after interviews conducted in English, or translations appear in the press.

The only cure seems to be is rest and measures to reduce inflamation. As the bupa factsheet says, it is an injury that is sustained with prolonged stress or activity to the knee.

He did used to wear white tape like strapping below his knees in the past and that disappeared in 2009 I think if I recall.

I mean good grief if that is the case I would've thought that the tendon itself would've been eradicated with the running he does and on different surfaces over the years.

Apparently the remedy is to rest the knee for 6 months, yet team Nadal were making noises about Davis Cup.

reckoner wrote:Apparently the remedy is to rest the knee for 6 months, yet team Nadal were making noises about Davis Cup.

How long was he out for in 2009?

Every player should ruin their knees if it gets you guaranteed 11 slams, numerous millions, appearances in Shakira videos...

I would be amazed if he was fit for that. Unless Toni himself plays.

The Special Juan wrote:

reckoner wrote:Apparently the remedy is to rest the knee for 6 months, yet team Nadal were making noises about Davis Cup.

How long was he out for in 2009?

It was shorter than this time, I think?

I'm sure there were threads on the original 606 saying Nadal's body would break down by 25/26, unfortunate though it is, it looks like that point of view is being vindicated.

reckoner wrote:

The Special Juan wrote:

reckoner wrote:Apparently the remedy is to rest the knee for 6 months, yet team Nadal were making noises about Davis Cup.

How long was he out for in 2009?

It was shorter than this time, I think?

If it was shorter than now that doesn't bode well for him. I remember seeing him when he came back; he looked really thin (his Sam Stosur sized arms had shrunk considerably) and it took him a good while to get back up to speed. If he has to do extra gym work he could end up doing more damage.

Obscure injury with a set timeframe for recovery.

Sound like Serena Williams all over again.

The Special Juan wrote:

reckoner wrote:Apparently the remedy is to rest the knee for 6 months, yet team Nadal were making noises about Davis Cup.

How long was he out for in 2009?

He lost end of June at RG and was back at the US/Canada masters events but was definitely back end of August as he lost in the semis to JMDP. So about 6 weeks or so.

http://www.tennis-x.com/xblog/2012-08-17/10502.php

http://www.washingtonpost.com/blogs/early-lead/post/rafael-nadal-out-indefinitely-may-limit-future-schedule-to-prolong-career/2012/08/17/2e234722-e8ab-11e1-a3d2-2a05679928ef_blog.html?wprss=rss_sports

I still feel that despite this news, his detractors will still not be satisfied about actually having some sympathy for another human being who by injury is having is career limited.

I am not a Nadal fan, but I don't like to see anyone's career shortened by injury. That said I guess this was always on the cards because of his brand of tennis.

To answer lydian's point earlier about his schedule, I think he might play the slower HC tournaments. Paris, Miami, Possibly Toronto. The thing to take into account is whether the US Open would be out of limits given that Tokyo, Shanghai and WTF are pretty fast. My guess is he will cut out Indian Wells, Halle, Cinncy, Doha, Brisbane.

Might this spell the end for Toni as I would imagine if Rafa is to change his style somewhat to prolong his career he might need a 'better' coach who bring in changes gradually and successfully.

Yeah Legend there are some online who almost are gleeful when the man gets injured, thankfully most of those people don't post anymore. Can't think of fans of any player that would take glee in a great of the game going down with injury. But at one time there was a big contingent of people who be hammering away at the guy even now. I hope he does get better soon, I also don't know if one could conclude for certain that his style of play caused all his leg problems. I mean the guy could just have predisposition or genetic or traumatic weakness in the knees. In sports I have played with a lot of guys that just seemed to suffer a lot these types of injuries and they weren't doing anything different than anyone else. They seemed almost genetically to be more susceptible to certain types of injures.

It is a real shame for Nadal. Apparently they can remove the fat pad if conservative treatment does not work. Hopefully it will not come to that.

http://orthopaedic.com.sg/hoffas-syndrome-fat-pad-impingement-syndrome-a-cause-of-anterior-knee-pain/

Yep it's a shame when people come out with 'he deserves this injury' as I've read elsewhere.

The link carrieg4 posts says "As the fat pad is one of the most sensitive structures in the knee, this condition is known to be extremely painful.". So it's no wonder he has been experiencing pain in his knee for so long and probably making him think there are oth things going on in the knee as well. I wonder if arthroscopic surgery is going to be the only proper route out of this?

Event-wise, he may go South American clay before/after AO, do IW where he always does better then drop Miami and head south again or have more rest before European clay. There he'll simply drop Madrid as planned anyway.

Then onto Wimbledon after FO, may ditch Halle unless they move SW19 back a week or so. Then onto Hamburg, etc, clay before Toronto (he doesn't like Cincy nor does well there) and gives him week extra break before USO. After USO I don't know....but ending with Paris indoors and WTF.

But an hard-court light schedule puts ATP in a dilemma....do they allow one of its top star to willingly drop 2+ HC (or other) Masters events without penalty? Also does this start to make ATP think about the preponderance of Hardcourt on tour? After all 6 out of 9 Masters, 2 out of 4 slams are played on it at a time when the tour is more gruelling than ever before, partly due to slowing conditions, partly due to racquet and string tech which they have done NOTHING about....perhaps a top star in trouble will finally make them reanalyse the parameters of their own sport for once?

Is he just unlucky though? Would any other player playing like that have lasted anywhere as near as long as he has? What's equally astounding as people saying he deserves it is the attitude that this is just some unforseen tragedy that has befallen him.

lydian wrote:... Also does this start to make ATP think about the preponderance of Hardcourt on tour? After all 6 out of 9 Masters, 2 out of 4 slams are played on it at a time when the tour is more gruelling than ever before, partly due to slowing conditions, partly due to racquet and string tech which they have done NOTHING about....perhaps a top star in trouble will finally make them reanalyse the parameters of their own sport for once?

The other argument is rather than cutting down on hard court masters to the whim of Nadal, Nadal should adjust his style to increase his own career endurance. He already increases the time taken between points to catch his breath for recovery etc (as do others e.g. Djoko, DelPo, Murray ...). To be fair to Nadal however he has been on the senior tour since around 15/16 years of age, winning over 50 million dollars in prize money plus gaining more than that in sponsorship. With careful investment and tax breaks he will soon be on his way to join the billionnaire's global elite.

On a more general note, as others have mentioned, organisers should reconsider speeding up the courts and hence the game, to account for the increase in technology, fitness, and time take between points.

ps Good to see you (Lydian) back and well after your break.

I suppose they could introduce sabbaticals onto the tour, e.g. a 6 month "career break", just to counter mental and physical exhaustion. Players would of course drop points but wouldn't be penalised.

Fair points guys, and thanks NS, just needed abit of time away...coincided with a huge peak in work too.

I don't think anyone surely feels Nadal is the victim of a sudden tragedy. However, in his case it appears to be a combination of long term wear, yes due to the gruelling style he plays perhaps (but I maintain no-one deserves an injury due to that style), but also that a condition such as Hoffa's is not necessarily related to his playing...a lump of fat behind the patella seems unrelated to this poster.

However, lets look at this another way. We know he's had knee issues since he was 13 so perhaps this condition has dogged him that whole time but he never knew/it was never diagnosed. Any inflammation caused could then spread to other tissues in the knee...i.e. for all we know his other knee problems are as a result of the fat pad. After all, for all his gruelling style he's never had a chronic hip, back, arm or shoulder problem. Just his knees. He had a congenital foot problem, corrected for by customised shoes, so perhaps a congenital/secondary knee problem has also always been his issue....and Hoffa's is very hard to diagnose.

But the wider discussion is beyond Nadal, he's merely a catalyst of whether the ATP should do more to a) extend the careers of its top stars...after all they are the cash cows for ATP...through redesigning the whole ATP calendar as surely it's way way overdue, b) introduce more variety of speed and surface, c) limit racquet technology which all the top players use (yes even Federer uses Luxilon strings).

This would also benefit newer guys coming into the game and stop the sport being dominated across all events by 4 guys, the like of which we've never seen before.

I think perhaps there needs to be a little more lee-way to allow players (especially top players) to drop tournaments without penalty to counter potential physical and mental burnout. I also quite like the idea of a 6 month sabbatical or perhaps one year out of say five where the commitments and penalties are dropped.

No-one should be "blaming" Nadal's style of play per se - he is making use of the rules and conditions. If he wasn't doing it, others would. In fact I see Nadal as one of the game changers in the history of the sport: others have followed his style and approach to the game (drawing out the game where necessary (making the match longer), exploiting the "safety" in the top spin etc). It is up to the tournament organisers to "counter" with speeding up the courts etc.

In the meantime he and others have been making noises about the problems with the demands made of them on the tour. So I suppose he knew about the issues he was encountering. It has been said that Borg played in a similar style (despite the differences in technology) to Nadal, and we know what happened to Borg - probably more mental burnout than physical burnout. I think Borg tried to do a deal with the ATP tour organisers in terms of allowing him a reduced schedule. They didn't accept his proposition and they as well as tennis lost him from the sport.

However I think the Williams sisters have shown it is possible to play around with the schedules (to suit them), despite all the penalties and commitments required of them (assuming the WTA have the same approach as ATP to tour commitments).

Good to see you back Lydian

Nore Staat wrote:No-one should be "blaming" Nadal's style of play per se - he is making use of the rules and conditions. If he wasn't doing it, others would. In fact I see Nadal as one of the game changers in the history of the sport: others have followed his style and approach to the game (drawing out the game where necessary (making the match longer), exploiting the "safety" in the top spin etc). It is up to the tournament organisers to "counter" with speeding up the courts etc.

I've got to say that I disagree violently. Nadal has previous form in taking rules related to time between points and breaking them. Umpires seem unwilling to enforce the rules but I doubt that his behaviour is done unwittingly since so much of his perfomance on court is a series of well choreographed moves. If the umpires don't act, then his behaviour is still outside the rules - he simply hasn't been called on it often enough to make him change his behaviour. Suggesting that if he didn't do it then someone else would hardly seems to excuse him.

Turron wrote:

Nore Staat wrote:No-one should be "blaming" Nadal's style of play per se - he is making use of the rules and conditions. If he wasn't doing it, others would. In fact I see Nadal as one of the game changers in the history of the sport: others have followed his style and approach to the game (drawing out the game where necessary (making the match longer), exploiting the "safety" in the top spin etc). It is up to the tournament organisers to "counter" with speeding up the courts etc.

I've got to say that I disagree violently. Nadal has previous form in taking rules related to time between points and breaking them. Umpires seem unwilling to enforce the rules but I doubt that his behaviour is done unwittingly since so much of his perfomance on court is a series of well choreographed moves. If the umpires don't act, then his behaviour is still outside the rules - he simply hasn't been called on it often enough to make him change his behaviour. Suggesting that if he didn't do it then someone else would hardly seems to excuse him.

Fair enough: put up your dukes


Ps: I do think Nadal and others take as much time as they feel they can get away with in order to catch their breaths and to mentally refocus for the next point. It seems a "small price to pay" in the pursuit of potential riches, up to a billion dollars with prize money, sponsorships, brand value etc, and success so it is not surprising that others have followed Nadal (although perhaps not to the same extent). There have been examples both in tennis and in other sports of rule changes specifically to counter the effect of an individual player (e.g. Pancho Gonzalez)* or beast (horses).

*During this time Gonzales was known for his fiery will to win, his cannonball serve, and his all-conquering net game, a combination so potent that the rules on the professional tour were briefly changed to prohibit him from advancing to the net immediately after serving. [wiki]