What is the Muller-Weiss syndrome that Nadal suffers from

He wrote on his Instagram page: “Hello Rome! Thanks for everything!!! See you next year!”. The author is Nadal and the post raises hopes for the continuation of his career. Yes, because the Spanish tennis player, nicknamed the legend of the clay court for his skill, suffers from Muller-Weiss syndrome, a degenerative pathology at the moment still without resolutive therapies. And that causes pain to exaggerated levels, so much so that it was the cause of the elimination of the tennis player Nadal during the quarter-finals of the Internazionali d’Italia in Rome. During the conference in Rome, he declared “I’m not injured, I’m a tennis player who lives forever with an injury”. And that’s right. Muller-Weiss syndrome is a constant companywhich from the moment it manifests itself onwards, continues to make its presence felt.

What is Muller-Weiss Syndrome

Little is known about Muller-Weiss syndrome. It affects the tarsal scaphoid, a spacecraft-shaped bone located approximately in the middle of the foot, and usually occurs around 45 years old, especially among women in a ratio of seven, against three men. Nadal, for his young age, is an exception, but there is a reason: the exaggerated use of the body, including the feet, which probably accelerated the syndrome. “The syndrome is atypical in its evolution,” he explains Umberto Alfieri Montrasio, head of the Foot and Ankle Specialist Unit (USPeC) foot and ankle surgery of the IRCSS Galeazzi Orthopedic Institute of Milan. “Probably those who suffer from it, are already born with the syndrome, but asymptomatic and without warning signs, for example in the posture, which would make us suspect a future onset”.

The disease is characterized by bone fragmentation, deformity, displacement of the scaphoid, necrosis of bone tracts, but without an apparent explanation. Between hypothesisthere is the one relating to a delay in ossification of the scaphoid, which would lead the bone to exploit its plasticity to maintain balance, but with a limited duration over time. According to some Spanish researchers, on the other hand, there would be at the base nutritional deficiencies“.

What are the symptoms

What is certain is the presence of symptoms, which suddenly explode with major pains and over time, of limitations functional because of the deformity. And surgery in this case is not a solution. “Various strategies have been tried, such as the removal of bone fragments and joint fusions”, explains Professor Alfieri Montrasio. “But there are not always benefits, with the additional risk of altering the physiology of the foot and consequently, the movements, the posture”.

How to manage pain

Nadal has stated several times to keep pain under control with anti-inflammatory. And to have used an insole with a very aggressive action, deviating the fulcrum of the foot. But it only worked for a while. “It is a degenerative disease and for this very reason, every strategy works for limited periods”, says Professor Alfieri Montrasio. «The therapy is based on braces, orthotics, physiotherapy, special shoes and pain relievers as needed, with approaches to be gradually modified, based on the changes in the structure and not only on the scaphoid. Over the years, in fact, a form of arthrosis occurs in the foot joints, with a further worsening of the painful condition, as well as of the ability to move ».

So is Nadal’s exit from the scene close? “None of us have seen the x-rays and this cannot be said”, concludes Professor Dr. Alfieri Montrasio. “The hope is that cases like yours will stimulate research, which is still scarce in this area. The pathology was first described in 1927, but there is still a long way to go. Admittedly, Nadal’s case is quite atypical. Usually, those who suffer from it do not have such a striking shape as his, because he does not subject the foot joint to the immense stresses caused during competitions, as well as intensive training ». One thing is certain though: no correlation between the anti-Covid vaccine and Muller-Weiss syndrome. The news is a fakewithout any endorsement from science.

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