He won his 14th title at the end of the suffering. The Spaniard Rafael Nadal was once again crowned, Sunday, June 5, at Roland-Garros, after several complicated weeks for his physique. Between his rib injury after Indian Wells, which cut short his preparation on earth, then his persistent pain in his left foot, the former world number one was able to lift the Musketeers cup, in particular thanks to injections.
“I had no feeling in my foot anymore, because my doctor was able to put an anesthetic on the nerves and that took away all the feeling in my foot,” he explained at a post-match press conference on Sunday. Franceinfo: sport interviewed Marie-Aude Munoz, orthopedic surgeon, specializing in the foot and ankle in Montpellier, to understand how he was able to play in such conditions.
Rafael Nadal explained that he received infiltrates in the nerves “to cut the pain” and played without any sensation in the foot. How can you play with a “sleeping foot”?
Marie-Aude Munoz: You must first know that you have three types of nerves: the nerve that gives the sensation, the nerves that go to the muscles to give them a command and make them move, and the pain nerves. Then, in order for the foot to move, there are muscles in the calf and in the foot. Even if you can’t feel your foot, your muscles are still working, and you can walk normally.
It is not the whole foot that has been put to sleep. If Rafael Nadal didn’t feel his foot at all, he wouldn’t have been able to play or even walk. The sole of the foot therefore had to be sensitive. He said it in a general way, but it was only the pathological area that was put to sleep, that is to say certain small nerve branches on the area of his Müller-Weiss pathology, in order to block the nerves that convey pain information. So his muscles were working since they didn’t block the nerves that make the muscles work.
The Spaniard explained that he had “been able to play for these two weeks” thanks to these injections of an anesthetic. Is there a risk of receiving these injections over two weeks?
Yes, it is not unusual. There is the risk that the product damages the nerves of the affected area. In the worst case, there may be partial damage, that is to say that the nerve will regain sensitivity, but as it has been damaged, this will create even more pain. Instead of giving you the information “You’re touching my foot”, the nerve will report the information “I’m in pain”.
Are there other risks?
As the patient has less sensation, he can push his foot a little too far, and risk breaking his ankle because he will make a bad support, which he will not be able to control. The danger is that on a support, his foot turns, and he gets a fracture or a serious sprain.
Our sensory nerves are also there to stop us. We must not forget that pain is above all made to protect us. Rafael Nadal took a very important risk, because his body is his working tool, but this risk must be measured, punctual, and reserved for this level of activity, and not a practice to be carried out at Mr. and Mrs. All-the- World.
Nadal also announced that he was going to try another treatment, “by radio frequency”. What does this treatment consist of?
I think it is a therapeutic trial, a treatment that is not yet recognized. Because, as far as classic and validated treatments are concerned, he has already tried them all, I presume. But I can’t tell you what it is.
Given where he is today, he’s at a terminal stage, he’s going to try anything. The only thing we could do is to block the small joints that are painful, but by opting for this option, no one can guarantee that he will be able to regain his level, or even play tennis again. That’s why he wants to try other solutions before this one.