Rafael Nadal will try to find this week a solution to the intense pain in his left foot, caused by Müller-Weiss syndrome (see graph) and that has forced him to play Roland Garros with the anesthetized area. “In the circumstances in which I’m playing I don’t want to and I can’t continue,” he said.. And he revealed the technique he is going to undergo: injections with retractile push, a technique applied by anesthesiologists.
“The technique is not new, what is innovative is to use it for that,” says Ian MacVeigh, head of the Pain Unit at the CEMTRO Clinic.which explains the mechanics: “It is done with a needle having an active tip with an electrode which is inserted into the damaged area and emits radio waves, pulses of 20 milliseconds with pauses of another 480. It does not destroy tissues, but produces neuromodulation in the nerve. With the electric and magnetic field the pain fibers are altered and with it their transmission”, explains the doctor.
“With the new treatment, we will seek to avoid surgical intervention to continue competing. It may be more effective over time than an infiltration, but it won’t solve the problem,” Ramón Navarro, head of the Ankle and Foot Unit of the same Madrid clinic. The penultimate table that Nadal could hold on to, already 36 years old.
“Pulsatile radiofrequency does not remove sensitivity to the joint because it does not destroy nerve fibers. In principle, mobility would not be affected”, MacVeigh reassureswhich considers Wimbledon (since June 27), “too close to see a spectacular result.”
What if it doesn’t work? “The indicated thing would be a calcaneal osteotomy to eliminate the varus of the foot. With that, it would improve enormously, but it would not be possible to fix the scaphoid because it is supposed to be fractured. Therefore, It would be convenient to carry out an arthrodesis, a fixation of the joint so that it does not move and stops hurting. But that can mean the end of his professional life”, reveals Joaquín Óscar Izquierdo, director of the International Chair of Podiatric Surgery at UCAM (San Antonio de Murcia Catholic University).
“The two interventions, in the case of an elite athlete, can mean the end of his career; it would be a solution to lead a normal life”, agrees Navarro, who despite having treated many athletes, knows of no case of Müller-Weiss syndrome in high-level sport. “Although Nadal’s case is unpredictable… It was a miracle that he arrived in good physical condition infiltrating himself just to compete. And that he said he was exchanging the title in Paris for a new foot, indicates the pain he is going through,” reflects the doctor from the CEMTRO Clinic. The solutions for Nadal are increasingly scarce. But, as he repeats, he will continue to give himself opportunities to compete.
