Nadal Collapses After Winning Third Round of U.S. Open

Tennis star Rafael Nadal collapsed during a press conference after the U.S. Open on Sunday due to extreme pain caused by cramping in his right hamstring and thigh. The press conference ground to a halt as reporters cleared the interview room while the defending champion iced his leg. He also rehydrated himself with water.

Reporters returned when Nadal recovered after about 10 minutes. “I just have cramping in my leg. That’s all,” he explained and continued with the Spanish portion of the interview. This isn’t the first time the Spanish athlete has encountered problems with his legs.

Earlier, Nadal overcame a blister on his right foot and two tight sets to beat 2002 Wimbledon runner-up David Nalbandian 7-6 (5), 6-1, 7-5 to reach the fourth round.

While leg cramps occur quite commonly among athletes, there are some important things to know.

A muscle cramp is an involuntarily and forcibly contracted muscle that does not relax. When a muscle or muscle fibers contract involuntarily, it is in a “spasm.” If the spasm is forceful and sustained, it becomes a cramp. The affected muscle(s) may feel harder than normal or visible twitch. It is important to note that any muscle under voluntary control, called a skeletal muscle, can cramp. Involuntary muscles of organs (uterus, blood vessel wall, bowels, bile and urine passages, bronchial tree, etc.) are also subject to cramps.

There are four types of muscle cramps:

  1. True cramps – the most common type; thought to be caused by hyperexcitability of the nerves that stimulate the muscles; affects part or all of a single muscle or a group of muscles that work together; some reasons true cramps occur: injury, vigorous activity, lack of muscle use, dehydration, body fluid shifts, low blood calcium, magnesium, and potassium.
  2. Tetany – all of the nerve cells in the body are activated, stimulating the muscles which causes cramps; can be caused by insufficient calcium and magnesium, which increase the activity of nerve tissue; sometimes indistinguishable from true cramps.
  3. Contractures – uncommon type; occur when the muscles are unable to relax; caused by a depletion of adenosine triphosphate (ATP), an energy chemical within the cell which prevents muscle fiber relaxation; some reasons contractures occur: disorders like McArdle’s disease which is a defect of the breakdown of glycogen to sugar within the muscle cell; conditions like hyperthyroid myopathy (a muscle disease associated with an overactive thyroid).
  4. Dystonic – fairly uncommon type; muscles not needed for a particular movement are stimulated to contract; usually affect small groups of muscles (eyelids, jaws, neck, larynx, etc.); repetitive activities can affect hands (writer’s cramp) and arms.

Most skeletal muscle cramps, like the one Nadal experienced, go away on their own within anywhere from a few seconds to a few minutes, but are they dangerous? While they are often severely painful, they are not fatal. A cramp can, however, signal another, more serious problems such as poor circulation, dehydration or malnutrition. The affected individual must usually cease activity and seek relief which can be dangerous depending on the circumstances (e.g. swimming, climbing, etc.). Soreness and swelling may accompany severe cramps and can persist up to several days after the cramp subsides.

Treatment for cramps depends on the type.

  • What type do you think Nadal had?
  • Did he receive adequate treatment and recovery time?
Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.


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