Do hard courts shorten tennis players’ careers?

Rafael Nadal of Spain celebrates winning his quarter final match against compatriot Nicolas Almagro at the French Open tennis tournament in Roland Garros stadium in Paris, Wednesday June 6, 2012. Nadal won in three sets 7-6, 6-2, 6-3. (AP Photo/Bernat Armangue)

Andy Murray won his first Grand Slam tournament Monday night on the hard courts in Flushing Meadows. As were most fans, I was happy Murray finally ascended to the top of his sport. I couldn’t help wondering, though, if a healthy Rafael Nadal would have stopped him.

Long hampered by a chronic patellar tendon injury, Nadal elected to skip the two grueling weeks on the Arthur Ashe Stadium hard courts and try to rehab his ailing knee.

It led me to ponder a bigger question, though. Do those hard courts shorten the careers of professional players like Nadal?

At only 26, Nadal has won 11 Grand Slam titles and the 2008 Olympic gold medal. But his lingering patellar tendon problems have proven to be a formidable opponent.

After missing the London Olympics, Nadal withdrew from this year’s U.S. Open. In a statement, he acknowledged having a “partial tear of the patella tendon at the distal pole of the patella plus an inflammation of the Hoffa’s fat pad of his left knee.”

Unfortunately for Nadal, there are no easy treatments for his injury. Rest, rehab to strengthen the knee, and occasionally braces or taping make up the main treatment options. Unproven injections can be attempted if pain persists. No reliable surgical options exist.

Nadal’s withdrawal has renewed speculation that his best years might already be behind him. Many tennis observers have urged the Spaniard to play a more judicious schedule to preserve his health for the Grand Slams.

Would a reduced schedule help him win the U.S. Open again? In an article for the New York Daily News, Filip Bondy argued that Nadal would never win another major title on a hard court, because the surface is too unforgiving for his knees.

I disagree that Nadal couldn’t battle through two weeks of matches on the Deco Turf at the U.S. Open. But Bondy’s argument that the hard courts could be shortening his career and the careers of other pros might have some merit.

Some players acknowledge the toll hard courts take on players. Lindsay Davenport pointed out to Bondy, “I think the days of players lasting as long as Jimmy (Connors) did are over, just because there’s more tennis on hard courts.” Brad Gilbert stated even more bluntly, “Put it this way. How many sports do you know that they play on cement?”

Little data exists to prove that the court surface by itself leads to more injuries. Too many other variables — such as the number of tournaments played, the different numbers of matches played, and different styles of play — make definitive conclusions difficult.

Theoretically the argument makes sense. Running all over the court for hours every day for many months of the year causes a tremendous amount of repetitive stress on the knees, ankles and feet. With the tennis season now running almost all year long, these players’ bodies can break down.

I would never argue that the hard court surfaces necessarily cause injuries. For players with overuse injuries of their lower bodies, they probably don’t make the tournaments easier either. I do wonder if we will see players like Nadal play fewer hard court tournaments later in their careers.

On another tennis note, this weekend the World Team Tennis Finals return to Charleston. It is one of my favorite events that I have worked as a physician. This year, some of the best players of the last 20 years — John McEnroe, Martina Hingis, and Venus Williams — are scheduled to play. If you like exciting tennis, music and fun, this shapes up to be a great weekend at the Family Circle Tennis Center Stadium.

Dr. David Geier is an orthopaedic surgeon and Director of MUSC Sports Medicine. For more information about tennis injuries and other sports medicine topics, go to his blog at