The 38-year-old Majorcan has suffered from osteonecrosis of the navicular bone, also called Müller-Weiss syndrome, since he came of age. A degenerative, chronic and incurable disease, often accompanied by chronic pain.
This syndrome affects the navicular bone, located on the dorsum of the foot, between the talus and the cuneiform bones.
“This bone is subjected to significant stress and, for reasons that are unknown, loses its vascularization and becomes necrotic”Professor Didier Mainard, at the time president of the French Foot Surgery Association and head of the orthopedic surgery department at Nancy hospital, explained to AFP in 2022.
In the most serious cases and “In subjects who put a lot of strain on their feet, the bone will disintegrate, flatten, it can fragment and, ultimately, this can develop into osteoarthritis with a shortening of the plantar arch”he elaborated.
Causes discussed
Only the tennis player’s left foot is affected by this pathology, which most often affects both feet. This pathology affects women more often, and people between 40 and 60 years old.
Müller-Weiss syndrome has five stages: the first is without symptoms, the last is osteoarthritis.
The causes of this disease remain unknown. “In the two authors who initially described it, Müller thought it was more traumatic in origin, Weiss more vascular. For the moment, we consider that the origin is rather vascular”noted Didier Mainard.
Certain factors can increase its risk of occurrence (overweight, flat feet, stress fracture, etc.).
This disease is often difficult to diagnose initially because it develops silently in the early stages. The pain generally appears later.
In addition to rest, orthopedic insoles can reduce mechanical stress. Faced with pain, anti-inflammatory treatments and infiltrations complete the therapeutic range.
Surgery may be considered
“I live with a ton of anti-inflammatories every day to give me a chance to train (…) If I don’t take them, I limp”Rafael Nadal confided in 2022. And “my problem, for some time now, is that there are many days when I live with too much pain”.
For patients whose pain is no longer relieved and who can no longer walk, surgery may be prescribed. This blocks the two joints involving the navicular bone.
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“In cases where the navicular bone has disintegrated, a bone graft is also required to restore the length of the internal arch of the foot”according to Didier Mainard who specified that “playing sport at a high level after such an operation seems difficult”.
With AFP
