In tennis, pain just part of the game

AP Photo/Mark Baker

Serbia's Jelena Jankovic knows pain. She retired from a fourth-round match at Wimbledon in 2010 because of a back injury.

NEW YORK -- Jelena Jankovic had just finished talking about competitive advantage, running a player with a bad leg, for example, or hitting more to the forehand of an opponent with the knowledge that it aggravates her injured wrist.

"That's why it's not a good idea to advertise your injuries," said the former world No. 1, who is the No. 9 seed at the US Open. "If you have a pain, I don't know where, it's not going to do you any good if you go around and talk to everyone."

And with that, she walked away. Or, rather, limped. Badly.

"Look, now I can't walk," she said, turning back, "and I guess I can't hide it."

All around the players lounge on a rainy day this week, there was more limping than lounging, more ice wrapped around knees than floating in drinks.

With a little imagination, it could have been any NFL training facility.

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Sania Mirza of India said she can't remember a time in the past 10 years when she didn't wake up with pain.

"I think tennis is one of the most physically demanding sports in the world," said Sania Mirza, currently in the women's doubles quarterfinals with partner Jie Zheng. "I don't remember one time in the last 10 years waking up without feeling anything."

"If you don't have pains," Jankovic said, "it's weird. If you wake up in the morning and you don't have pain anymore, you haven't done a good job."

Tennis players don't deal with concussions like athletes in contact sports. They don't have gruesome bruises from being tackled and missing toenails from being stepped on. But those other sports don't have 11-month seasons. Nor do their athletes lose money if they miss a game because of injury.

"This is our job, we're independent contractors and we have a job to do, so you just go for it whether you're hurting or not," said American Liezel Huber, who's in the mixed doubles quarterfinals with partner Marcelo Melo.

"There are no substitutes in tennis," Jankovic said. "You're there and you can't say, 'I don't feel good today, I'm tired or I have an injury. Let's postpone the match until the next day.' Or someone else can go and play instead of you, like in team sports where you have teammates in better form to play for you instead. When it comes to us, if you don't feel good, too bad, that's the way it is."

One thing all athletes, especially the younger ones, do seem to have in common, however, is a sense of invulnerability, that playing through pain and sometimes against doctors' advice is often necessary, regardless of future harm.

Although playing through pain will not cause long-term brain trauma in tennis players, it might affect their ability to play golf or, yes, tennis, run around with their children or just enjoy a pain-free life when they're retired.

"I've had numerous surgeries, and we do get beat up and we're all candidates for knee replacements and hip replacements one day," Huber said with a laugh. "But we don't think like that.

"We just do our job. This is what you've grown up to do, and this is what you're going to do. You're going to play injured. In the US Open? Are you kidding? You're going to play injured. You want that title like your opponent. You want that check. You want those points.

"Also, we're in the entertainment industry, so you want to do it, not just for yourself but for the fans."

Mirza agreed.

"The most we think about is how are we going to recover for tomorrow's match," she said. "That's as far as we can look. We can't even look at what tournament we're going to play next week.

"I have had three surgeries myself, so I know how important it is to be as healthy as possible, realizing you can't be fully healthy ever. So you just have to manage those smaller injuries and not let them become bigger, kind of live in the moment. If you worry about what's going to happen 10 years from now, it's going to be tough."

Preventive measures

Trying to guard against too much of that mindset is the Women's Tennis Association, which employs doctors and trainers to educate players as much as treat them.

"The more knowledge you can give to the athlete and the trainer, the better the athlete can make an informed decision," said Dr. Alexis Colvin, chief medical officer for the USTA. "The important thing is trying to preserve the longevity of their careers. The other thing is when there's an injury, planning for recovery. Especially in an elite player, saying you have to stop playing for five months may not be the best plan or the most realistic.

AP Photo/Charles Krupa

Martina Hingis came out of retirement to play doubles at the US Open, and admitted her body wasn't used to playing competitive tennis again.

"It's person by person. 'If I go out and play this match, is it OK to play through pain, or are there going to be long-term consequences?'"

Carole Doherty, a physical therapist and primary health care provider for the WTA, points to proactive steps the tour has taken to prolong players' careers, including the age-eligibility rule, adopted in 1995, which limits the number of tournaments 14- through 17-year-olds can play. It also provides programs to help athletes cope with the stress of the game.

An independent panel commissioned by the WTA found that since the institution of the age-eligibility rule, the median career length for WTA players has increased 24 percent -- from 12.4 years to 15.4 years. This compares favorably with 3.5 years for NFL players and 4.8 years for NBA players -- though those numbers tend to fluctuate, depending on whether they come from the leagues or the players' unions.

The WTA also has an online module, Doherty said, in which players can program in their schedules and be told if they need a break.

"Obviously, there are going to be times when it's going to be a very hard decision for players [whether to compete with an injury or not], but all we can do is give them the facts," Doherty said.

"At the end of the day, it is their decision."

Body language

Former world No. 1 and five-time Grand Slam champion Martina Hingis, 32, who is making a comeback this summer and played doubles at the US Open (she and partner Daniela Hantuchova lost their first-round match), knows firsthand the toll tennis takes on a body.

"My body is screaming, 'What are you doing to me?'" Hingis said.

And what was her body telling her on two double faults, in particular?

"My calf was killing me. I couldn't get up on my serve anymore," she said. "Not playing at a Grand Slam for six years doesn't really help, either."

Although Hingis attributed the source of her pain more to nonuse than residual injuries, Jankovic, 30, said she is trying to be smarter now as she gets older.

"Now I try to be more careful, but when I was younger I was a little bit hard-headed and was like, 'OK, I have an injury, but I still want to go on court, I still want to play,'" Jankovic said. "Then when you make your injury worse, you really regret it and wish you didn't do it. I think you learn until you die. It's always a new learning experience. If you're smart, you have to try not to make the same mistake again."

Although players have no problems discussing attempts to exploit their opponents' weaknesses due to injury while trying to hide their own maladies, they are not so eager to talk about the psychological element of faking or exaggerating injuries.

Mind games

When then-top-ranked Victoria Azarenka was granted a medical timeout in her semifinal match against Sloane Stephens at the Australian Open, fans and journalists alike were skeptical at best, accusing Azarenka of faking an injury to collect herself and calm her nerves after failing to convert on five match points.

After a 10-minute break, Azarenka's serve was broken, but she closed out a 6-1, 6-4 victory and has been hearing about it ever since. Afterward, Stephens told The New York Times the practice of calling for injury timeouts is "trendy" and "the 'in' thing." ESPN analyst Patrick McEnroe tweeted at the time that Azarenka's timeout was "an absolute travesty."

AP Photo/Andrew Brownbill

Many were skeptical when Victoria Azarenka, the eventual champion, took a 10-minute injury timeout during her Australian Open semifinal against Sloane Stephens.

ESPN analyst Pam Shriver, who interviewed Azarenka after the match, told the Times, "... We've seen the rule abused for years. I abused the rule when I played."

When dressing before a tennis match, where opponents share the same locker room, visiting the trainer can become a covert operation, with players trying valiantly not to reveal specific injuries.

"Sometimes you'll see somebody is in there every day, but we're all in the same boat, and the main thing is not to have it go outside of the locker room because there's online betting and all that," Huber said. "Or if you wake up with a sore throat, don't put it on social media. …

"[But] the more you play, the more you start noticing little things on the other side," Huber said. "You can see if somebody is moving their neck, and you'll take advantage of it. One day we were playing a match, and I said to my partner, '[the opponent's] wrist is hurting,' and she said, 'Yeah, let's hit her.' I mean, not literally, but let's go at her. It's cutthroat, it's what we do, and you try to take advantage of it because another time, somebody will take advantage of it if you're injured."

But more often than not, Huber said, players ignore their discomfort on court.

"Yes, you have all your precautions and we have the staff that either tapes you or you've taken some Advil, Tylenol, anti-flam [nonsteroidal anti-inflammatories]," she said. "We do play in pain, but it's different than what these big guys go through. We have little muscles or little tears or little strains, but sometimes we can get pulled together with tape."

And sometimes, they agree, one thing simply takes precedence over all.

"The fact is that you want to win," Mirza said. "That's of primary importance, and hence you see us go out there and play while we're injured because playing and competing is so important to us.

"But as a professional athlete, it's impossible to go in and say, 'I don't feel anything on any part of my body.' Yes, of course it's hard, but you have to know in the back of your mind that you have to do that to be a top-level, professional tennis player."

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