Tired, tearful and visibly ill: What’s bothering Novak Djokovic?
Even for an athlete of near superhuman ability, gradually diminishing reserves in aerobic capacity, coordination and joint health can take an enormous physical and psychological toll, a physician says.
Novak Djokovic is out of the U.S. Open at the first hurdle.
The last time the 39-year-old Serb, who has 24 Grand Slam titles to his name, lost in the first round of a major was the 2006 Australian Open.
A tired, tearful and visibly ill Djokovic — who reached the semifinals at Wimbledon and the final at the Australian Open this year — battled the unseeded Argentine Mariano Navone for five sets over the course of four hours and thirty-six minutes over the weekend.
Navone, 25, secured the opening set after a grueling 73 minutes before Djokovic mounted a comeback, winning the second and third sets in typically competitive fashion.
It was in the latter stages of the match that Djokovic began to falter. Visibly struggling, he appeared to be dealing with cramps about midway through the fourth stanza, grimacing after points and at one point vomiting off court. Weeks earlier
For a player known for his prodigious consistency and court coverage, who’s contested some of the longest grand matches in the Open Era of modern tennis — prevailing in a great many of them — Djokovic’s shock first round exit is all the more startling given age-defying performances in recent years against the sport’s ascendant young stars, tennis experts say. Some observers noted that Sunday’s opener was exactly the kind of grinding match Djokovic has always found a way to win.
But there’ve been sure signs of deterioration, including knee surgery midway through the 2024 season.
Tennis commentators and fans have marveled at his ability to remain competitive with the likes of Spain’s Carlos Alcaraz, 23, and Italy’s Jannik Sinner, 25, which they attribute to the Serb’s meticulous focus on his health, diet and fitness. At the same time, Djokovic has significantly reduced the number of tournaments he plays to preserve his body in what he has admitted is a quest for a 25th Grand Slam title.
Dr. Gian Corrado, head team physician for Northeastern University athletics, who frequently tends to athletes sidelined during play, said there’s an array of conditions and complaints common among older athletes. Based on what is publicly known about Djokovic, the range of possibilities is no less expansive, he said.
But some common culprits among more mature athletes like Djokovic, Corrado said, might include gastritis, an inflammatory condition that can flare up during intense exercise; heat intolerance, an impaired ability to tolerate high temperatures, paired with dehydration; or a cramping condition that he may be developing over time.
“Cramping in sport is an interesting issue that we don’t fully understand,” Corrado told Northeastern Global News.
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“Some people think it’s [muscle cramping] neurologically mediated,” he said, meaning it may be caused in part by problems in the nervous system, which controls muscle contraction.
It could also be some combination of problems — or all of the above. Corrado noted that male athletes tend to reach their physical peak around age 30. Aerobic capacity, coordination and joint health typically begin to deteriorate after that point. Even for an athlete of near superhuman ability, gradually diminishing reserves in those areas can take an enormous physical and psychological toll, Corrado said.
In addition to the physical deterioration, Corrado explained that VO₂ max, or the maximum amount of oxygen the body can use during intense exercise, declines with age, as does hand-eye coordination, the ability to translate what you see into precise physical movement.
“Unfortunately, it’s something I’ve been dealing with in pretty much every match this year,” Djokovic said in a press conference following Sunday’s defeat. “Nausea, vomiting, serious issues. And then my whole body basically starts breaking down, cramps, pain. My back simply gave out in the end, as did my shoulder and knee.”
Former Canadian-British tennis player Greg Rusedski suggested that the issue could be conditioning, or endurance, noting that the Serb’s ground strokes, movement and tactics remain as sharp as ever. Watching Djokovic struggle through the match, ESPN commentator Mary Carillo said he looked “punch drunk,” underscoring just how physically compromised he appeared.
“One of the things that we look for are patterns over time,” Corrado said. “It certainly doesn’t look like this is acute illness because we’ve seen it over and over again now.”
Is it time for Djokovic to hang up his racquet?
In an era of remarkable longevity in fitness and performance, with many athletes competing well into their 30s and 40s, there are ways to keep Father Time at bay, Corrado said, adding that there are “good data” on cold plunges and sauna use, among other things, for recovery.
“But at the same time, you’re working an uphill battle the whole time,” he said. “Your joints are getting older, you have limited cartilage, and these guys beat up on every joint in their body. There’s nothing you can do to put back cartilage when it’s gone.”
