Mueller-Weiss syndrome, which has plagued Spanish tennis star Rafael Nadal for more than 15 years, is a rare condition that affects the bones of the foot and causes chronic, incurable pain.
This syndrome affects the navicular bone on the back of the foot, between the ankle and the cuneiform bones. “This bone is under great pressure, and for reasons we don’t know, it loses its blood vessels and is exposed to necrosis,” explains Dony Menard, President of the French Society of Foot Surgery and Head of the Department of Orthopedics at Nancy Hospital.
And he continues: “In the most serious cases and in cases that put great pressure on their feet, the bone will disintegrate, flatten and may crumble, and in the end it can develop into arthritis with a shortened arch of the foot.”
Müller-Weiss syndrome can affect one foot, but most often it affects both feet.
The syndrome consists of five stages: the first without symptoms and the last arthritis, and this disease usually affects women and people between the ages of 40 and 60 years.
Since the age of 18, tennis legend Rafael Nadal has suffered from necrosis of the scaphoid bone, also known as Müller-Weiss syndrome. A “chronic and incurable” degenerative disease, he said, and his greatest suffering was with his left foot.
The 22-time grand slam champion lived with his pain, often trying to avoid the topic in front of reporters. But in the Italian capital in May 2022, he touched on his exhausting daily life away from tennis: I play because this thing brings me happiness, but at some point the pain takes that happiness from you, not only in tennis, but in everyday life. My problem, for some time now, is that I live many days with aches. And the player, who was excluded from 12 major tournaments by injuries, the last of which was Roland Garros 2023, and withdrew during his participation in it five times, continued: “I love what I do, the competition gives me unforgettable moments, but also sad days.”
The causes of this disease are still unknown, and Professor Menard notes that “in the authors who first described it, Müller believed that its cause was related to trauma, while Weiss saw that it was more related to blood vessels. Nowadays, we consider more of the origins to be related to blood vessels.”
Some factors can increase the risk of its appearance (excess weight, flat feet, stress…).
This disease is often difficult to diagnose at first, because it develops silently in its early stages. Aches usually begin in the second stage.
In addition to comfort, orthotic insoles can reduce mechanical stress. To combat pain, analgesics and drainage complete the therapeutic scene.
For patients who are unable to bear the pain to the point of preventing them from walking, surgery may be prescribed. The surgery immobilizes the two joints attached to the navicular bone. “In cases where the scaphoid bone has disintegrated, a bone graft is also needed to restore the length of the inner arch of the foot,” explains Professor Menard, and concludes: It is difficult to exercise at a high level after this surgery.