Rafael Nadal, who has won 21 Grand Slam tennis titles, lost his first match after winning 20 consecutively in the BNP Paribas Open in Indian Wells, California. Taylor Fritz, 24-year-old California native, upset Nadal in straight sets in the men’s finals. Fritz was the first American to win this tournament since Andre Agassi in 2001. Fritz entered the match nursing severe ankle pain, but was able to get through it and win in straight sets, the second set in a tie breaker. Nadal, on the other hand, had been having chest and rib pain, to the point of this needle-like agony making it severely painful for him to take a deep breath. It turns out he has a stress fracture of the ribs, which is a rare yet extremely painful overuse injury. As the rib cage expands during breathing, and is impacted with upper body twists and turns, the pain is exacerbated by exertion and deep breaths. Treatment is rest.

While not complete fractures in the traditional sense, stress fractures, more commonly seen in extremities due to overuse, are exquisitely painful, and often require interventions such as anti-inflammatory medications, non-weight-bearing if involving the legs, and splinting if in the arms or hands. Stress fractures of the ribs are most commonly seen in athletes such as crew team rowers, baseball players, and yes, tennis players, due to continuous strain and impact on the muscles and ligaments along the bones of the rib cage. Most of these injuries require four to six weeks of rest to heal. Rib fractures are not always easily seen on plain chest radiographs, and may be better evaluated with bone scans or magnetic resonance imaging, depending on the extent of the injury.

The anti-vaccine crowd jumped on Nadal’s complaint of pain during breathing, concluding that he was likely suffering from a Covid-19 vaccine-related lung condition. Nadal, among other athletes, has been vocal about the importance of protecting oneself and others by getting vaccinated, as well as the importance of sticking to the rules of each country as well as to those of the Association of Tennis Professionials (ATP) for each individual tournament. Several folks took to Twitter as soon as it was evident that Nadal was having breathing issues (now known due to a stress fracture, not a lung issue), as it being linked to his Covid-19 vaccine.

In January 2022, tennis player and Grand Slam rival Novak Djokovic was not allowed to compete against Nadal and other rivals in the Australian Open because Djokovic chose not to be vaccinated against Covid-19. In comments, Nadal intimated that, although it was Djokovic’s choice, it was not a wise one. Nadal was quoted as saying: "The only for me clear thing is if you are vaccinated, you can play in the Australian Open and everywhere, and the world in my opinion have been suffering enough to not follow the rules...he made his own decisions, and everybody is free to take their own decisions, but then there are some consequences," he said of Djokovic. Nadal’s strong sentiments on the importance of getting vaccinated were shared by other players including Andy Murray and Stefanos Tsitsipas.

Covid-19 infections often affect the lungs, resulting in the death of over 6.1 million people to date worldwide. Nearly one sixth of those deaths have been in the U.S., which accounts for only one twenty-fifth of the world’s population. There have been several reported cases of Covid-19 vaccine-related lung issues, specifically in an 86-year-old man who presented with breathing issues several days after receiving a Covid-19 vaccine. He recovered with medical treatments a few days later. This event is extraordinarily rare, treatable, reversible, and has been experienced as a rare event following various medications, including medications for heart disease and joint problems.

But a vaccinated professional athlete who sustains an overuse injury better known as a rib stress fracture? That’s a lot of pain. But it’s not from the Covid-19 vaccine. The vaccine won’t even cause tennis elbow, let alone a stress fracture.

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