A wrist injury is pretty much a tennis player’s worst nightmare, and Carlos Alcaraz has been stuck in that nightmare for over four months. After missing two Grand Slams, the Spaniard has now pulled out of Cincinnati to give his wrist more time to recover. But his decision to prioritize recovery has now opened a rather unexpected debate, with the Italian Federation’s chief doctor questioning Alcaraz’s mental stability.

Dr. Gianni Daniele, president of the Italian Tennis Federation’s medical commission, made the remarks in an interview with La Repubblica while comparing the Cincinnati withdrawals of both Carlos Alcaraz and Jannik Sinner. But when discussing Alcaraz, Daniele went beyond the Spaniard’s wrist issue.

“From Spain, it hasn’t been known with certainty what type of wrist injury Carlos had. Now he would be going through a kind of mental weakness. Having difficulties recovering the previous work intensity, a kind of depression would have been created in his head, a vicious circle that doesn’t allow him to have the confidence he had before.” he stated.

However, it is important to understand that Alcaraz’s wrist problem isn’t exactly something he can simply tape up and forget about. The Spaniard has been dealing with tenosynovitis, an inflammation of the sheath around the wrist tendons that can make everyday racket movements painful. All that gripping, swinging and repeated wrist action can keep the inflammation around for much longer than anyone would like.

For a mild case, rest can sometimes do the trick over a few weeks. But when the problem refuses to cooperate, players can be looking at months of physiotherapy and, in more serious cases, even surgery. Alcaraz hasn’t needed surgery, but his latest withdrawal means his time away from competitive tennis will stretch beyond four months.

Nevertheless, overlooking the potential consequences of playing through such an injury, Dr. Daniele added, “Doubts would start to take hold of his mind, and it’s a shame, because even for the number one, it means not finding a rival of such an extraordinary caliber.” Still, there’s a pretty important physical factor in all this.

Trying to play through an irritated wrist isn’t exactly the best bargain. It can aggravate the inflammation and push the comeback even further away. And tennis has seen just how costly that gamble can be before, with Dominic Thiem serving as a stark example.

The former US Open champion injured his wrist during a match against Adrian Mannarino in 2021, and the issue eventually ended his career prematurely. Notably, Dr. Melissa Leber, the US Open’s director of player medical services, has also highlighted why rest matters with wrist injuries, noting that immobilization gives the inflamed tendons and surrounding structures a chance to settle down.

So, Alcaraz’s decision to skip Cincinnati could simply be the Spaniard choosing to give that stubborn wrist some extra breathing room before heading to Queens to defend his US Open crown. However, that stands in contrast to how Dr. Daniele viewed Sinner’s situation, with the Italian taking time away from the tour to recover from his own knee discomfort.

He said Sinner made a sound and logical call to pull back from Cincinnati ahead of the US Open, attributing his knee issue simply to the transition from post-Wimbledon rest into an intense training block. But there was no physical explanation offered for Alcaraz’s absence. Instead, it was framed around an unconfirmed psychological issue, rather than as an injury he was simply working his way back from.

Both Sinner and Alcaraz were on the Cincinnati entry list before dropping out one by one: Alcaraz first and Sinner later, so the tournament will go without the two finalists of the previous year. Neither has pulled out of the US Open, but both have their own reasons to doubt their readiness. 

Sinner is coming into the tournament with his Wimbledon title, whilst Alcaraz has not played competitive tennis since April. There are reports out of Spain suggesting his team may even consider a wildcard into the smaller Winston-Salem Open the week before New York simply to get match rhythm.

However, there has been no statement by Alcaraz or his team that he is suffering from depression or any other mental-health issue, and the comments are speculation by a federation official, not confirmed information from Alcaraz’s team.

But this isn’t the first time Italian Tennis Federation officials have made unverified claims about Alcaraz. Similar remarks have surfaced before, putting the Spaniard under an unexpected spotlight off the court.

A pattern of provocative comments from Italian officials toward Alcaraz

This isn’t the first time the Italian federation has faced criticism following remarks made by one of their higher-ups towards Alcaraz. Federation president Angelo Binaghi previously criticized the Spaniard over his decision to purchase a yacht.

“Unlike Alcaraz, Jannik would never buy a six-million-euro yacht. I am convinced of that, and I doubt anyone can prove me wrong,” Binaghi stated.

His remarks were widely condemned at the time as an inappropriate intrusion into a player’s personal life.

Taken together with Daniele’s latest comments, the pattern has fuelled accusations from fans and commentators that figures within the Italian federation have repeatedly overstepped in their public remarks about Sinner’s rival.

The real and verifiable facts of Alcaraz’s situation are a lot less complicated than Daniele’s statement implies. His recovery reports have suggested that he recently passed a medical exam and that doctors had declared him fit to return to play, and his team has said he is likely to play at the US Open.

Other Italian tennis commentators have also voiced doubts over the length of time the injury has been sustained, with former player Corrado Barazzutti previously confessing that it was “hard to understand” with little concrete information having been circulating regarding the initial diagnosis. 

Amid all the different analyses surrounding Alcaraz’s recovery, Dr. Daniele’s remarks have added another chapter to what has become an increasingly tense relationship between the Spaniard and voices within Italian tennis’s governing body.