The US Open has begun under a growing cloud of injuries, with several of tennis’ biggest names missing major tournaments in 2026 and concerns mounting over the physical demands of the modern game.
Carlos Alcaraz and Jannik Sinner were expected to continue their Grand Slam rivalry after splitting the major titles last year. Instead, injuries have prevented a potential showdown at three of the four Grand Slams.
Alcaraz missed the French Open and Wimbledon because of a wrist injury, while Sinner is absent from this year’s US Open with a knee problem.
They are not alone.
Italy’s Lorenzo Musetti and France’s Arthur Fils missed earlier Grand Slams because of injury but have returned in New York. Women’s world number two Elena Rybakina is also managing a heel problem at the US Open, while Canada’s Victoria Mboko and Britain’s Jack Draper have missed the tournament because of injuries.
The growing list has renewed questions about whether the modern tennis calendar is placing excessive physical demands on elite players.
Bigger, faster and stronger
Tennis has become increasingly physical, with players bigger, faster and more powerful than previous generations.
Advances in racket technology have also allowed players to generate extreme levels of topspin and power, intensifying the strain placed on their bodies.
“We’re losing the battle overall despite the advances in sports medicine,” said Neeru Jayanthi, who leads the tennis medicine programme at Emory Healthcare in Atlanta.
Fitness expert Mackie Shilstone, who worked with Serena Williams for 14 years, said the modern game’s intensity was a major factor.
“The game has gotten more intense because the players have gotten bigger, faster, and stronger,” Shilstone said.
The increased pace places greater stress on players when they accelerate, stop and change direction. Extreme weather conditions can add another layer of physical strain.
The demanding international calendar is another concern.
Professional tennis is played for almost 11 months of the year, with the four Grand Slams supplemented by mandatory high-level tournaments and extensive global travel.
“You can’t go 11 months straight and travel all over the world,” Shilstone said. “There has to be planned recovery built in.”
Players increasingly choosing recovery
Doctors say the rise in injuries is not necessarily being met by players simply pushing through pain.
New York hand and wrist surgeon Remy Rabinovich said the increasing number of wrist injuries could be linked to the extreme topspin now common in modern tennis.
However, he sees a positive development in players becoming more willing to take time away from competition.
“There is a big element of preventative medicine and more strategic ways of playing in the hopes of having a longer career,” Rabinovich said.
Alcaraz also explained his decision to take time away from competition, saying he wanted to protect his body and “hopefully have a really long career”.
At 39, Novak Djokovic remains in contention at the US Open despite having dealt with injuries during the later stages of his career.
A problem that goes beyond the current generation
Injuries have always been part of professional tennis.
Rafael Nadal endured lengthy periods on the sidelines during his career, while Andy Murray’s career was significantly affected by hip problems after his breakthrough successes in 2016.
Roger Federer, who largely avoided serious injuries during much of his career, eventually retired in 2022 after persistent knee problems.
Federer has also questioned the physical and mental demands created by changes to the tournament calendar.
Since his retirement, several 1,000-level tournaments have expanded into two-week events featuring 96-player draws.
Federer acknowledged that players are still adjusting to the demands of the expanded format and said avoiding overplaying was “easier said than done”.
Research has also pointed to an increase in match retirements over the decades, although the available data on injuries in elite tennis remains limited.
The issue is now expected to receive greater attention through a new Grand Slam Player Advisory Council, whose mandate includes player welfare.
Could the solution start with younger players?
While reducing the demands of the professional calendar remains one of the most discussed solutions, Jayanthi believes the problem could begin much earlier.
He argues that serious injuries can be the result of cumulative wear and tear from years of intensive training and competition during junior careers.
“Perhaps we should revisit the way we decide to train our younger players to position them for long-term success,” he said.
The debate comes at a US Open where several leading names are already missing, providing another reminder that tennis’ pursuit of greater speed, power and entertainment comes with a significant physical cost.
Venus Williams exits after late-night battle
The injury concerns have been accompanied by another major storyline in New York, where Venus Williams’ singles campaign came to an end in the first round.
The 46-year-old American, who received a wild card almost three decades after reaching the US Open final as a teenager in 1997, lost 6-2, 7-6 (8/6) to compatriot Sofia Kenin.
Williams left the Arthur Ashe Stadium court with her head held high after a spirited performance that ended shortly after 2am local time.
Kenin appeared in control after winning the opening set and moving 4-2 ahead in the second.
She then earned a break point for a potential 5-2 advantage, but Williams launched a remarkable fightback and forced a tie-break.
The veteran surged into a 6-2 lead in the breaker, raising hopes of an extraordinary comeback. Kenin, however, held her nerve and won six consecutive points to secure the victory.
The match began shortly after midnight following Novak Djokovic’s marathon five-set defeat earlier in the night session.
Williams has not indicated when she intends to retire from singles tennis. Her last Grand Slam singles victory came at Wimbledon in 2021, and she has since made six Grand Slam singles appearances, losing in the opening round each time.
Her US Open campaign will continue in doubles, where she is scheduled to team up with her sister, Serena Williams.