Yesterday, Novak Djokovic sat in front of the reporters ahead of his China Open campaign and beamed a confident smile at them. He was not chasing a pipe dream, though. The Serbian was returning to Chinese soil after 11 years with an immaculate 29-0 record, chasing his first title of the season. But more importantly, it was his health.

Djokovic’s health has been a concern for some time now. But ahead of his opener on Wednesday, he felt good about where his body was, and his mind was already on winning. “That’s actually the primary motivation,” he said. Yet, in a 6-3, 7-6 (7-2) win over Portugal’s Nuno Borges, where he extended his unbeaten record in Beijing, the 39-year-old still gave us all a scare when he called for a medical timeout, before seemingly forgetting about it in the presser.

“In the second set he started playing better and I struggled a little bit physically to stay fresh,” he said in his postgame presser. “When I was serving, I was dominating and going through my games quite comfortably.

“It was helping getting those first serves in, that high percentage makes my life easier in my service games, and I played a great tiebreak to close it out in two, so I am very happy about that.” 

The Joker did get the last laugh over Borges, but it didn’t come easily. While trailing 3-2 in the second set, Djokovic appeared to feel a sharp stab between his back and ribs, prompting him to take a medical timeout. And the visual was enough to create panic.

During his changeover, he was sitting on the bench with a towel draped over his head. He was breathing heavily, visibly drained, as he reached for his water bottle. To make it more nerve-wracking, he held his head as if massaging it to get rid of the pain. Apart from this, as well, the physical side of the match clearly weighed heavily on him.

At one point, cameras caught the Serbian communicating with his box through gestures. It appeared that he was signaling to them that his energy levels were fluctuating throughout the match, and he just needed a little burst to get over the line. Despite the alarm it caused, the issue did not appear to actually slow him down once play resumed.

Djokovic held his final two service games of the set to love, playing some of his best tennis of the match immediately after the medical timeout, before racing through the tie-break, opening up a 4-0 lead and closing it out on his first match point when Borges found the net.

He will now face home favorite Bu Yunchaokete in the second round, who came through his own tricky three-setter, beating Juan Manuel Cerundolo 6-2, 5-7, 6-4. The path beyond that gets even harder, as the top seed Alexander Zverev will be waiting in the quarterfinals, and if he manages to surpass that test, he can face former world No. 1 Daniil Medvedev in the semifinals. However, he will have to find a solution for his ongoing physical limitations.

Djokovic revealed his health issue that continues to linger

The scare in Beijing is far from an isolated moment this season. At the Cincinnati Open in August, Djokovic faced an exit in the second round against Thiago Austin Tirante. He was visibly struggling in the heat and humidity and even vomiting into his towel, dropping to his knees. He called for a medical timeout while leading the second set, but he eventually collapsed before explaining what was bothering him.

“It’s just a condition that I have, health-wise, that has been bothering me for the past couple of years,” Djokovic said then. “A lot of issues, especially when it is humid and it is hot. I did anticipate it (would be humid), but there are all these things, like nerves and everything involved that make it worse, and that’s what happened.”

A few weeks later at the US Open, he faced similar physical issues. Djokovic battled through a five-set match against Mariano Navone while visibly ill, cramping and vomiting — all the symptoms he faced in Cincinnati, only more alarming. 

“Unfortunately, it’s something I’ve been dealing with in pretty much every match this year,” he admitted afterward. “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.” 

With his perfect 30-0 record on line against a stacked draw, the question that’s hanging is not about the draw but whether his body can sustain the test that lies ahead of him.