Novak Djokovic sounded confident about his US Open chances during his pre-tournament press conference, brushing aside the significance of his early exit in Cincinnati.

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But that defeat may have been more telling than the Serb initially thought. On opening day at Flushing Meadows, Djokovic was in for another difficult night, one that eventually ended in tears.

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Novak Djokovic leaves US Open in tears

The night quickly became a physical and emotional battle for Djokovic. The 24-time Grand Slam champion looked increasingly uncomfortable as the humid New York conditions took their toll, even being forced to vomit into a towel bin during the match. By the deciding set, the frustration and exhaustion were written all over him.

When Djokovic won the fourth game, the crowd rose. But instead of celebrating, he was in tears. In an even more poignant moment, Djokovic’s wife appeared to leave the box, while two of his children, Tara and Stefan, watched on with visibly forlorn expressions.

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Jelena returned to the stands as Djokovic slipped to a 6-1 loss in the fifth set, finishing his chances of winning a 25th Major before it even started.

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After the match, Djokovic acknowledged just how difficult the night had been for him, while still making sure to give Mariano Navone credit for the victory. He admitted that it had been a miserable experience on court but refused to take anything away from the Argentine’s achievement.

“I think it was obvious that it was an awful feeling on the court for me,” Djokovic said. “I don’t want to take too much out of Mariano’s win. Congrats to him. He’s a nice guy and a fighter. But I didn’t enjoy myself.”

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Djokovic eventually managed a smile as he congratulated the 25-year-old, who had just secured one of the biggest wins of his career. But once the handshake was over, the weight of the defeat appeared to catch up with the Serbian again. As he made his way toward the locker room, Djokovic looked visibly distraught and appeared close to tears.

His longest first-round match at a Slam ended in a first-round exit: his first since the 2006 Australian Open.

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Novak Djokovic loses the first set despite getting a lead

A first-round fixture against Mariano Navone was nothing to sweat over for someone like Djokovic, but the Argentine proved that notion wrong. It was the Serb who started the match strong, taking a 3-0 lead, only for Navone to fight back and force a tiebreak in the first set. The 25-year-old kept his cool and got the job done under pressure, winning 7-5 in the tiebreak.

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A long, grueling rally appeared to trigger Djokovic’s physical struggles, leaving the former World No. 1 visibly drained and unable to recover quickly. His serve and groundstrokes began to lose their usual pace, and after the ninth game, he called for the doctor and asked for medication to ease his discomfort.

The Serbian continued to look increasingly uncomfortable as the set headed into a tie-break, repeatedly lowering his head and doubling over between points. Navone, meanwhile, stayed composed and kept pressing, eventually taking the opening set after 73 minutes.

Novak Djokovic wins a long rally and wins the second and third sets

The second set was a close affair as well, with the Serb finding it too difficult to crack his opponent’s serve, but he found the opening in the twelfth game, winning the second set 7-5.

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Once again, one break of serve proved enough in the third set once again, with the Serb winning it 6-4. The second set had a rally that was a 25-plus shot barrage of baseline strokes, which the Serb won with a signature backhand winner.

However, the match was full of long rallies and long service holds on both sides of the net. Navone, who has impressive clay-court skills, brought the same to the hard courts at Arthur Ashe with great effectiveness, keeping play behind the baseline and making Djokovic move sideways.

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Novak Djokovic struggles physically

By the end of the third set, the match had gone well over three hours, with Nole visibly hunching over after every point and even vomiting on the court during the third set. He was also spotted using an inhaler and taking tablets during the fourth set.

However, when the Serb got a break to have a 2-1 lead in the fourth set, it looked like the match was nearing its conclusion. That was not to be, as the physical struggles increased for the Serb. He lost all power on his serve, and his court coverage went down dramatically. Navone won four consecutive games to win the set 6-2.

The scenes were all too similar to those of Djokovic’s Cincinnati loss against Thiago Agustin Tirante, where the Serb had a bout of vomiting in his match and admitted to suffering from a physical condition in the heat.

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His match on Arthur Ashe was under the roof, but conditions in New York were muggy and humid, which took its toll on the Serb.

Novak Djokovic takes a medical timeout in the fifth set

With the match going past four hours and into a fifth set, the Serb called for a physio on court, who gave him a rubdown to his lower back for three minutes during the designated medical timeout. The crowd encouraged the Serb for a miracle, but the night was a nightmare.

After the match, Djokovic shed some light on what had gone wrong, revealing that a recurring health condition had once again surfaced in New York’s punishing conditions. The Serbian admitted that the problem has troubled him for years and described it as a serious issue when speaking to reporters after the defeat.

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“It’s something that I have been carrying pretty much every match this year – vomiting, throwing up,” the 39-year-old said.

He explained that the physical problems don’t stop there, with the vomiting eventually followed by cramps and widespread pain that made it increasingly difficult to keep competing at his usual level.

“And then my whole body starts to collapse basically, cramping and pain. The back just gave up in the end, and my shoulder, and I couldn’t close it out.”

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