Tennis does not care how talented you are if your body cannot survive the grind. One bad landing, one awkward slide, one overloaded joint, and suddenly a season can tilt. Zverev, Alcaraz, and Sinner have all paid that price in different ways. Wimbledon made it impossible to ignore, from Sinner crashing to the grass in the first round to Zverev losing momentum after a nasty slip in the final. Sinner’s summer only drove the point home, with a right-knee issue forcing him to manage his workload, skip the Canadian Open again and eventually withdraw from Cincinnati.

Sinner is not easing into the US Open; he is trying to drag a compromised knee there. According to Richard Crivelli of La Gazzetta dello Sport, he underwent shockwave therapy at JMedical in Turin to calm the inflamed area before turning his full attention to New York. Sinner’s knee clearly needed more than rest, and now recovery, not match play, is his only route to New York.

“After consulting with my doctors and my team, I have to announce that I need to withdraw from the Masters 1000 tournament in Cincinnati. My right knee has been bothering me and even though we have been working hard with my medical team, I have to accept that I’m not ready to compete yet. I can’t wait to be back next year and I’m now focusing on getting ready for the US Open,” Sinner said.

According to Crivelli’s report, Sinner and his team chose not to rush his return. With therapy completed, the plan is now firmly set: a couple of days in Monte Carlo to celebrate his 25th birthday with family, followed by a trip to New York between Monday and Tuesday, leaving him roughly 12 days to train and regain rhythm before the US Open begins on August 30.

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There is a real split over Sinner’s knee, with Greg Rusedski seeing the Cincinnati withdrawal as a red flag that leaves the Italian heading into New York without a warm-up event or match rhythm before facing the heat and grind of five-set tennis.

“It’s concerning because he always plays a lead-up. Everybody plays Cincinnati usually, then a week off, then gets ready for New York,” Greg said. “So, obviously, the knee is worse than we think. New York, that’s a different kettle of fish. There are very few players who have come into New York without at least one week and one tournament before winning the US Open.”

That concern, however, is not shared across the board. Dr. Giovanni Di Giacomo sees Sinner’s knee issue more as a case of overload than a major injury, with rest and workload management at the center of the recovery plan. In his view, skipping Cincinnati was less a warning sign and more a calculated decision to avoid unnecessary stress before the US Open.

“If his colleagues deemed it appropriate to slow down the overload on the knee, it means he has an overload syndrome, just like so many other athletes have had in the past. Rest always represents the best treatment,” Giovanni Di Giacomo said. “I assume they preferred not to risk Cincinnati in order to show up in the best possible condition for the US Open. You always have to do the math and figure out where it’s worth not taking risks.”

But Daniele is not buying the panic either. The Italian Tennis Federation medical chief sees Sinner’s Cincinnati withdrawal as a precaution, not a major problem, and expects him to be ready for the US Open. Rusedski sees danger, Di Giacomo sees overload, while Daniele sees nothing more than a calculated gamble.

That optimism is about to face a brutal reality. Sinner will have barely a few days to sharpen up before New York, where he returns as the 2024 champion and last year’s runner-up. And he is hardly the only superstar limping toward the final Slam of the year.

Alcaraz’s own injury battle continues to cloud his US Open defense

Carlos Alcaraz has not played since his April 14 first-round exit in Barcelona, when an awkward backhand triggered sharp wrist pain. The injury has already wiped out Madrid, Rome, Roland Garros, Wimbledon and Cincinnati, and now growing reports from Spain suggest his US Open defense could be next.

Alcaraz may be back hitting in Murcia, but practice footage proves little. His pace has fueled talk of a possible Winston-Salem wildcard to build match fitness, yet looking comfortable in training is nowhere close to surviving five-set tennis in New York’s heat and humidity.

Former world No. 7 Emilio Sanchez was even more doubtful about Alcaraz’s chances, questioning whether two weeks is enough to go from half-speed training to Grand Slam intensity.

“I know he trained at 50 percent last week. There are now two weeks left. If he’s capable of getting to 100 percent, we might see him, but I don’t think he has enough time,” Sanchez told Sky. “If it were a normal tournament, there would be a better chance, but the US Open features seven best-of-five-set matches, with players in good shape. Maybe he should wait until the fall,” he added. 

Alcaraz has already paid a price for the layoff, with Alexander Zverev taking his world No. 2 ranking.

Now the Laver Cup in London from September 25 to 27 looks like the safer comeback target, giving him elite competition without the brutal demands of defending a Grand Slam title.