Jack Draper's injury saga took another painful turn this week when the former British number one withdrew from his planned comeback in Washington, citing renewed discomfort in his serving arm. It is the latest chapter in a frustrating ordeal that has seen the 24-year-old Englishman play just 14 matches over the past 12 months, missing all three Grand Slam tournaments this year in the process.
The culprit is bone bruising in his left arm, a condition Draper himself has called complicated. According to Professor Amar Rangan, vice-president of the British Orthopaedic Association, bone bruising involves internal bleeding deep inside the humerus, the long bone running between the shoulder and elbow. When the spongy inner tissue known as trabecular bone breaks down, the resulting bleeding increases pressure within the bone, producing that signature dull, deep-seated pain.
Tennis players are especially vulnerable to this type of injury. The explosive acceleration and deceleration involved in serving puts enormous repeated stress on the humerus, making full recovery incredibly difficult when a player tries to compete before the bone has fully consolidated.
Perhaps most importantly for Draper's camp, Prof Rangan was emphatic that surgery is not a solution. He told BBC Sport that operating would simply cause further damage to an already compromised area, and that rest remains the only genuine remedy. "It is almost a race between the bone healing and further stresses," he explained.
Draper's ranking has slipped to the edge of the world's top 150, meaning he will likely need a wildcard or to come through qualifying to feature at the US Open beginning August 30. He continues to preach patience, but the clock is ticking.
TennisDraw users had Draper penciled into several deep US Open runs before his fitness concerns became clear, and bracket predictions for the Slam will need serious rethinking.