Tendonitis has been a problem with Rafael Nadal since he withdrew from defending his Wimbledon title after losing in the French Open to Robin Soderling in 2009. Since then, the status of his knees has been in constant question. 2010-2011 saw a resurgent and healthy Nadal playing and winning (a lot) without the heavy taping we had been seeing around his knees. It wasn't until early 2012 that news of continuing knee tendonitis surfaced.
Nadal has long been critical of hard court tennis in general, as well as the year-round schedule that the ATP demands of its players, mostly on hard court. However, these are universal factors that every pro tennis players deals with and Nadal isn't any different. No one likes playing tennis on a 103 degree August day in Cincinnati. But its part of the gig.
However, given the nature of Nadal's game, and of the injury, the year-round schedule may be the problem here. Nadal puts huge loads of force of his lower body when he plays. His knees suffer the consequences of playing a clay court game on hard court. Nadal is the first pure clay court player to be a dominant number one and legitimate all-time great. His athleticism and mental toughness allowed him to translate clay court success into success on other surfaces in a way that no one, except Bjorg, has been able to. That meant that he ended up playing a lot of matches.
Tendonitis is a long-term diagnosis with only one legitimate cure. Rest. Long-term rest is the only cure for tendonitis and the ATP schedule simply doesn't allow for that kind of time off. Three months off would be a minimum for recovery. However, tendonitis has a tendency to slowly return. And since Nadal hasn't changed his style of play I would assume the pressure on his knees will continue to be the same: massive.
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