Tennis’s injury discussion has sharpened in 2026, with the ATP Tour losing several leading names and major events feeling the effect. Carlos Alcaraz’s five-month absence has already underscored the strain on the sport, and now Jannik Sinner’s withdrawal from the US Open because of a knee injury has added another major setback.

Holger Rune, Arthur Fils and Jack Draper have also dealt with significant injuries over the past year, reinforcing the sense that the problem has spread through the tour. While the packed calendar is often cited as the main culprit, Patrick Mouratoglou says the issue runs deeper than scheduling alone.

Speaking on Instagram, the former coach of Serena Williams said: “You know the reason, the calendar? I don’t think so. I have a completely different explanation. Since the early 2000s, the governing bodies have decided to slow down the surfaces and homogenise them.

“Some surfaces that used to be very fast are not fast anymore. “Now, most of the players play fully from the baseline, hitting the ball extremely hard with a very high intensity. Look at the injuries that are listed. It’s only upper body injuries.

“We’re not talking about the movement. One of the explanations is the fact that, you know, all the players have to hit the ball way harder than before. The second explanation is the balls. First, from one tournament to the other, it’s a different ball.

“Some are lighter. Some are heavier. It’s constant adaptation for your upper body, and constant different stress on the joints of the upper body. A lot of players have complained that the balls are reacting differently. They get old extremely fast.

“So I think that it’s important that the governing bodies at this point, knowing now that there is a huge increase in injuries from the upper body, work to find the explanation of this phenomenon and then find solutions so we go back to a percentage of injury that is acceptable.”

Mouratoglou is not alone in raising the issue. Earlier this year, Emma Raducanu said: “I do think the balls are a big challenge for all of us. The way that they deteriorate is really challenging.

“I think it gets very fluffy. You see a lot of wrist, elbow, shoulder injuries happening now. And it is hard because the dynamic of the points can be different from when they’re new to when they’re old.”

Daniil Medvedev has also been a persistent critic. “I’m crying because it disadvantages me,” he said earlier this year at the Rotterdam Open. “But if you take six balls out of the new balls out of the can, if you look closely and you bounce them, there are going to be six different balls. I don’t think that’s how it’s supposed to be.”

With top players repeatedly voicing concern, pressure is building for tennis to address one of the sport’s most persistent complaints.

Carlos Alcaraz’s return to competition at the US Open came after a five-month absence, and his first matches back were always likely to draw attention. The Spaniard teamed up with Serena Williams in mixed doubles, where they opened with a win over Lloyd Glasspool and Erin Routliffe before falling to Flavio Cobolli and Belinda Bencic.

That appearance has sparked debate over why the world No 2 chose to play doubles after such a long spell away from competitive tennis. Some critics have gone further, suggesting he may even pull out of the US Open main draw after the doubles event and that the mixed doubles outing was mainly for sponsors.

Konta, however, sees the situation very differently. Speaking to Eurosport, Konta said: “To be fair, I think that nowadays drama is an important part of a player’s personal brand. I think generating hype, creating interest, is part of building an image. So I don’t see anything wrong with analysing it from that perspective.

“And if in the end he only plays the mixed doubles and still creates all this hype, that’s perfectly fine by me. “What’s happening with Alcaraz is that I get the feeling he plays without inhibitions.

“And by that I mean we’re talking about a player who’s on his way to challenging the greats in terms of numbers and achievements, especially considering his age and where he is in his career.

“However, when he’s on the court, he plays with so much joy and, from an outsider’s perspective, with an enormous sense of freedom. That’s why I sincerely believe he may have come simply because he loves to play and wants to play. So what?

“Does it really matter if he can’t yet show his best form? Does it really matter? I think he has a very healthy perspective on where he is in his career and how much time he has left.

“I don’t get the sense that he feels pressured to reach certain milestones or to prove a certain level. Honestly, I think he’s simply happy and eager to get back. And that’s why he wants to play: because he feels ready. And why not? That’s how I see it.

“And every time I’ve seen him on the court, he conveys exactly that to me: someone who plays without any constraints. I think that fits perfectly with his personality and the image we’ve seen of him. His decision to play seems consistent with who he is.”

Alcaraz did look different alongside Williams, which is hardly surprising given how much of the season he has missed. His serve appeared slower, and at times Williams seemed to carry more of the load.

Even so, the seven-time Grand Slam champion still has four days to get ready for the US Open main draw, and there has been no indication yet that he plans to withdraw.

Arthur Fils has made the biggest move in the Race to the ATP Finals after winning the Cincinnati Open, while Novak Djokovic has fallen out of the top 10.

The Frenchman is now up to a career-best ATP ranking of No 11 after beating Frances Tiafoe in the Cincinnati final to secure the most significant title of his career. That victory has lifted him to fifth in the Race to Turin, underlining the impact of his run in Ohio.

With the back-to-back ATP Masters 1000 events in Montreal and Cincinnati now complete, the North American hard-court swing will finish at the 2026 US Open.

The Race to Turin is the seasonal points table that determines which eight players qualify for the ATP Finals, scheduled this year in Turin from 15 to 22 November. The event, first staged in 1970, will be played indoors on hard courts at the Inalpi Arena.

The two players ranked ninth and 10th in the Race can still travel to Turin as alternates, ready to replace any withdrawals. If a Grand Slam champion from the current season finishes between ninth and 20th, he takes the final qualifying place.

At the top of the standings, Jannik Sinner has not played since winning the Wimbledon final last month, yet he remains first with 7,950 points. Alexander Zverev was unable to make full use of Sinner’s absence in Canada and Cincinnati, collecting only 110 points and staying 1,300 points behind.

Carlos Alcaraz, who has not played since April, is still third on 3,650 points ahead of his US Open return. Flavio Cobolli sits just 220 points behind him in fourth, with Fils 290 points further back in fifth after his Cincinnati title.

Ben Shelton is sixth, Daniil Medvedev seventh, and Tiafoe has moved into eighth after reaching the Cincinnati final.

Rafael Jodar is ninth on 2,499 points, just 31 behind Tiafoe, with Taylor Fritz 10th. Djokovic’s loss in his opening Cincinnati match has pushed him down to 11th.