Are the injuries in Madrid a result of the physicality of the sport or the demands of the tour? 

Injuries were one of the top stories of the last two weeks of the Mutua Madrid Open, at least as far as the ATP was concerned, from Jannik Sinner’s hip injury and Carlos Alcaraz's arm problem, to mid-match retirements by Daniil Medvedev and Jiri Lehecka—not to mention the continued specter of Rafael Nadal's overall health.

The talk continues on this week's episode of Served with Andy Roddick, where the former world No. 1, journalist Jon Wertheim and guest Dr. Joshua S. Dines discuss the challenges that players face at all levels of competition.

“Sinner was training in the gym in Madrid, lifting because he had to do his lifting cycles during these events because there's no off time,” Roddick said. “Am I an idiot for thinking that these weeks would be better spent intentionally being somewhere where you're not switching time zones, surfaces, et cetera?"

Looking ahead to Rome (where Sinner won't be competing, having officially announced his withdrawal on Saturday), Wertheim questions whether it’s the sport or the tour that’s affecting so many players.

“The buzzword with these young athletes is overuse,” Dines, renowned sports orthopedic surgeon and the U.S. Davis Cup team's doctor, added. “Everybody is so focused on scholarships or turning professional, and coaches on the other hand see there's a money grab, so it's I think it's multifactorial, but I think to boil it down it's just kind of overuse, and to be fair, at a much higher level.

"Everything now is a 20-, 30-shot rally where there's no quick points, there's no easy points, so I think it's probably all of the above.”

With competitive demands at an all-time high, player recovery sometimes takes a back seat in terms of priorities.

“Resting at a hotel, even if it’s a Four Seasons, knowing you’re going to play the next day, is completely different than being somewhere else that’s really your home, your own bed, your own routine, [to] really rest,” Dines said. “As a fan, I love to watch those tournaments. From a player’s perspective, I’d rather get the work done then recover.”

With Dines’ practice scaling most sports and athletes across the country, conversation about tennis was quickly compared to the likes of others.

“NFL [players get] seven to eight months off; NBA, four months off; Euro soccer, three to four months off; baseball, three to four months off,” Roddick said. “How psychotic are we in tennis that we play 11, 11-and-a-half months a year?”

Discussions about the future of the tour, and what the forthcoming calendar might look like, are still very much present. Although not in the room himself for them, Roddick says he hopes that player recovery is being considered.

“The last month or six weeks of the calendar should all be 250-level events for players that need to put points on the board to make a living for the next year, and the people that play the most throughout the year are done if they want to be,” he said. “I could be No. 4 in the world and play a 250 event if I wanted to, if it made sense, if there was one an hour away and I wanted to use it as like a training block to get matches.

“I don't think the players that play the most throughout the year should also have to add two or three weeks to their season at the end of the year, but also I understand that the guys that are 80, 90 in the world want to cash paychecks because they have to. Give them a month, give them six weeks, where it's paycheck season, where it's ranking point season, for the next year. But also, that's a choice, right? You're actually choosing to opt into that schedule as opposed to it being basically just presented.”

While this week’s episode is under an hour in length, every minute is deeply conversed in the injury trend on the tour, how the trend came to be, and how to prevent it. Tune into the episode live Sunday night on T2, Tennis Channel’s second network, or catch the recording on Served media channels starting Tuesday.