RESOLVING THE LEDGER
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BBC Sport tennis news reporter Published 1 hour ago By his own admission, the arm injury which has derailed Jack Draper's career is "complicated".
Former British number one Draper withdrew from a planned comeback in Washington on Monday after feeling more discomfort from bone bruising in his serving arm.
It is a similar situation to what happened at Wimbledon last month, where the 24-year-old Englishman also spoke positively about his fitness - and seemingly practised well - before pulling out on the eve of the tournament.
Draper continues to insist "finding acceptance and being patient" remains the key - but his fans can be forgiven for fearing the worst.
So what is bone bruising in the arm, how does it affect tennis players and would surgery solve Draper's long-standing issue?
Contact form Contact form What is bone bruising and why do tennis players suffer? Draper has been hampered by the bone bruising in his left arm for more than a year, playing just 14 matches in the past 12 months and missing all three Grand Slam tournaments so far this year.
He has dropped to the cusp of the world's top 150 as a result and will need to come through qualifying - or be given a wildcard - to play at the upcoming US Open, which starts on 30 August.
Bone bruising is essentially internal bleeding in the centre of the humerus bone, according to Prof Amar Rangan, vice-president of the British Orthopaedic Association.
The humerus is the long, tube-like bone between the shoulder and elbow joints, with the stronger outer layer - known as the cortical bone - protecting a spongier tissue called trabecular bone.
When the trabeculae break, the bleeding increases pressure inside the bone - causing bruising.
Tennis players are particularly liable to this injury because of the stresses imposed on the humerus by the rapid acceleration and deacceleration of their shots - particularly the serve.
Generally it tends to cause a dull, deep-seated pain, as well as limited mobility and inflammation for some people.
"How do you recover from this injury? A lot of patience - basically that is it," Prof Rangan told BBC Sport.
"It is almost a race between the bone healing and further stresses."
However, the notion of a player potentially needing surgery to fix the issue is emphatically rejected by Prof Rangan.
"The only thing can heal it is rest. The body has to heal and strengthen the bone," he said.
"Surgery would be further injury to the area and would not help.
"As long as there is sufficient relative rest to allow the bone to heal and strengthen and consolidate it should settle down."
Draper has leaned on other players who have dealt with the same injury, including British pair Arthur Fery and Toby Samuel.
Both players endured frustrating long spells on the sidelines, but have each come out of the other side to enjoy the best results of their careers.
Fery, 24, was a shock Wimbledon semi-finalist last month after suffering with bone bruising for most of 2024 and 2025.
Samuel, 23, is close to breaking into the world's top 100 having come back from almost a year out in 2024.
Eventually the pair felt they were able to play through the pain, but Draper remains at the stage of his recovery where he is happy to continue taking extra caution.
"It is a tough injury because there's no set time or magic cure for it," Samuel told BBC Sport.
"At first it was tough to play again. I was still feeling pain and not playing amazing. But I came through it and I haven't looked back."
Since first becoming aware of the problem in May 2025, Draper has taken a series of measures to alleviate the issue.
Initially he tried to play through the discomfort, before withdrawing from last year's US Open before his second-round match and swiftly deciding to curtail his 2025 season.
Draper opted not to play this year's Australian Open in January, then missing the French Open and Wimbledon as he continued to take precautionary moves.
Another tactic saw Draper switch to a platform serve - standing with his feet slightly wider throughout the motion to allow a smoother transfer of weight - which put less load on his arm but "didn't necessarily help" his knee, which he injured at the Barcelona Open in April.
Spending more time in ice baths, saunas and red light therapy has also become an important part of his recovery.
"You start looking into all things when you have this type of injury," Draper said at Wimbledon last month.
"I definitely looked more into my sleep and nutrition. I always did these things pretty well, but it's probably now an elite level.
"I think that will help the longevity of my career hopefully - going through this experience now."
This article is the latest from BBC Sport's Ask Me Anything team.
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