D&V Debates: Timing Out
By: Victoria Chiesa & David Kane
We typically look to the final Grand Slam of the year to answer questions posed throughout the season and close the book. Yet this year’s US Open left us with a substantial amount of moral grey, primarily when it came to the handling of medical timeouts. The rule, first questioned by Maria Sharapova in Cincinnati, was put under a microscope when a heat-struck Peng Shaui needed a timeout during a major semifinal. The incident prompted lively discussion, proposed changes to the rule, and yelling. But in order to fix the game, you have to know what’s broken. Resident rulebook Victoria Chiesa joins me for a conversation about injuries, timeouts, and how the two can be rectified for the betterment of the sport.
David Kane: We might have been busy checking our blood pressures on Long Island while Sharapova was succumbing to Ana Ivanovic, but we were within feet of Peng Shuai when she appeared to cramp in both legs. At the time, the Chinesewoman was only a hair behind 2009 US Open finalist Caroline Wozniacki after a hard fought first set tiebreak, and was looking to even the second before becoming suddenly overwhelmed. First shocked, what soon washed over the crowd was a profound sense of confusion as Peng looked within seconds of retiring, yet no formal announcement was made. It wasn’t until she had been helped just off-court by doctors that chair umpire Louise Engzell quietly informed murmuring spectators that Peng was receiving treatment. What do you remember about that moment, Victoria?
Victoria Chiesa: Things.
DK: Fascinating. Elaborate?
VC: Everything happened so quickly, and I think that played a part in the mass confusion of the moment. One minute, Peng and Wozniacki are playing a 20+ shot rally, and the next, Peng is doubled over at the back of the court. I initially thought she had twisted an ankle, or a knee. It was clear she needed some kind of medical attention, but I don’t think she was in a position (both literally and figuratively) to communicate that to Engzell from where she was on the court. Therefore, I initially felt (and still feel, because you can’t tell for sure) that the latter took it upon herself to call the trainer on Peng’s behalf. I most certainly think that played a part in the initial delay and confusion. Nobody, not even the on-court parties, quite understood what was going on at first, and that’s not even taking into account the time the trainer needed to get to the court.
DK: Typically, injuries or illnesses are (or look like) what they are. What it looked like was cramps, a tricky development given the stage of the match. I know you leaned over early in the process to remind me of the rule, which was enforced during American Steve Johnson’s first round match earlier in the tournament. For the uninitiated, or those who aren’t semi-qualified to discuss these delicate issues, what is the rule for cramping and what made Peng’s situation so different?
VC: Essentially, the difference between the two situations is as simple as a medical diagnosis. On page 17 of the 2014 edition of the ITF Grand Slam Rulebook, which you can find here, it says the following:
“In cases where there is doubt about whether the player suffers from an acute medical condition, non-acute medical condition inclusive of muscle cramping, or non-treatable medical condition, the decision of the Physiotherapist/Athletic Trainer, in conjunction with the Tournament Doctor, if appropriate, is final.”
Note how that precludes any/all of the following people: chair umpire, referee, Twitter, Brad Gilbert.
DK: The longer it went on – or was that time standing still? – it felt like more than cramps had to be at play. Though Johnson fell, he was able to walk to his chair without assistance after being stood up. Peng had to be helped off court by two people. What seemed to confuse people (read: the Internet), was how soon Johnson began receiving time/delay of game violations compared to Peng.
VC: When both Peng and Johnson went down with their respective maladies, neither incurred any penalty for the time that it took the medical staff to come on court and look at them. Once it was determined that Johnson was suffering from cramping, and only cramping, while Peng’s issues were symptomatic of heat illness, the second section of rule 3c came into play:
“If the Physiotherapist/Athletic Trainer believes that the player has heat illness, and if muscle cramping is one of the manifestations of heat illness, then the muscle cramping may only be treated as part of the recommended treatment by the Physiotherapist/Athletic Trainer for the heat illness condition.”
Now that we’re aware of that, it’s easier to see why each incident unfolded as it did. Once Johnson’s evaluation was complete, he was instructed to resume play immediately in accordance with the rule. Since he could not, he was assessed one code violation for delay of game. As it was his second code violation of the match, he received a point penalty and Ito was given the advantage in the game. He couldn’t continue after another 20 seconds elapsed, and he received a third code violation and a game penalty. Once that happened, Johnson made the decision – in accordance with the rule – to concede the next game to get to a changeover and receive treatment for his cramps. While you cannot receive a medical timeout for cramping, you can receive treatment on two changeovers, which do not have to be consecutive. After all of this, he couldn’t continue to play and retired from the match.
When medical staff diagnosed Peng as suffering from heat illness, she was taken off-court and given a three-minute medical timeout as you would see for any other injury. The rule states that “all clinical manifestations” of heat illness are considered one treatable medical condition; as a result, she could only receive one MTO for the heat illness.
DK: Clearly, then, two different rules were applied correctly. But correct application doesn’t necessarily mean the rules are sound in the first place. Sharapova began the US Open declaring all MTOs come with a $2,500 fine, others wanted game penalties for mid-game interruptions, or no MTOs for cramps at all. Are the rules too lax? What, if anything needs to change?
VC: I’m inclined to agree with the first part. It’s not that the officials didn’t know what they were doing, it’s that they looked like they didn’t know what they were doing. And that’s bad. The incident with Peng unfolded unlike anything I’ve seen on a tennis court at any level; you had three ITF officials in Engzell, Brian Earley and Donna Kelso not only needing to talk things over, but looking a little bewildered at what was going on. Now, do I think that an incident like is the kind of thing that needs to prompt a rule change? Not necessarily. Rules aren’t written for situations that occur 1% of the time; they’re written for what happens 99% of the time. I think the idea of MTOs for cramps and mid-game MTOs are two completely separate issues, but they stem from the same idea. Should we be comfortable with the idea of umpires being allowed to make medical decisions? I’m certainly not – both as a tennis watcher and occasional umpire. I certainly wouldn’t want to be put in a position where I’d have to decide whether or not to allow a player to call a trainer, and I doubt that ATP and WTA officials would be either. So that’s not the answer. I’m not sure if I think forfeiting the game to take a MTO is the answer, either.
DK: It’s hard for me not to look at the sport from a business perspective; people pay to come watch a match, and unless a player is unequivocally advised against continuing, they should not only be allowed to, but also given every opportunity within the rules to do so. Forfeiting games creates more grey than it eliminates, as one risks more situations where an already disadvantaged player is being asked to give up valuable games in order to be treated. Streamlining the classification/treatment of injuries seems like the best solution; if all injuries were taken care of in the same way, it would do away with the questions of how to proceed and give timeouts the clockwork of a Wimbledon rain delay.
Some have argued that sympathy for the injured player – nay, wounded warrior – obscures how things ought to be kept fair for the healthy player. Timeouts can upset momentum and cause a cruising opponent to lose his or her focus. On the same token, I don’t have sympathy for the healthy, in control player who allows him/herself to become distracted by a six-minute break. Both of those things are already advantages, and they need not be further rewarded. All players have dealt with medical timeouts at one point or another, and should be mentally prepared to deal with them.
To the extent that the rules remain unchanged, I have to add the following. The lack of communication between officials and spectators is problematic at best and, when commentators are left to draw their own conclusions, dangerous at worst. In the moment, John McEnroe’s guess is as good as anyone’s, but guesswork shouldn’t be broadcast across the globe. If officials aren’t making stadium-wide announcements, efforts should at least be made to keep those in charge of explaining our sport in the loop.
VC: John McEnroe never had much regard for the rules as a player, so I suppose its foolish to expect he show any as a commentator. However, it’s incredibly irresponsible to have him calling the Peng incident “badly bungled” and a “black eye for our sport” when he doesn’t know a hindrance from a permanent fixture. When Brad Gilbert is getting into Twitter altercations with yours truly, you know there’s a problem. It’s just not a good way to be going about things; if I was a casual viewer, I’d expect that the people tasked with explaining things to me have a grasp on what’s actually going on. I said this during the US Open, and I’ll say it again: if you’re going to criticize the rules of tennis, then I expect you to actually know the rules of tennis. It’s bad enough that there’s no accountability for anything anyone says in tennis commentary anyway. McEnroe and Gilbert can bemoan the lack of Hawkeye on clay without actually knowing the reasons for it; Chris Evert can say that Ana Ivanovic and Agnieszka Radwanska play the same style of game, we laugh on Twitter, and everyone moves on. Nothing gets done about it.
DK: So it would seem players calling timeouts aren’t the only “extremely injured” party, but that’s likely a discussion for another day. It seems like an overblown discussion about something that (thankfully) rarely happens in the grand scheme of things. But it’s not the first time that a Grand Slam semifinal has ended in a retirement, and something ought to be done to tighten the links between all those involved in a match.
VC: Turn to page 394. *throws down rule book, walks away*
The Tennis Island 
I like the idea of “paying” for treatment with time-violation penalties. If I were a pro player, I’d think that’s fair. But daggone, the rules are so complicated. I’m still confused, though this was an excellent column!
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