Novak Djokovic revealed that an undisclosed health issue contributed to his physical struggles during a stunning second-round loss at the Cincinnati Open, raising questions about his condition ahead of the U.S. Open.
Thiago Agustín Tirante, ranked No. 50 in the world, defeated Djokovic 2-6, 6-4, 6-4 Saturday in the Serbian star’s first match since Wimbledon.
Djokovic appeared in complete control after racing through the opening set. The match changed dramatically early in the second, when the 39-year-old dropped to his hands and knees following a grueling game.
Djokovic appeared to vomit into a towel before receiving treatment from medical personnel. His blood pressure was checked, and he used an ice pack while sitting shirtless during a medical timeout.
He continued playing but never regained the command he displayed in the first set.
Novak Djokovic Discloses Recurring Health Problem
Getty Novak Djokovic of Serbia reacts during a match against Thiago Agustín Tirante of Argentina on day five of the Cincinnati Open at Lindner Family Tennis Center on August 15, 2026 in Mason, Ohio.
The oppressive heat and humidity appeared to overwhelm Djokovic, but he said afterward that the conditions were not the root cause of his difficulties.
Djokovic disclosed that he has managed the unspecified health problem for years and that hot, humid weather can aggravate it.
“It causes me a lot of problems,” Djokovic said, according to the ATP Tour.
He did not identify the condition or offer further medical details. Djokovic explained that he anticipated Cincinnati’s humidity, but said the combination of physical stress, nerves and match tension made the problem worse.
The episode carried added significance because Cincinnati was Djokovic’s only scheduled singles tournament between Wimbledon and the U.S. Open. He withdrew from the National Bank Open in Montreal after consulting with his team.
Djokovic’s limited preparation showed once Tirante extended the exchanges and forced him to work through the Ohio heat. The former world No. 1 committed costly errors late in the deciding set, while Tirante maintained his composure to complete the biggest victory of his career.
The upset ended Djokovic’s first Cincinnati appearance since 2023, when he defeated Carlos Alcaraz in a nearly four-hour final widely regarded as one of the finest best-of-three-set matches ever played.
Novak Djokovic Casts Doubt on Cincinnati Return
Djokovic also acknowledged that Saturday’s loss might have been his final appearance in Cincinnati.
“It seems more likely that I won’t be back next year,” he said.
Djokovic stopped short of making the decision final, leaving open the possibility that he could return. Still, the admission offered another reminder that the 24-time Grand Slam champion is navigating the closing stages of his career on an increasingly selective schedule.
His immediate focus now shifts to New York.
Djokovic is entered in the U.S. Open mixed doubles event with world No. 1 Aryna Sabalenka, scheduled for Aug. 24-26. The singles main draw begins Aug. 30.
A four-time U.S. Open champion, Djokovic will pursue a record-extending 25th major singles title. He remains capable of contending on the sport’s biggest stages, having reached the Australian Open final and Wimbledon semifinals this season.
The larger concern is whether his body will cooperate through seven best-of-five-set matches.
Djokovic has repeatedly found ways to recover from physical setbacks throughout his career. This time, however, he heads toward the season’s final major with an unresolved health issue, limited match preparation and more uncertainty than his Cincinnati return was supposed to produce.
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