A timeout jeered round the world

When the world's top-ranked female tennis player requested a medical timeout Thursday during her semifinal match at the Australian Open, the howling commenced immediately. Skeptical fans at Rod Laver Arena and those watching on television worldwide were convinced that the player, Victoria Azarenka of Belarus, was suffering from nothing more than an attack of nerves and faked an injury to collect herself after losing several crucial points.

After her 10-minute reprieve, Azarenka closed out a 6-1, 6-4 victory.

The incident captured the latest vexation for a sport that in recent years has dealt with loudly grunting players and accusations of match fixing: determining what constitutes a real injury.

Azarenka's opponent, Sloane Stephens of the United States, called injury timeouts - legitimate or not - "the in thing," noting that Azarenka was her fourth straight opponent to use a medical timeout.

"It's trendy," Stephens said.

Others were more critical.

"I thought it was a little unfair play," said David Nainkin, Stephens' coach. "I thought she bent the rules. I don't think she broke the rules, but she bent them, and I think those rules need to be looked at because I think there's a gray area there."

TV analyst Patrick McEnroe called it an "absolute travesty" in a post on his Twitter page. (McEnroe also heads the U.S. Tennis Association's player development program, which has supported Stephens.)

"I mean everybody's appalled by it," said Pam Shriver, an analyst and a former player.

The controversy arose when Azarenka, serving for the match against the 29th-seeded Stephens at 5-3 in the second set, failed to convert on five match points and was eventually broken.

When she took her seat during the changeover, she wrapped a towel stuffed with ice around her neck and was examined by the primary health care provider for the women's tour, Victoria Simpson, and by a tournament doctor, Tim Wood. She then left the court for further treatment, leaving Stephens, in her first Grand Slam semifinal, waiting nearly 10 minutes for the next game.

Stephens, who had upset tournament favorite Serena Williams in the quarterfinals, proceeded to lose her serve and the match. She did not blame Azarenka's timeout for her loss.

Azarenka did not mention an injury during her on-court interview after the match but did refer to a feeling of crisis at the 5-4 changeover.

"I almost did the choke of the year," she said. "I just felt a little bit overwhelmed. I realized I'm one step away from the final, and nerves got into me, for sure."

Later, in a news conference, Azarenka said she left the court for treatment of a rib injury.

But if Azarenka was not legitimately injured, is calling a medical timeout cheating? Playing at the edge of the rules? Good old win-at-any-cost strategy?

To Michael F. Bergeron, executive director of the National Youth Sports Health & Safety Institute, it is part of a disturbing trend that has taken hold in youth sports, emphasizing winning over sportsmanship and developing character.

"I'm not saying everyone does that, and I'd like to think there are still players who would never do it," Bergeron said. "It shows a lack of character, a lack of respect for her opponent and the game. You'd like to think sports would be developing those traits. But in the bigger picture, this emphasis on winning and losing over everything else is doing athletes a disservice. It's not making them better people. It's not making them better athletes."

Bergeron, a clinical and scientific consultant to the Women's Tennis Association, acknowledged that tennis was harder on athletes' bodies than ever before. But he suspected that Azarenka had used the timeout as a strategy to stop Stephens' momentum.

"We'll never know whether she was really injured, but it does point to a bigger problem," he said. "It's alarming."

Other sports have seen similar issues. In football, there have been debates over timeouts taken just before field goals. During a college game between Cincinnati and Duke this season, Cincinnati took a too-many-men-on-the-field penalty to negate a 53-yard field goal, leaving Duke coach David Cutcliffe irate. And after an NFL game last season in which the New York Giants appeared to fake injuries to slow the St. Louis Rams' offense, Seattle Seahawks coach Pete Carroll said the phenomenon was nothing new or alarming.

In tennis, though, the injury timeout is tricky because medical personnel have to treat all calls for treatment seriously, no matter when they happen.

Grand Slam supervisor Donna Kelso confirmed that Azarenka had been given two consecutive medical timeouts of three minutes each to be treated for two injuries: one to a rib and one to her left knee. Azarenka explained that she was having trouble breathing on court because of a rib problem that was causing her back to seize up.

"I had to unlock my rib, which was causing my back problem," she said. "The trainer said, 'We have to go off court to treat that.' I just didn't really want to take off my dress on the court."

Nainkin, Stephens' coach, said he had "never heard of two medical timeouts back to back."

"In all my years, that's a first," he said. "Two different injuries? I think it's unprofessional. Saying that, she did win the match and played a great game at 5-4, but tennis is a game of momentum and Sloane had the momentum, and obviously the little break definitely changed things."

Azarenka agreed that the timing of her timeout was unfortunate.

"The timing, yeah, it was my bad," she said. "The game before that, when I lost my service game, it kept getting worse. I thought I would have to play through it and keep calm. But it just got worse. You know, I had to do it."

Several coaches and analysts expressed hope that the incident Thursday would lead to a re-examination of the medical timeout rule at Grand Slam events and on the WTA Tour.

"I think if you can continue to play in any way, it's bad luck but you've got to wait until the person is finished serving," Shriver said.

But ultimately, the decision lies with the medical personnel on court. According to the Grand Slam rule book, if they determine that a player needs a medical timeout, their word is final.

From a sports medicine perspective, there is some irony. The biggest problem team physicians usually face is when athletes lie to minimize an injury during a game, said Dr. Margot Putukian, Princeton's director of sports medicine. This is a particularly vexing issue when it comes to concussions.

"As doctors, we really need athletes to be honest with us about what is going on, but usually it's just the opposite situation," Putukian said. "They don't want to tell you because they don't want to come out of the game."

Putukian added: "It's really difficult to tell for sure if an athlete is feeling discomfort or is in pain. We want them to be honest with us. And we want to believe them."

Sometimes, though, they make that particularly difficult.

© 2013 New York Times News Service