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THE KNEE OF FREEDOM (CHINA MORNING POST)

LiNa

Translated from Chinese. An article from the China Morning Post, October 2014.

The almost magical alliance between tennis world star Li Na and the Munich knee specialist Dr. Erich Rembeck

Sometimes a knee operation is not only a medically necessary intervention, sometimes, rarely enough, also an act of liberation. March 31, 2008, 8 o’clock on the dot, marks such a memorable momentum for the Chinese tennis player Li Na, 32, at which not only her physical complaints were taken seriously, but above all her desire for independence, for a self-determined life. Seldom has a top athlete in the world the right to a free choice of doctor, which has not existed in China for folk heroes until today, been so fought for as the two-time Grand Slam winner from Wuhan, who ended her career after 15 years on the professional tour in September. „The prerequisite for developing such a special relationship was that Li Na was the first Chinese star ever to take out the right to have surgery and treatment abroad. Nobody had this courage before her and we supported you in it“, Dr. Erich Rembeck, 56, recalls the perhaps most unusual patient of his career.

When Li Na came to him for the first time, it was completely unclear whether she would ever be able to meet the high expectations of Chinese officials due to her vulnerability to injury. When Li Na resigned, Stacey Allaster, head of the women’s tennis tour, spoke historical sports sentences. „No doubt, Li Na has had the greatest influence on the development of women’s tennis in this decade. She is „our Billie Jean King“. The American became famous in the 1960s for her fight for equality between men and women in top international sport. Li Na is now admired in China like an icon, she has personally kicked off a tennis boom throughout Asia, which has made her a world star and the second richest sportswoman in the world. She was on the cover of Time magazine, she is counted among the 100 most influential personalities in the world, 300 million Chinese saw her success at the 2011 French Open and yet she has remained a modest, shy, even mysterious young woman who has had to work hard to achieve everything. „There is no other athlete who has ever been operated on with us who has so reliably implemented everything she has been told,“ says her doctor, Munich knee and rehabilitation specialist Erich Rembeck, who knows one of Li Na’s secrets.

Erich Rembeck and Li Na met in 2007. Their coach, the Swede Thomas Hogstedt, an acquaintance of Rembeck’s, sent Li Na to Munich because of a rib injury, after fourteen days the injury was cured and the ways parted again. When Li Na seriously injured her right knee for the first time at the Australian Open in January 2008, she remembers her „german doctor“ in Munich. When the tournament doctor in Australia confirmed to her that there was the best combination of surgery and rehabilitation in Germany, Li Na asked Rembeck if she could show him her damaged knee. At the beginning of March 2008 Li Na came to Munich and Rembeck quickly diagnosed a „serious cartilage damage“ in the right knee. Even in the 80s or 90s, such a diagnosis was the certain end of a top athlete’s career, and this time too „we weren’t sure whether she could continue to play at all,“ recalls the orthopaedist, who for many years was a team doctor for the footballers of TSV 1860 Munich and the German Davis Cup team. In a touch of gallows humour her Rembeck advises if she should sign a bigger sponsorship contract, she should have the money paid out at the beginning in one fell swoop, you never know. In any case: Rembeck advises the strong baseline player to an immediate operation. The Chinese federation leadership sees things differently. Li Na is programmed for Olympic gold in Beijing, five months before the games they don’t want to take the risk that they might miss the games and recommend conservative treatment. Erich Rembeck can convince Li Na despite the pressure from above. In the morning a few minutes before the operation, Li Na is in the vestibule of the operating theatre and has already swallowed a sedative tablet to prepare the anaesthesia, she gets an urgent call from China. When she hangs up she still says slightly dazed: „I can not do this operation“. One hour later, Li Na, anaesthetised with a Valium, departs for China again with the hint that she still needs a stamp with the necessary permission, otherwise she could not have an operation. Fearing a missed Olympic medal, the association wanted to force the country’s best tennis player to give up the operation. When Li Na wants to know from Rembeck about a week later what he thinks of conservative therapy without surgery and urgently advises her against it, she finally insists on the release for surgery on 31 March 2008, 8 a.m. in Munich. A monstrous act of personal disobedience by Chinese standards. In retrospect, Rembeck says today that his patient would not have been able to get back on her feet with conservative treatment and would certainly have missed the Olympics. „She never received injections for pain or cortisone injections from us, which would have torn her knee. An operation with subsequent intensive rehabilitation was unavoidable.“ The association officials demanded a detailed long-term plan from Dr. Rembeck as to when Li Na could start training again, when she would be fit again, and that the Olympic Games would not be endangered. „The Chinese team leadership expressed doubts about Rembeck’s master plan,“ writes Li Na in her 2012 autobiography „My Life,“ „I apologized to him. <...> The decision was now in my hands“. It came as Rembeck foresaw it. It was her only chance, as her Munich doctor sees it today in retrospect. Every second day, the rehabilitation coach of Rembeck’s „Centre for Orthopaedics“ in the Atos Clinic in Munich worked with the Chinese special patient against the skepticism of the association management for the big goal: Olympic Games 2008 in Beijing. Erich Rembeck „kept asking me to believe in myself, but it was the first time I got involved in such a game,“ writes Li Na about her initial self-doubt. When she won her first game again three months after the operation at Wimbledon, it was „proof to me that the operation was right“. Rembeck had confirmed your confidence. She still had all her great successes ahead of her: bronze at the Olympics, her Grand Slam victories in Paris and Melbourne, second place in the world rankings, almost 17 million US dollars in prize money, her promotion to world star. Rembeck: „Over the years, despite the many operations, she has undergone a sensational development.

After the Olympics, Li Na completely detached herself from the paternalism of her association, which reluctantly, but without sanctions, let the popular heroine go. By the time she was in her mid-twenties, she was finally „really independent“, just like all her western competitors on the tour. From now on she had to pay all her bills for coaches, travel and Physio herself, a circumstance that was not easy for her from the beginning. In many conversations, Rembeck made it clear to her that world-class tennis on hard floors with this injury is a high-risk Vabanque game of which one would never know „how long it goes well“. The next OP on the day before Christmas Eve 2008 did not come as a complete surprise. „Li Na understood that a world-class athlete has to do a kind of permanent rehabilitation in order to withstand the stresses and strains demanded. Not a standard fitness programme, but an individual, personally tailored rehabilitation programme. If you hadn’t done this, it would have been over after the 2008 Olympics. The second operation welds the doctor and the tennis player even closer together. Because the shops have closed, Dr. Rembeck Li Na personally provides her with food, negotiates a cheaper hotel room and because the tennis player is still a little overtaxed and clammy with the new freedom, he gives her the costs for the operation. Li Na tells the story in her book. She talks about the „way he talked to me, how the father talked to his daughter“. She caresses him with adjectives like „respectful“ and „generous“, as a „man of decency“ who „looked cool“ in his white coat. As a reason for giving her the operation, she writes: „He only said to me: I hope you can return to the battlefield. That’s where you belong.“ Soon she returned to the place that is her battlefield, but only three quarters of a year later, in autumn 2009, she had another operation on her right knee. And in between, every six weeks cartilage therapy in Munich. The injections were important to protect the cartilage and keep it functional, which is one of the reasons why Dr. Rembeck wanted to give his now dearest patient the syringes herself. This would not have worked at least once by a hair’s breadth, because Erich Rembeck was not back from his holiday in time after the eruption of the Icelandic volcano Eyjafjallajökull in 2010 due to the ash cloud. According to Li Na, Rembeck drove a vintage Mercedes 300 SL from Malaga to Munich in two days in order to be able to give her one injection personally. As Li Na tells all these personal memories about her doc from Munich, you notice that she will never forget him. Li Na writes about Munich as „my port“ where she spent more time than anywhere else, she even thought about buying a house. When superstar Maria Scharapowa asks at the time whether Rembeck and his team could look after her exclusively, Rembeck cancels. „The personal relationship with Li Na was the deciding factor,“ he says. „After so many years of highs and lows, Li Na belonged to our little family.“

The tennis reporter of the „China Morning Post“ writes about a modern sports fairy tale. Like a little girl from the Chinese province who grows up as a half-orphan because her father dies early, with the help of her friendly doctor from Germany, who gives her an operation, manages to become a world star, who today has 23 million friends on Facebook. This fairytale came to an end in 2014. In January, Li Na wins her second Grand Slam title in Australia, and shortly afterwards her left knee also causes problems for the first time. The well-known diagnosis: severe cartilage damage. The operation in July can no longer prevent the only reasonable step, her resignation. „We got through all this because she had a healthy knee,“ explains Dr. Erich Rembeck in the interview. „But with two damaged knees, you can no longer play world-class tennis. Then it’s enough for 80 or 90 percent, but not for 120, which you need. We’ve been discussing the subject of resignation for about a year now, it was the right time. Li Na’s resignation does not mean the end of this highly unusual doctor-patient relationship in top international sport. Li Na’s „Dauer-Reha“ in Munich continues even after his active career, now every three months and no longer every six weeks. She doesn’t have to come anymore, she wants to come. Li Na is a free man.