"Tough Match for Venus?Most of you will now have heard of a previously very unnoticed disease; Sjogren's Syndrome (SS)after Venus Williams recently cited it as the cause of her withdrawal at the US Open.Sjogren's has thus far snuck under most radars, which is pretty much the way it behaves in sufferers.Symptoms are often minor issues which are ignored for a time, and diagnosis is drawn out, witheven The Sjogren's Syndrome Foundation (SSF) suggesting that diagnosis depends on medicalintuition after assessing a wide range of factors.As a Physiotherapist, because Sjogren's can mimic a number of musculoskeletal disorders, it isimportant for us to be aware of the symptoms and the body parts involved ,especially if our patientis not responding to our treatment as expected!SS is classified as a rheumatic disorder or auto-immune disease in the same family as RheumatoidArthritis and Systemic Lupus Erythematosus
(The Plain English campaign will be fuming!).
The body's own white blood cells, called Lymphocytes are thought to attack the body's own tissues,often reducing the essential lubricating fluids needing for many organs to function, causingsymptoms such as:Dry mouthDry EyesTooth decayGynaecological problems/genitourinary issues,FatigueAnxietyDepressionMuscle and joint pain (occasionally extending to Fibromyalgia)Liver problems andHeartburn,Brain 'Fog' and memory lossto name but a few!So how does this relate to Venus? Well, one can only speculate as to the range and severity of her symptoms, and that is a private matter for her and her medical team, but she has suggested invarious articles that numbness (in SS this normally includes the feet and lower legs), fatigue,muscle and joint pain are her primary issues, and to be clear THERE IS NO CURE.Venus will need excellent medical advice, perhaps from a Rheumatologist, and she will benefit fromvery sensitive management of the condition. The great news is, just to succeed at the level she hasfor as long as she has, Venus and her team have always expertly managed the many facets of her health, fitness, activity and lifestyle. Therefore coping with Sjogren's will at it's best be a minor complication of her daily routine, but there are no guarantees. Venus' ongoing health and ultimatelyher participation at the pinnacle of the game may be at risk. Not everyone suffers with the extent of symptoms Venus appears to, and one piece of research byAsmussen et al found that dry mouth and dry eyes are the ONLY symptoms in approx 30% of SSsufferers who were monitored over a seven year period.(
A new model for classification of disease manifestations in primary Sjogren's Syndrome:evaluation in a retrospective long-term study. J Intern Med 1996; 239:475
)Why haven't we heard of it before? Well, perhaps one reason is that the incidence rate in the UK isestimated at 3-4%, and in the USA it is believed to affect just 4 million out of over 300million