One played needed a medical time-out when they were tagged in the head.

Bethanie Mattek-Sands fell after a ball hit her in the head (Image: X)

The Madrid Open always brings drama. This year, we’ve seen play cancelled due to a blackout, while top players like Novak Djokovic have suffered big upsets. And it was no different in 2024, with plenty of stories throughout the tournament.

Among some injury withdrawals and a farewell ceremony for Rafael Nadal, there was concern in the women’s doubles event when Bethanie Mattek-Sands fell to the ground after being hit in the head with a ball and had a frosty handshake with her opponent.

The former world No. 1 continued her successful partnership Sofia Kenin in Madrid weeks after they lifted the Miami Open title. But they had a tough time in their opening match against Erin Routliffe and Ashlyn Krueger, with the match going down to the wire.

Late in the second set, one of Routliffe’s returns hit Mattek-Sands in the head, and she collapsed onto the court. The American was given an ice pack before seeing one of the medics.

Mattek-Sands took a lengthy medical time out while a concussion check took place, but Routliffe didn’t seem happy with how long her opponent had been given in the middle of the match.

Play resumed and, after winning the first set in a tiebreak, Mattek-Sands and Kenin dropped the second set. The match went to a first-to-10-point breaker and the American duo came out on top, winning 7-6 5-7 [11-9].

Sofia Kenin and Bethanie Mattek-Sands had won the Miami Open a few weeks earlier (Image: Getty

There was a frosty handshake between Mattek-Sands and Routliffe at the end of the first-round contest.

The Kiwi doubles player had suffered defeat to Mattek-Sands and Kenin in the recent Miami Open final, where she partnered with Canadian star Gabriela Dabrowski.

Mattek-Sands, a five-time women’s doubles Grand Slam champion, and Kenin only got into the Miami doubles draw as alternates and went on to win the whole thing.

However, their luck ran out in Madrid, as they lost in the second round to compatriots and No. 4 seeds Coco Gauff and Taylor Townsend.

So far in 2025, Mattek-Sands has played with various partners. She also revived her wildly successful partnership with Czech star Lucie Safarova, who retired in 2019 but recently returned to the tour.

Nicknamed ‘Team Bucie’, the duo won five Grand Slam titles together in their heyday.

They lost their opening matches in Abu Dhabi and Doha earlier this year but finally notched another win together in Charleston last month before going out in round two.