With US Open Semi Spot, Djokovic Shows the Power of Preventative Care

Watch Novak Djokovic, bidding for his 25th grand slam at this year’s US Open on mute, and you’ll see an athlete with sharp footwork, unshakable reflexes, and precise shot selection. Unmute, and the booth plays one note: Djokovic’s unbeatable opponent isn’t Alcaraz, Sinner, or Auger-Aliassime—it’s his own body.

Djokovic is 38, and “often looks much older than that,” noted a recent New York Times article that also categorized his performance as “lethargic and slow.” ¹

Even Djokovic concedes the point. “I know the amount of hours I’m putting in daily to care for my body, but at the same time, you know, biological age is not something that you can reverse, and it is what it is,” he said after beating Cameron Norrie. “The wear and tear on the body all these years is taking a toll, and I’m aware of it, but I’m resisting it.”

The age-related wear and tear Djokovic is masterfully fighting off is real. Biological changes do reliably shift as we age:  

• Hormones decline. Testosterone declines with age, dropping by about 1 to 2 percent per year after the age of 30, affecting energy, muscle mass, and recovery. ²
• Endurance declines. VO₂ max, a measure of cardiovascular capacity, falls by around 10 percent per decade after 30. ³
• Muscle shrinks. Adults lose up to 8 percent of muscle mass per decade after 30, with acceleration after 50. ⁴ That loss (called sarcopenia) drives slower metabolism, weaker bones, and higher injury risk.
• Recovery slows. Mitochondria, the power plants of your cells, get less efficient with age. That means slower recovery, more inflammation, and the nagging soreness that lasts days instead of hours.

But the data is just as clear about something else: This decline isn’t absolute, and the ways age shows up in your body are more malleable than these numbers suggest. 

For example, muscle loss can be slowed or even reversed. Progressive resistance training is first-line therapy for sarcopenia.^{4 5} Testosterone therapy (with eligibility and monitoring) plus training can further improve lean mass and strength. 

Interval work and steady Zone 2 blocks add back meaningful VO₂ max capacity, even in middle age. Meta-analyses show substantial VO₂ gains with HIIT and endurance training. ^{6 7}

Physician-supervised TRT or menopausal hormone replacement therapy can normalize levels of hormones like estrogen and testosterone, and improve symptoms when indicated, per major guidelines. ^{8 9}

The early research on therapeutic plasma exchange and hyperbaric chambers are starting to show real promise for reducing markers of biological aging.

Sleep quality is tied to mitochondrial function, while exposure to environmental toxins can impair it and cause cellular damage. 

Djokovic has long acted on this reality. He eats surgically, famously tightened his nutrition years ago, shifting to a gluten-free diet. He meditates, does yoga, and even brought a hyperbaric chamber to the US Open. He’s tried edge gadgets, like the taopatch “nanotechnology” disk he wore in 2023 (efficacy debated, but the intent—leave nothing to chance—is unmistakable). He runs his body like a Formula 1 team: measure, tweak, repeat.

For the rest of us, the lesson isn’t to live like a touring professional. It’s to stop treating decline as a binary. See what’s shifting inside the body, intervene before problems harden into fate, and check whether it worked.

At Hone, we build around that premise. Our clinicians track a broad set of biomarkers over time—hormones, thyroid, glucose, ApoB, inflammation—repeatedly over time. When the data warrants it, we adjust hormones with medications. We strengthen muscle and aerobic capacity with fitness protocols, improve sleep, and lower inflammation. 

The outcome people notice isn’t abstract: more energy, faster recovery, strength, stamina, and reduced biological age.

The fact that Djokovic is still feeling the squeeze of time isn’t proof that proactive health optimization doesn’t work. It’s why he’s still competing at all.

About the author

Saad Alam is the CEO and co-founder of Hone, a modern health optimization platform that helps men and women take charge of their hormones, metabolism, and longevity through advanced biomarker testing and personalized, clinician-guided care.