During the Indian Wells final, Nadal said he had breathing difficulties.
Nadal was out of sorts and quickly found himself in a big hole before leaving the court for treatment.
He looked more comfortable on his return, but he couldn't break down the determined Fritz who won.
It is difficult for me to breathe. Nadal said that when he tries to breathe it is very uncomfortable.
It is like a needle when I am breathing and moving inside. I get dizzy because it hurts. It is a kind of pain that limits me a lot. I don't feel well because it affects my breathing.
Nadal had won his previous 20 matches in the previous year.
He made 34 unforced errors in the match.
I am sad because I was not able to compete, he said.
The first American to win at Indian Wells since 2001 was Fritz.
He saved two break points at 5-5 in the second set and then won a tie-break to win his first Masters 1000 title.
He showed no ill-effects from the ankle injury he sustained in the semi-final win against Rublev, despite concerns about his fitness.
I can't even begin to describe how ridiculous it is to play, how I could play today, and I have never experienced worse pain like I did before the match.
I took a few steps and screamed. We did a lot of work leading up to the match and I was trying to act tough.
I almost cried because I thought I was going to have to pull out.
I went through a roller coaster of emotion and thought maybe I can play, but it didn't affect me at all.
This is one of those childhood dreams that you never think will come true.
Russell Fuller is a tennis correspondent for the British Broadcasting Corporation.
As his streak came to an end, Nadal confessed to being sad and worried.
The sadness stems from not being able to complete a perfect hard court season, and the worry is not knowing how the injury will affect his clay court season.
After fearing he wouldn't be able to take to the court, Taylor Fritz did a great job.
His fast start may be a sign that he didn't know how long his ankle would last. He was able to win the title in a very tight and tense second set tiebreak after realizing he was in better shape than he thought.
This tall and powerful former junior world number 1 is rapidly heading into the world's top 10 - which is his next stated goal.
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