A medical timeout is three minutes of treatment—not three minutes from the request.

Scope: the four Grand Slam tournaments in 2026

This page applies to the Australian Open, Roland-Garros, Wimbledon and the US Open under the 2026 Official Grand Slam Rule Book. Grand Slam Tournament Regulations Article I.K adopts the ITF Rules of Tennis and the ITF Duties and Procedures for Officials unless Grand Slam Tennis specifies otherwise. The controlling provisions here are Regulations Article I.W.3–4 and Grand Slam Code of Conduct Article III.J–T, read with the 2026 ITF Rules of Tennis and 2026 ITF Duties and Procedures for Officials.

ATP, WTA, ITF tour, national, collegiate and recreational events can use different medical personnel, toilet-break allocations, penalty codes and technology. The three-minute ITF principle is widely used, but the detailed Grand Slam procedure below is not a universal rule for every tennis match. Wheelchair-specific regulations and published event instructions may also supplement the Grand Slam baseline.

Classify the interruption before choosing a penalty

1. Medical: did the player request an evaluation through the chair umpire, and did the Sports Physiotherapist identify a treatable condition?
2. Administrative break: is it an authorised toilet or change-of-attire break, taken at a permitted time and within its clock?
3. Ordinary delay: is the player merely exceeding the 25-second, 90-second or 120-second continuous-play limit?
4. Misconduct: does the act fall under a Code category such as racquet abuse, verbal abuse or unsportsmanlike conduct?
5. Review: is the dispute a line-call fact on a court with player-requested Electronic Review, Live Electronic Line Calling, or neither?

The label matters. A Time Violation, a Code Violation for Delay of Game and an authorised medical interruption can produce different clocks and different penalty sequences.

The physiotherapist—not the player—authorises treatment time

Grand Slam Regulations Article I.W.3 defines an acute condition as a sudden illness or musculoskeletal injury during the warm-up or match that needs immediate attention. A non-acute condition develops or is aggravated during the warm-up or match but can be assessed at the next changeover or set break.

The player requests the Sports Physiotherapist through the chair umpire. Ordinarily the evaluation occurs at the next changeover or set break; play stops immediately only when the condition is acute and requires it. The evaluation lasts a reasonable time, balancing safety against continuous play. It is separate from the medical timeout and may occur off court or with the Tournament Doctor.

The clock starts when treatment is ready to begin

A medical timeout begins only when the Sports Physiotherapist has completed the evaluation, decides extra treatment time is required and is ready to treat. It is limited to three minutes of treatment. If taken at a changeover or set break, the timeout is additional to the ordinary changeover or set-break time.

One timeout is allowed for each distinct treatable medical condition. All manifestations of heat illness count as one condition, and linked musculoskeletal problems in the same kinetic chain count as one condition. Two consecutive timeouts are possible only where the medical assessment identifies at least two distinct acute, treatable conditions.

Fatigue, unchanged conditions and cramp are not ordinary medical timeouts

Under Grand Slam Article I.W.3, general fatigue is non-treatable. So is a condition that did not develop or worsen during the warm-up or match, cannot be improved within the available treatment time, or requires an injection or intravenous infusion, subject to the rule’s certified diabetes exception. No medical timeout is authorised merely to recover condition.

Muscle cramping has its own rule: it may be treated only during changeovers or set breaks, with a total of two full change-of-ends treatments in the match. If severe cramp prevents a player reaching the next changeover, the player may concede the necessary points or games to get there. If cramp is one symptom of medically diagnosed heat illness, it may be treated as part of the heat-illness treatment.

Changeover treatment and bleeding are separate allowances

On-court treatment or supplies may also be given during a changeover or set break. The Grand Slam rule treats two such changeovers or set breaks per treatable condition as a guideline; they need not be consecutive and may come before or after the medical timeout.

Bleeding is a safety exception. The chair umpire must stop play as soon as possible and call the Sports Physiotherapist. On medical request, the authorised official may allow up to five minutes in total to control the bleeding. Play cannot resume until blood on the court or immediate vicinity has been cleaned appropriately.

“Treatment complete” does not create recovery time

The ITF 2026 officiating procedure gives the player the time needed to put necessary clothing and supports back on, after which the chair umpire announces “Time”. If play has not resumed within 30 seconds, the delay is a Code Violation for Delay of Game under the applicable Point Penalty Schedule. Treatment ending early means play resumes early; there is no right to use the unused portion of the three minutes.

Abuse of the medical rule can instead be treated as Unsportsmanlike Conduct. That judgment is about the player’s conduct, not a public finding that the player was or was not genuinely injured.

Grand Slam allocations differ by match category

• Women’s singles: one authorised toilet/change-of-attire break per match.
• Women’s doubles and mixed doubles: two authorised breaks per team; partners leaving together use one team break.
• Men’s best-of-three singles: one toilet break.
• Men’s best-of-five singles: two toilet breaks, but only one may be taken during the first three sets; the second is available only after the third set.
• Men’s best-of-three doubles: one break per team; partners leaving together use that break.

A departure after the warm-up has started counts as an authorised or additional break even if the opponent also leaves.

Three minutes inside the toilet; travel time is separately managed

At a Grand Slam the toilet clock is three minutes from entry into the toilet until exit. A change-of-attire break, alone or combined with a toilet break, is five minutes from entry into the changing area/toilet until exit.

Women may take a toilet-only break on a set break or before their own serve; attire-only and combined breaks are on a set break. Men’s authorised toilet and attire breaks are on a set break. The stated three or five minutes measures time inside the toilet or changing area; the 2026 ITF procedure describes the authorised departure as lasting a reasonable time overall.

An extra visit may be allowed, but the clock keeps penalising delay

Exceeding the allowed time, taking an additional break, or taking one at a non-permitted time does not necessarily mean the official physically prevents the player leaving. The 2026 Grand Slam rule permits the departure but uses back-to-back Time Violations while the player is not ready: a warning if the player has no earlier Time Violation, followed by successive point penalties. Only warnings and point penalties—not service faults—apply to this toilet-break sequence.

This differs from being slow after medical treatment, which the Grand Slam rule expressly sends to the Code’s Delay of Game ladder.

Ordinary pace uses a separate warning–fault/point sequence

Grand Slam Code Article III.J allows 25 seconds between points, 90 seconds on a changeover and 120 seconds at a set break. The first ordinary pace violation is a Time Violation warning. A later Time Violation is a fault when the player is serving and a point penalty when the player is receiving. A receiver can be penalised before 25 seconds expires if delaying the server’s reasonable pace.

That sequence is not the Code Violation ladder. Where delay results from a medical condition, refusal to play or failure to return within the allowed time, Article III.J directs the official to a Code Violation for Delay of Game.

Misconduct normally escalates warning, point, then game

Grand Slam Code Article III covers categories including audible or visible obscenity, abuse of balls, racquets or equipment, verbal or physical abuse, and unsportsmanlike conduct. Article III.S applies the match penalty schedule: first Code offence—warning; second—point penalty; third and each later offence—game penalty.

The ladder is cumulative across Code offences, so a warning for racquet abuse can make a later verbal-abuse offence the point-penalty stage. After the third Code Violation, the Referee, in consultation with the Grand Slam Chief of Supervisors, decides whether each later offence warrants default.

A serious single act does not have to start with a warning

Grand Slam Code Article III.T permits the Referee, in consultation with the Grand Slam Supervisor, to default a player for one violation or through the normal schedule. The ITF’s 2026 officiating guidance describes bypassing the ladder as a serious step reserved for severe and flagrant misconduct.

A default is therefore discretionary within that standard, not an automatic fourth rung. On-court score penalties and later fines or disciplinary consequences are also separate decisions; a warning during the match does not establish the eventual off-court fine.

A traditional line challenge must be immediate

Where a court uses the ITF player-requested Electronic Review procedure, a request is allowed on a point-ending shot or when the player stops during the rally; returning the ball is permitted only if the player then stops immediately. The chair umpire may refuse an untimely or unreasonable request.

Each player or team receives three unsuccessful reviews per set plus one additional review in a tie-break. Successful reviews are unlimited. A match tie-break counts as a new set with three reviews. If the system cannot decide, the original call or overrule stands; the review outcome announced by the chair umpire is final.

Live ELC is not the same as having three challenges

The 2026 ITF Duties and Procedures distinguishes traditional review from Live Electronic Line Calling (Live ELC), where no line umpires are present and the system makes line calls automatically. Under the Live ELC procedure, a player may stop immediately during a rally and ask for review, or request review of a point-ending shot. The three-unsuccessful-review allocation belongs to the separate player-requested Electronic Review procedure and should not be assumed on a Live ELC court.

If Live ELC stops functioning, the match must initially stop. The Referee or Supervisor decides whether to wait, move courts, use line umpires if available, postpone, or continue with the chair umpire calling all lines. Technology failure does not automatically award a replay or let the players choose the replacement procedure.

A review answers the line fact, not every dispute about the point

Under Grand Slam Regulations Article I.U, whether a ball landed in or out is a Question of Fact. On-court factual determinations bind the players and Referee, subject to the applicable electronic-review or clay ball-mark procedure. A player cannot take an ordinary factual appeal to the Referee.

A Question of Tennis Law is different: it concerns how the rules apply to the established facts. The chair umpire rules first, and a player may professionally request the Referee’s ruling. Electronic line review does not decide whether the correct penalty ladder was used, whether a let follows, or whether a rule was interpreted correctly.

A ball-mark inspection is another distinct procedure

The ITF 2026 procedure permits ball-mark inspections only on clay. A player may request one on a point-ending shot or by stopping immediately during the rally, and the chair umpire inspects the mark. If the mark cannot be located or read, the original call or overrule stands; once the chair umpire rules on the mark, that factual decision is final.

Do not infer from the word “challenge” that every Grand Slam court uses the same technology or allocation. The appointed event and court procedure controls.

An ankle injury occurs at 2–2, 15–30

Situation: a player rolls an ankle during a rally and cannot safely continue to the changeover.

2026 Grand Slam ruling: the player requests the Sports Physiotherapist through the chair umpire. Because the sudden injury may be acute, evaluation may take place immediately. If the physiotherapist finds a treatable condition and authorises extra treatment, the three-minute clock begins when treatment is ready to start—not when the injury happened or when the call was made.

Cramp stops a player before the next changeover

Situation: the Sports Physiotherapist determines that the problem is muscle cramping, not an acute injury or heat illness, and the player cannot continue the game.

2026 Grand Slam ruling: no medical timeout is available for cramp. The player may concede enough points or games to reach a changeover or set break and then receive one of the two permitted full change-of-ends cramp treatments. The decisive fact is the medical classification, not how painful the symptoms appear.

A player is still not ready after treatment

Situation: after an authorised medical timeout, the player replaces an ankle support, the chair umpire calls “Time”, and 30 seconds pass without play resuming.

2026 Grand Slam ruling: issue the applicable Code Violation for Delay of Game. If the player has no earlier Code offence in the match, this is a warning; if there was already a racquet-abuse warning, this becomes a point penalty. It is not treated as the player’s first ordinary Time Violation.

A late line challenge after another shot

Situation: on a player-requested Electronic Review court, a player thinks a baseline ball was out, plays two more shots, then stops and asks for review.

2026 ITF procedure: the chair umpire may refuse the request as late. During a rally the player may return the disputed ball but must then stop immediately. Continuing the rally removes the option to wait for its later outcome before challenging.

The review image is unavailable

Situation: a timely challenge is accepted, but the Electronic Review system cannot produce a decision.

2026 ITF procedure: the original call or overrule stands. The point is not automatically replayed and the chair umpire does not substitute a personal guess for the missing review result.

What to check outside a 2026 Grand Slam

Start with ITF Rule 29, which supplies the continuous-play baseline and permits one three-minute timeout for a treatable condition while leaving limited toilet/change-of-attire breaks to announced event rules. Then check the sanctioning body’s current regulations for who may evaluate the player, lower-level extensions, toilet allocations, heat rules, the applicable Code and the line-calling system.

For example, the 2026 ATP Rulebook also uses a three-minute treatment limit and one timeout per distinct treatable condition, but permits the Supervisor to extend treatment at professional events with prize money of $50,000/€43,000 or less. The ITF’s 2026 general procedure has a different lower-event threshold: non-professional events and professional M15, M25, W15 and W35 events. Those exceptions do not extend treatment at a Grand Slam.

Five shortcuts that produce the wrong ruling

• “The physio arrived, so the three minutes started”: the timeout starts when evaluation is complete and treatment is ready to begin.
• “Every physical problem earns three minutes”: fatigue, cramp and non-treatable conditions do not.
• “Every late return is a time warning”: delay after medical treatment enters the Code’s Delay of Game schedule.
• “Every Code category gets its own warning”: Grand Slam Code offences accumulate on one match ladder.
• “Every electronic court gives three challenges”: that allocation belongs to player-requested review, not automatic Live ELC.

Controlling 2026 source material

• Grand Slam Tennis — 2026 Official Grand Slam Rule Book — Tournament Regulations Article I.K, U and W.3–4; Code of Conduct Article III.J–T.
• ITF — Duties and Procedures for Officials 2026 — Part II.B–C and E.4, Electronic Review Procedures, Live ELC duties and Appendix C medical-timeout timing.
• ITF — 2026 Rules of Tennis — Rule 29 (Continuous Play) and Appendix VII (ball-mark and Electronic Review procedures).
• ATP — 2026 Official Rulebook, Chapter VII: The Competition — medical rule and lower-prize-money extension in Section VII.R.

Source note: checked on 28 August 2026 against the 2026 Grand Slam, ITF and ATP documents linked above. The linked Grand Slam and ITF documents identify themselves as the 2026 editions but do not state a separate commencement date. The Grand Slam rules are the primary scope. Tournament instructions and the technology appointed to a particular court may supplement the baseline; this page does not apply tour-specific variations to a Grand Slam by analogy.