One year ago, Dominik Koepfer was at one of his lowest lows. The German lefty, beset by a mystery left arm injury, lost in the first round of qualifying at the US Open to Italian Raul Brancaccio, who was ranked outside the world’s Top 200.

“I already had accepted that my ranking was pretty sh***y. I’d already lost enough points by then. But it’s not fun,” Koepfer told ATPTour.com. “Everyone plays tennis to play at this site, to play these events and play in the main draws of Slams and that’s the most fun. It’s not fun to play in Mexico on Court 3 at a Challenger. It’s just different.

“It was definitely hard, it wasn’t easy. But you have to accept it and just treat every match the same.”

One year on, the former Tulane University star is ready to play World No. 1 and defending champion Carlos Alcaraz in the first round of the main draw at Flushing Meadows. Getting back to such a big moment has been full of adversity and, as the 29-year-old made clear, plenty of pain.

The trouble began in Vienna in October 2021. Just months earlier, Koepfer had reached a career-high No. 50 in the Pepperstone ATP Rankings. When the pain started, the lefty thought he would finish the year at the Rolex Paris Masters and take time off to recover. Even with pain in his left humerus (upper arm), Koepfer defeated Andy Murray and Felix Auger-Aliassime at the season’s final ATP Masters 1000 event and pushed Hubert Hurkacz to three sets.

“I played a great tournament, but the arm was done. I played with a lot of painkillers, got checked out there. They said there was nothing really wrong,” Koepfer said. “I took some weeks off, got an MRI, nothing was wrong and then went to Australia and couldn’t really serve the entire offseason. In Australia, they diagnosed it with bone bruise, which it never was apparently.”

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That was the beginning of what felt like a never-ending cycle. Koepfer would play with pain, take some time off, get several scans and learn nothing about what his injury actually was, rinse and repeat.

“No doctor really knows what it is. It’s probably instability in my shoulder and just maybe some nerve stuff too that’s a little stuck. Nothing really helped,” Koepfer said. “I’ve literally tried everything I could. There was no surgery you could do because if there’s no diagnosis, really, you can’t really do anything to fix it.”

Koepfer was able to hit three hours of forehands and backhands without issue. But as soon as he had to serve, everything began to hurt.

“The first 20 to 30 minutes were alright and then after that it’s just like a dead arm. You couldn’t swing really. And then it’s just throbbing pain I would describe it as. Even at night sometimes when I played too much, it was just constantly in pain and it was just not tolerable anymore,” Koepfer said. “If you break your arm, you know you’re going to get surgery and you’ll probably be fine in like two or three months. This is just on and off and not really knowing.

“It was frustrating to see a lot of different people. At every Slam I saw every doctor. I’ve seen so many doctors and physios and no one really could figure out what it actually was or what’s wrong with it. Still at this point, it’s just kind of a guessing game.”

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At the beginning of this year, as Koepfer’s Pepperstone ATP Ranking slipped as low as No. 262, he spent two months in Switzerland to rehab his arm and found exercises that helped with the pain.

At the end of March, Koepfer played an ATP Challenger Tour event in Mexico City, where he trailed a player ranked outside the world’s Top 400 in the first round of qualifying and nearly lost before pulling through in three sets. He ended up winning the title.

“It just took one win for me to play well again and have confidence and belief in myself,” Koepfer said. “It was crazy quick, I didn’t expect that. I was hoping that I would win some matches and get there really quickly, by the end of the year maybe.”

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Koepfer had hoped to earn his way into Roland Garros qualifying. Just months later, he is back to World No. 75 behind another Challenger title, two more finals and a run to the Los Cabos ATP 250 semi-finals.

Now the German will play inside the biggest tennis-only stadium in the world against Alcaraz, the top seed at the US Open.

“He’s not perfect. No tennis player is perfect. I’ve played Novak before, won a set against him. I played Roger, I’ve played those guys before. It’s a different feeling because it’s just the name that makes you a little more anxious or nervous or makes it more special to play them,” Koepfer said. “But he’s just a tennis player, too. He’s going to miss some like every other guy too. Obviously, he’s a little faster than most guys. But I will just go out there and have fun and try my best.”

Koepfer has a lot of respect for Alcaraz, whom he called “the best player to watch right now”. Considering where he was one year ago, the 29-year-old feels he has no pressure and can “swing for the fences”.

“I kind of see it as a payoff for the last year that I had. Just coming from 260, playing first round of qualies here and losing to playing on Ashe in the night session against the No. 1 in the world,” Koepfer said. “It’s a win-win situation. I have nothing to lose. I’m excited to play him.”