Kei Nishikori went from dominant to debilitated in a span of five minutes at the Japan Open on Wednesday as an injury forced him to pull out in the first set of his second-round match against Joao Sousa of Portugal.

With two service breaks in his pocket, Nishikori appeared to strain his back and immediately called a medical timeout with trainers lying him down and manipulating his lower left side.

When he returned to the court he was clearly hampered, but the home hero's pulling out seemed unimaginable as he battled on.