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Djokovic in Rome shocker after water bottle incident

Novak Djokovic's performance was so poor in his early Italian Open exit that even the 24-time grand slam champion admitted it was "concerning."

World No.1 Djokovic put on one of his worst displays at one of his favourite tournaments as he was upset by 29th-seeded Alejandro Tabilo in the third round in Rome on Sunday.

It was his first match since accidentally getting hit on the head by a fan's water bottle dropped while he was signing autographs after his opening win on Friday.

"That has really impacted me a lot. After that, I got medical care, been through half-an-hour, an hour of nausea, dizziness and blood," Djokovic told a news conference, adding that he would go for scans later.

"I managed to sleep okay. I had headaches. The next day or yesterday was pretty fine, so I thought it's okay. Maybe it is okay. Maybe it's not.

"The way I felt on the court today was just completely like a different player entered into my shoes. Just no rhythm, no tempo, no balance whatsoever on any shot. It's a bit concerning."

The six-time Rome champion lost his first two service games and went on to lose the match 6-2 6-3 in just 68 minutes, handing Tabilo the victory when he double-faulted amid boos at the Foro Italico.

The third-round loss marked Djokovic's worst performance at the Italian Open as he followed Rafael Nadal to an early exit after the record 10-time Rome champion lost his third-round match to Hubert Hurkacz 6-1 6-3 on Saturday.

While Djokovic had said he was "fine" after the water bottle incident, it was an unusually off-key performance before he attempts to defend his title at the French Open, which starts on May 26.

"I was going for kind of easy training yesterday. I didn't feel anything, but I also didn't feel the same," Djokovic said.

"Today under high stress, it was quite bad - not in terms of pain, but in terms of this balance. Just no coordination. Completely different player from two nights ago ... I don't know. I have to do medical checkups and see what's going on."

Djokovic is still without a title this year - the first time he's reached May without a trophy since 2018, when he was returning from a right elbow injury.

Third-seeded Alexander Zverev advanced after the 2017 Rome champion beat Luciano Darderi of Italy 7-6 (7-3) 6-2. Grigor Dimitrov and Thiago Monteiro also advanced, while Taylor Fritz beat American compatriot Sebastian Korda 6-3 6-4.

In the women's tournament, Australian Open champion Aryna Sabalenka eased through to the fourth round with a 6-4 6-2 win over Dayana Yastremska.

American Sofia Kenin, who won the Australian Open in 2020 and also reached the final at Roland Garros the same year, was upset by Slovakian qualifier Rebecca Sramkova 6-4 4-6 6-4.

American Danielle Collins is safely through after beating Caroline Garcia 6-3 6-3. Also advancing in third-round matches were Maria Sakkari, Irina-Camelia Begu, Jelena Ostapenko, Victoria Azarenka and Elina Svitolina.