Novak Djokovic falls to Alejandro Tabilo in Italian Open upset

Novak Djokovic put on one of his worst performances at one of his favorite tournaments as he was upset by 29th-seeded Alejandro Tabilo in the third round of the Italian Open on Sunday.

It was Djokovic's first match since accidentally getting knocked on the head by a water bottle while signing autographs after his opening win Friday, and he said the "unfortunate" incident affected him on court.

"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 said at a news conference, adding that he would go for scans later. "I managed to sleep OK. I had headaches. The next day, or yesterday, was pretty fine, so I thought it's OK. Maybe it is OK, 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."

Djokovic started off with a double-fault, and it didn't get much better for the six-time Rome champion.

The top-ranked Djokovic lost his first two service games and went on to lose the match 6-2, 6-3 in 68 minutes, handing Tabilo the victory when he double-faulted -- his fifth of the match -- as the boos rang out at the Foro Italico.

It was an unusually off-key performance from the 24-time Grand Slam champion as he tries to step up his game on clay before attempting to defend his title at the French Open, which starts May 26. He has played only six matches on clay this year.

Asked about his French Open chances, Djokovic said: "Everything needs to be better for me to have at least a chance to win it."

Djokovic was broken four times Sunday and didn't have a break opportunity in the match. He had 12 unforced errors to Tabilo's four and produced 14 winners to his opponent's 22. It was also a rare occasion when he had zero break-point chances.

The third-round loss marked Djokovic's worst performance at the Italian Open. He had lost only once before to an opponent outside the top 10 at Rome, where he had never gone out before the quarterfinals.

"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 followed Rafael Nadal with an early exit after the record 10-time Rome champion lost his third-round match to Hubert Hurkacz 6-1, 6-3 on Saturday.

Djokovic remains without a title in 2024 -- the first time he has reached May without a trophy since 2018, when he was returning from a right elbow injury. He has failed to reach a final this year.

The victory made Tabilo, who won a Challenger Tour tournament two weeks ago, the first Chilean player in 17 years to beat a world No. 1 since Fernando Gonzalez beat Roger Federer at the ATP Finals in 2007.

"It's incredible. I came on court just looking around and soaking it all in, trying to process everything. I'm trying to wake up right now," Tabilo said.

Tabilo next faces 16th-seeded Karen Khachanov, who beat Francisco Cerundolo 6-2, 6-4.

In the women's tournament, second-seeded 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 reached the final at Roland Garros the same year, was upset by Slovakian qualifier Rebecca Sramkova 6-4, 4-6, 6-4.

The Associated Press and Reuters contributed to this report.