Rublev was feeling sick all week but rallied to beat Felix Auger-Aliassime in three sets on Sunday and clinch his second Masters 1000 title.
Rublev won 4-6, 7-5, 7-5 after Auger-Aliassime double-faulted on the last point of the final at the clay-court tournament in the Spanish capital.
Rublev gave “full credit to the doctors,” who were “doing some tricky things” just to make sure he could play.
The 26-year-old Russian won his first Masters 1000 title at Monte Carlo last year. Auger-Aliassime was playing in his first final at this level.
Rublev entered Madrid on a four-match losing streak after early exits at Indian Wells, Miami, Monte Carlo and Barcelona. One of his victories in Madrid came in the quarterfinals against home-crowd favorite Carlos Alcaraz.
He now has 16 career titles, and two this season after Hong Kong in January. He had arrived with a 5-1 record against Auger-Aliassime, including a win in their sole matchup on clay.
Auger-Aliassime’s path to the final saw second-ranked Jannik Sinner withdraw because of an injury ahead of the quarterfinals, and Jiri Lehecka retired against the Canadian in the first set of the semifinals.
Other injuries hit the men’s draw in Madrid, starting with Novak Djokovic’s withdrawal before the tournament. Daniil Medvedev retired in the quarterfinals, while Alcaraz was hampered by a sore right arm and Rafael Nadal bowed out of what was likely his last appearance in his home country.
Iga Swiatek won the women’s title for the first time in her career on Saturday.
