• What the Deuce

Roddick running on empty

Andy Roddick is set to slip out of the top ten © PA Photos

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"It's deep in the chest. It's not even so much nasally or throat or anything, it's just when I laugh, I start sounding like a car trying to start," said Andy Roddick after his second-round defeat to Pablo Cuevas in Miami.

A bronchial complaint has been troubling the American No. 1 for a number of months, as the gruelling nature of a decade on the tour begins to take its toll on Roddick's body.

Like a faithful old car that has hundreds of thousands of miles on the clock, Roddick has done the mileage and has the silverware to prove it. He finished the year in the top ten for the ninth straight year in 2010 (a feat only equalled by Roger Federer), has 30 titles to his name and has won nearly $20 million in prize money.

But even with the most reliable automobile, the years begin to show and things begin to go wrong. Last year it was mononucleosis, the year before a knee injury kept him out of action. Just a year ago What the Deuce was waxing lyrical about Roddick's performance at Miami, but following the defending champion's failure to reach the third round this time around, it could signal the beginning of the end.

When the rankings are published on Monday, Roddick will drop outside the top ten for only the third time in his career - but it could be for the last time - and he could see his status as American No. 1 snatched from his grasp at the same time.

While Roddick was unceremoniously dumped out in his opening match, his best friend and former school-mate Mardy Fish eased into the third round with a hard-earned victory over Richard Gasquet.

While Fish is unlikely to have enough in the tank to navigate his way past Juan Martin del Potro, a semi-final appearance in Miami would be enough to see him leapfrog his old buddy A-Rod. That there will be no American men in the top ten is pretty humiliating for a tennis-proud nation like the USA - but the short-term future does not look bright.

While at 28 Roddick could expect to see his time as the nation's No. 1 coming to an end, even more concerning is that his likely successor to the throne is not some young upstart, but 29-year-old Fish - a player with such a pocked history one that even the most silver-tongued second-hand car salesman would fail to smooth over.

Roddick could be replaced as American No. 1 © Getty Images

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Having failed to beat Roddick in nine consecutive meetings between 2003 and 2008, Fish has now won their last two meetings, and he could be set to overtake Roddick at the top of the American pecking order - but the question remains - where is everyone else?

While Ryan Harrison may be the future of American tennis, the 18-year-old has a couple of years before he will be expected to make any real impact on the top ten, but in the meantime the likes of John Isner and Sam Querrey have failed to live up to expectations.

American men have won 51 men's singles grand slam titles in the open era - more than double that of any other country, but the country that produced the likes of John McEnroe, Pete Sampras and Andre Agassi has not seen a slam in American hands since the 2003 US Open, when a 21-year-old Roddick stormed to the title before finishing the year as world No. 1.

Despite being an ever-present member of the men's elite group for the best part of a decade, Roddick has failed to emulate his early success. Three Wimbledon finals and three defeats to Federer may have something to do with it, but the reality is that Roddick could be hard-pressed to fight his way back into the top ten.

With little hope of picking up too many points on the clay, Roddick will be looking to the grass court season for a much-needed boost. Gunning for a record fifth title at Queen's, Roddick needs a strong grass campaign or risk slipping futher down the rankings.

If he had his way Roddick would add another month to the grass season. But he suffered defeats to lowly-ranked Dudi Sela and Yen-Hsun Lu and in August he slipped to No. 13 in the world rankings - his lowest ranking since 2002.

If Roddick is to pass his proverbial MOT this year, his month in London this summer could be the difference between a pass and a fail.

© ESPN Sports Media Ltd.