UPDATED Marc Marquez to step back from MotoGP and undergo a fourth arm operation

Updated with further quotes from Marc Marquez.

The decision, announced after qualifying for the Italian Grand Prix, has been made due to ongoing struggles with the upper arm bone he fractured in 2020.

Marquez will travel to the Mayo Clinic in Rochester, Minnesota on Tuesday, May 31 for surgery, under the direction of Dr. Joaquin Sánchez Sotelo. He will then return to Spain to begin his recovery.

Marquez’s Repsol Honda team manager Alberto Puig said: "18 months ago Marc had his last surgery on his right humerus and since then it has been a long process of rehabilitation, hard work with his medical crew in Madrid. And of course we have been making quite a lot of progress.

"Unfortunately his position on the bike is not what he really needs to race as he wants to race and match his expectations on a GP weekend.

"So after analysing with the medical doctors, with the group, and consulting with another doctor that is connected with our doctors in Spain, in the Mayo Clinic in Rochester, Minnesota. Finally yesterday we had the news that surgery can be done.

"The surgery can be done right now because the bone is ready now. In the past it was not ready, it was soft, and it was not recommended. But now it's recommended. And finally, we decided yesterday that this can be done and for that reason Marc will stop after this Grand Prix. And will take a break and will have this surgery in the US.

"It has been a long period for him, a lot of suffering and we want to thank him for his effort during all this time, because he suffered a lot. But we all believe that it's the correct timing.

"Just for you to understand, the surgery will consist of the extraction of the osteosynthesis material on the right shoulder, also together with humeral osteotomy to improve the external rotation, movement of the arm, and to fix the stability in the shoulder.

"That's the situation."

• Aprilia’s new F1-style rear wing ‘makes a difference’
• Miguel Oliveira ‘will consider’ Tech3 return, but...
• RNF swaps Yamaha for Aprilia in 2023 season

Marc Marquez: 'I’m suffering a lot, cannot ride like I want'

Marquez, who walked away from a nasty highside on a damp track in qualifying at Mugello, then added:

“As Alberto says, I will have surgery next week. It’s true that since I had the first injury with my right arm everything was really complicated, plus the infection was the worst thing. The doctors did an amazing job 18 months ago to take care of that infection and to recover my bone.

"It was a success, but it’s true that since I came back riding the bike I feel big limitations. Even like this I never gave up and kept pushing, working, doing what the doctors' said.

"But I realised this season that I don’t enjoy [riding now]. I’m just suffering a lot. A lot of pain. I don’t have power. I cannot ride like I want. I also start to injure the left shoulder because I’m pushing too much with the left arm.

"My performance is not bad, but it's not the one that I want. So together with the doctors we've been evaluating for a long time - even in October, when I had the first injury with my vision, I said to them ‘why we don't consider to make something in that arm?’. But the bone was not fixed completely then and they said the risk is too big. 

"Then I come back. I work a lot during these four months. But I don't see any improvement.

"Then I had another meeting after Jerez where we evaluate everything again. And then they start to consider another operation. It’s difficult and I gave all I could to avoid that operation, because to open again the arm is something that I don’t want. But it's the way to recover.

"One of the best things is that the problem is clear. It's a very big rotation in the arm and as you see my riding style is not the same one, not because of the bike, it's because of me. My right arm, even in the left corners, is not in a natural position.

"But even like this, I was able last year to win races, so for that reason this year I tried. But after that [post Jerez] meeting, Samuel Antuña [from my medical team] analysed deeply, and they saw that the rotation was very big. Then Samuel Antuña told me you must do this surgery in Clinica Mayo by Dr Joaquin Sánchez Sotelo, because he believes that he’s the best in the world.

"It looks like a nightmare. But I believe that soon I will come back. It will be hard. I know that. I don't know the [recovery] time. But the moment to do it is now because for them there is no doubt. There is a problem, the rotation is too big and. We will see if we can come back soon. But no rush."

Marquez admitted he had ‘lied’ when asked about the possibility of a fourth operation when asked earlier in the weekend, but insisted the final decision was only made after a call from America on Friday.

"You will not believe me, maybe. But I had a phone call yesterday at 12. Between one practice to the other one. Because in Mayo, Dr Joaquin Sánchez Sotelo was printing my bones in 3D, just to evaluate exactly, which was the rotation.

"And at 12 o'clock, he called me and said 'no doubt. Come. The rotation is too big. I don't know what you're doing but come here and we will fix it'. There will be an operation, so everything can happen, but they believe a lot in this."

Marquez warns recovery 'will be a long time'

Marquez didn't want to speculate on when he will be fit to return, but admitted it will be a 'long time'.

Given the delicate nature of his arm, many expect him to be out of MotoGP action for at least several months and he is now thinking in terms of preparations for 2023.

"I don't have any idea. Because the doctors say to me after the surgery, we will go step by step. But it will be a long time of course," Marquez said. "But the time to do it is now, because for me there is no way to ride like this and suffer too much. I'm not enjoying it and every weekend is a nightmare, just to keep pushing.

"Even like this, and riding like this, I know that I can be on the podium in some circuits. But it's not the way that I want to ride because I'm suffering a lot and I am creating another injury. I cannot continue riding like this.

"But my goal is the same, to come back and the way to do things now is just to prepare for 2023. I want to say thanks to Honda because they respect a lot the decision and they support me a lot."

Marquez: 'Without my strong character, I would have given up'

The run of arm operations followed major surgery on each of his shoulders, at the end of 2018 and then 2019, plus two rounds of recovery from double-vision issues, in October 2021 and March 2022.

"Always one of my strong points is just to be really strong in the mind. And believe me, if I don't have this character, during this time I would just give up. But if you want something, you need to believe in it, and you need to keep pushing," Marquez said.

"But I know what I have, I know what my limitations are, and I know which are my skills. But now I cannot take profit.

"I felt the limitation since preseason. But then in Portimao, Jerez, the Jerez test, I just was able to do 20 laps again so I didn't feel any improvement.

"Doing surgery now in the middle of the season is not the best way of course, but is the best way for my future.

"This is what I believe and is what we will do, because the doctors also say to me ‘please stop and come’."

The eight-time world champion originally sustained the broken right humerus in the closing laps of the 2020 season-opener at Jerez.

Marquez had the fracture plated a few days later, on July 21. However, the plate then failed due to stress accumulation caused by an attempt to return to action the following weekend.

A new plate was fitted on August 3, but as the recovery dragged on it became clear all was not going to plan and a third operation - lasting 8 hours and including both a new plate and bone graft - was subsequently needed on December 4, 2020.

During that surgery, infection was confirmed as having caused the previous healing problems, resulting in the need for lengthy antibiotic treatment.

After nine months on the sidelines, Marquez was finally passed fit to make a MotoGP return at Portimao in April 2021.

Struggling with both his reduced physical condition and handling issues for the Honda RCV, Marquez persevered to take an emotional first win since 2019 at Sachsenring in June.

Further victories followed later in the season at COTA and Misano, also on his favoured left-hand tracks, before a recurrence of diplopia forced the #93 to miss the final rounds.

Despite his extended winter break, Marquez has continued to struggle physically in 2022, often speaking of trying to adapt his riding style due to the arm pain and needing to save energy whenever possible during each race weekend.

Marquez just 10th in MotoGP world championship

Nonetheless, after a stunning start to the season for team-mate Pol Espargaro and the all-new RCV in Qatar, Marquez has again emerged as Honda’s stand-out rider (despite another dose of diplopia in Mandalika).

But Marquez is not among the ten different riders to have finished on the podium this season and is currently just tenth in the world championship, 48 points from Fabio Quartararo.

With the exception of his long favoured left-hand tracks such as COTA, Marquez has often spoken of 5th-7th place as a best-case scenario, due to the new bike’s turning difficulties and his own reduced physical capabilities.

Progressing through Qualifying 1 after a tow from Jack Miller, a frequent sight since Marquez’s injury comeback, the Repsol Honda rider was left 12th and last in Qualifying 2.