(CNN) Rafael Nadal suffered a shock defeat on clay in the Monte-Carlo Masters semifinals, going down 6-4 6-2 to Italian Fabio Fognini.

The defeat, in particular the second set which saw Nadal save five match points to avoid a bagel, will raise questions about the Spaniard's health heading into next month's French Open.

A knee problem meant the 32-year-old had to pull out of a semifinal against Roger Federer at last month's Indian Wells and forced him to withdraw from the Miami Masters a week later.

Seeking a 12th title in Monte-Carlo, cracks were perhaps beginning to show in the previous round, as Nadal had to battle back from 4-1 down in the first set against Guido Pella, before eventually taking it on a tie break.

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