Since they exchanged breaks of serve in the second and third games, both have held serve, with Nadal now ahead 5-4, with Thiem serving next. Nadal pushed through the mysterious pain and held on against Thiem's impressive backhand returns and - at times - equally matching forearm volleys.
Nadal became the second player in tennis history to win 11 singles titles at any Grand Slam tournament after Margaret Court, who claimed 11 Australian Open titles.
Thiem broke the Spaniard's serve in the third game of the match, nullifying Nadal's early break but earned only one more break point - which was saved by Nadal.
He's won a record-setting 10 titles on the clay at Roland Garros and often finished off his final opponents in straight sets.
That said, Nadal is wary of Thiem's threat.
The seventh seed comes into the match with the reputation of being the only player to have beaten Nadal in the last two seasons.
Despite matching Nadal forehand for forehand, Thiem was undone in the 10th game when three errors handed Nadal the opening set after 52 minutes on court.
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Information from The Associated Press was used in this report. Once again, 18-time Grand Slam victor Martina Navratilova will lend her expertise and insight to ITV's team for the women's final and the team also includes 2013 Wimbledon champion Marion Bartoli, four-time Grand Slam victor Jim Courier, Andy Murray's former coach Mark Petchey, Fabrice Santoro, who played in 70 Grand Slams, and former British ladies number one Samantha Smith.
Wimbledon remains a target for the 32-year-old, however his camp will have seen the number of physical problems he's been forced to overcome over the course of the French Open.
Slow starts have plagued Nadal in several of his matches this fortnight, most notably against 11th-Diego Schwartzman in the quarterfinals. Another forehand victor from Nadal followed, and this time Thiem looked up toward his coach and yelled. After guzzling water during his visit from the doctor, Nadal was back to playing his unmistakable brand of almost unbeatable clay-court tennis.
The No. 7-seeded Thiem, a 24-year-old from Austria, is appearing in his first Grand Slam final.
Rafael Nadal claims record-extending 11th French Open crown
Nadal had another massage at 5-2 and he ended Thiem's ordeal on his fifth match point when the Austrian returned long. The duo have met nine times throughout their career, all on clay, with Nadal taking six meetings to Thiem's three.
As he powered his way to victory, Nadal sported the Nike Air Zoom Cage 3 sneaker.
Many consider Thiem to be the second-best clay-court player in the world.
The forecast says there is a chance of rain.
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The liquid goes through a series of steps that include freezing it into pellets and then transforming it into a slurry. While the process requires a lot of electricity, the pilot plant in Squamish uses renewable hydro power.