WWE Champion John Cena vs. Ryback ended in a No Contest (Last Man Standing Match)

John Cena persevered through a nearly 18-month title drought before reclaiming the WWE Championship at WrestleMania, but if Ryback has his way, Cena’s 11th WWE Title reign will come to a quick and unceremonious end at Extreme Rules.

Watch Ryback's incidents of uncontrollable rage | How to watch WWE's most extreme show

The bald-headed shredder — arguably WWE’s most dominate competitor of the last year — will receive first crack at the new WWE Champion at the May 19 pay-per-view, and the golden opportunity will go down on Ryback’s terms, in a Last Man Standing Match. The stipulations could prove unfavorable for The Champ, who suffered an injury to his Achilles tendon while competing in Europe in April.

Watch Ryback choose a Last Man Standing Match.

As exciting as this first-time singles contest would be under ordinary conditions, the title bout is made all the more intriguing by its personal overtones and Ryback’s claim that he is looking to break out of The Champ’s sizable shadow, not to mention the dangerous addition of Last Man Standing rules. In such matches, there are no disqualifications, count-outs, pinfalls or submissions. The only way to win the match is by incapacitating your opponent to the point he is unable to answer the referee’s count of 10.

It was only last October that Cena labeled his Extreme Rules opponent as the “change” that the WWE Universe craved. At the time, the Shell-Shocking Superstar was on the verge of unseating then–WWE Champion CM Punk, but bizarre circumstances — ranging from a crooked ref to outside interference from the likes of The Shield — repeatedly prevented him from doing so. Since his  last title opportunity in January, Ryback has slowly drifted out of WWE Championship contention, while Cena’s career has taken the opposite path.

Following his shocking ambush of Cena on the April 8 Raw, the new No. 1 contender has stopped just short of outright blaming The Champ for his own stalled momentum, although he has questioned the Cenation leader’s loyalty. Noting that he came to Cena’s rescue during several sneak attacks by The Shield, Ryback says Cena failed to return to the favor when it mattered most — first during during Ryback's title match against Punk and then again during the final moments of a losing effort against the black-garbed trio at Elimination Chamber.

See photos of The Shield vs. Cena, Ryback & Sheamus

Ryback has since portrayed Cena as a self-preservationist who has little regard for those around him. Even though members of the Cenation would likely take exception to that portrayal, given it was Cena who advocated for Ryback’s first title match at WWE Hell in a Cell, one must wonder whether The Champ will suffer the consequences of his perceived missteps when the bell rings on May 19.

With their friendship perhaps irreparably frayed, Cena and Ryback are headed for a collision course at Extreme Rules, and questions about the big fight abound. Will the omnipresent Shield get involved, or was their April 15 assault on Cena part of an agenda that’s wholly unrelated to the WWE Title scene? Will Ryback maintain focus on winning the match and the championship gold, or will he enter St. Louis’ Scottrade Center with a primary objective of punishing Cena? Most importantly, is The Champ’s 11th WWE Title reign destined to end prematurely, or will the Cenation leader stop Ryback in his tracks?

The WWE Universe can witness Cena and Ryback’s WWE Championship clash when Extreme Rules  airs on pay-per-view Sunday, May 19, at 8 ET/5 PT.

ST. LOUIS — Ryback and WWE Champion John Cena threw everything they had at each other during Extreme Rules’ Last Man Standing Match.When the dust settled, it was clear both Superstars had hit the wall – figuratively and literally – and no man was left standing.

Who was the better competitor Sunday night? That remains a subject of debate. On the minds of the entire WWE Universe, meanwhile, is the well-being of the two match participants.

The bout was ruled a No Contest after 20-plus minutes of hard-hitting action culminated with a spectacular collision that not only brought the bout to an end, but also endangered the near-term careers of the WWE Champion and his top contender. While fighting on the entrance stage, Ryback bulldozed the Cenation leader through the entrance stage wall, sending sparks from broken light bulbs flying in the process.

View photos of the mayhem |  Watch John Cena refuse medical attention

Although the rules of the contest stipulated the winner must incapacitate his foe to the point of being unable to respond to a 10 count, official Charles Robinson had no choice but to rule the match over when neither The Champ nor Ryback could rise to his feet.

As WWE officials and medical personnel rushed to tend to the battered warriors, the WWE Universe inside Scottrade Center buzzed with excitement over the scene that transpired. Although it is too early to know the condition of either Superstar, Cena was removed from the scene on a stretcher, while Ryback left with assistance from officials. On the Extreme Rules Post-Show, cameras caught Cena removing his neck brace, getting off the gurney under his own power, and refusing further medical attention.

It was clear from the get-go that the Cenation leader was competing at less than full health. To even fight in the No-Disqualification, No-Count-out Match in the first place, The Champ courageously had to battle through a lingering Achilles tendon injury that would portend trouble in the most conventional of match types, let alone a Last Man Standing Match.

As it turns out, Ryback did not need to exploit Cena’s heavily taped ankle to gain an early upper hand. At the bout’s outset, the matchup looked wholly lopsided in the challenger’s favor.

Ryback plowed through Cena with his powerhouse offense. Although The Champ attempted his tried and true combinations, the effort seemed almost futile: Ryback brushed off Cena’s classic bulldog variation and ran through The Champ with a Lou Thesz press variant.

The top contender easily maneuvered the outsized Cenation leader. Screaming “easy” as he lifted Cena overhead in a gorilla press slam, Ryback demonstrated his power time and time again. He used a deadlift powerbomb on Cena, as well as a fallaway slam through a table. The latter impact kept the tenacious Cena down for a count of eight.

Ryback averted an Attitude Adjustment and connected with his “Meat hook” Clothesline, but a second attempt at his well-known lariat was reversed into an STF by the cagey WWE Champion. Cena appeared to knock Ryback unconscious, but the challenger made it to his feet at the count of nine.

What did the Raw managing supervisor say? |  Hear referee Charles Robinson's comments

Cena kept the momentum going when he countered a Shell Shocked into an Attitude Adjustment through a table — the second splintered table of the contest. Living up to his indestructible reputation, Ryback made it to his feet with one second left on the referee’s count.

As the action spilled into the WWE Universe, fans in the Scottrade Center got a close-up view of the heated battle. In fierce impact, Ryback slammed a piece of board, seemingly from a penalty box, against Cena’s skull. The Cenation leader joined his opponent in pulling out all the stops, later leaping out of the stands to splash Ryback through yet another table. The strategic Cena then got hold of a fire extinguisher, which he used to chase Ryback onto the stage. Two successive strikes with the fire extinguisher almost dropped Ryback for good.

Then, with Ryback positioned for an AA on the stage, fate took a turn for the worse, with Ryback spearing Cena directly into the set. EMTs were called for almost immediately as officials inspected the two warriors’ prone bodies.

Theodore Long comments on being first to arrive on the scene

The scary conclusion of the WWE Championship Match leaves in question the status of the WWE Championship scene and Ryback’s position as the top contender. As details emerge about the extent of any injuries suffered tonight, the WWE Universe is left to wonder just how the Cenation leader will recover from his first defense on pay-per-view of his 11th WWE Championship.