Running Isn't Supposed to Break Your Bones

What the Winter Olympics reveals about risk, control and overuse injuries...

There’s something beautifully humbling about watching the Winter Olympics as a runner.

You’re supine on the couch during an Australian summer, comfortably horizontal, snacks within reach, watching bodies fly, crash and spin at speeds that actively disrespect human anatomy. These are sports built on impact, chaos and accepted risk. And then you open Instagram to a confused algorithm showcasing the stark contrast of triple axles on ice, vs yet another post about the rise of bone stress injuries in distance runners.

For a sport that is, by comparison, repetitive, predictable and largely controllable, that disconnect feels worth talking about.

After last week’s onslaught of spotlighting the rise of bone stress injuries within the endurance athlete demographic, teamed with watching some truly horrific crashes on snow and ice, it got me thinking about how lucky we are as distance runners. A weird take, but stay with me.

Overuse running-related injuries are, for the most part, shaped by training, load and recovery, and very rarely require major surgery. There are always exceptions to this rule, like when I very embarrassingly got run over by an e-bike while jogging in Barcelona and ended up in a Spanish hospital with a dislocated jaw and unable to eat tapas for a week. Niche but true. And very unlucky.

Broadly speaking, with smart training, good nutrition, adequate rest, and consistent strength and mobility work, we can hold a relatively steady training graph. Easier said than done? Absolutely. But I’ve lived on both sides of this, through my work and through my own body. Not a flex, just the reality of a gymnast-turned-distance-running story arc which covers the full gamete of acute and chronic injuries, surgeries and fascial releases. Somewhat of a ‘fracture buffet’ if you will.

I’m speaking here both personally and professionally, having seen training, competition, rehab and fracture patterns from more angles than I would have liked. I’ve often kept my own injury stories quiet, partly because revisiting your past can feel indulgent unless it’s genuinely useful. And partly because it’s easier to tell people what to avoid than to pretend there’s a perfect formula.

Watching snowboarding, the luge and skating from a comfy couch through a Physio lens is confronting. These athletes are moving at speed, on ice, with forces that are chaotic and largely uncontrollable. One wrong edge, one variable they can’t control, and the injury is instant and obvious. Trauma injuries in these sports are violent, unavoidable and accepted as part of the risk. That’s what makes them so extraordinary to watch.

Running sits at the opposite end of the spectrum. It’s repetitive, predictable and largely self-governed. The risks are quieter. Which is exactly why overuse injuries feel so frustrating. They don’t happen in a moment. They accumulate slowly, through small decisions, training drift and ignored signals. And unlike a ski crash, they usually give us time, warning and choice. That contrast is the part I can’t stop thinking about.

I want it to be abundantly clear, this comparison between snow-sport trauma-based tibial fractures and sacral hot spots in runners is not meant to minimise the physical or emotional toll of any bone injury, regardless of cause. It’s simply a shift in perspective that may or may not resonate with you and your injury history. This is said with genuine empathy, spoken as a woman firmly inside a glass house who has spent more than her fair share of time on crutches, has multiple pins in her clavicle, and has written a solid volume of strength and return-to-run programs for orthopaedic patients as well as for overuse injuries. No bone injury is good. But there is a spectrum, and in my opinion, some sit on the more avoidable end, even if they are often harder to detect.

I was very young when I got my first fracture. I attempted a backflip off a homemade trapeze swing in the backyard, broke my elbow, and was put in a plaster cast by my dad. It was soon covered in signatures from family members and kinder mates saying “get well soon.” And I did. It was painful but clean, non-surgical, and nature did her job in six weeks.

At the other end of the spectrum, my first bone stress injury came when I switched sports as a uni student to distance running. It was a gnarly stress fracture through one of the bones in my pelvis and kept me off running for over 18 months. It was insidious in onset, tricky to diagnose, and very slow to heal. With the benefit of hindsight, I’d also say it was far easier to avoid.

Across 14 years in clinic, starting in gymnastics and later moving into distance running, I’ve worked with athletes far more talented than myself, chasing bigger goals, tolerating wilder training volumes, and performing at levels that often defy simple physics. Although I have zero knowledge around snow sports (besides working in a ski school at 20 where I was by far the worst skier on site, including the 3 year olds I was looking after), I’ve seen the similar power and impact demands within gymnastics. And as a contrast, I’ve lived & worked within & around distance runners & seen the toll of repetitive load of marathon training. Now, watching moguls (from bed) as an instant super fan, it’s got me thinking deeper about internal vs external load risks and obtusely about how it relates to some of the literal cracks we’re seeing in run training.

Getting to the start line of any race, summer or winter sport, is a celebration in itself IMO. But when it comes specifically to fractures, setting aside other injuries for a moment, endurance runners do have a genuine advantage. If we apply some basic preventative bone care, no rapid spikes in speed or volume, adequate recovery, nutrition, appropriate footwear, and consistent strength and mobility work, we really can run at a relatively low bone stress injury risk.

That’s part of the cathartic beauty of running. It’s repetitive, predictable and largely frontal-plane movement. We have far more control over our internal and external loads. Flipping off the side of a mountain or launching into a triple twizzle (?) with blades on your feet, landing on ice, is high risk no matter how talented you are. That risk is accepted, and it’s what makes those sports so diabolical and impressive.

Which does beg the question. If overuse fractures are relatively avoidable, why are we seeing such a sharp rise in them within the running community? We don’t have to accept bone stress injuries as just part of the sport. We can question them, diagnose them earlier, and put better strategies in place to reduce recurrence. This may sound idealistic, but with the current surge in running participation, it also feels necessary.

I’ve attached a no-BS list below. None of it is new and none of it is revolutionary, but it’s an easy-to-read summary that might help someone flag a budding fracture or, best case, avoid one altogether.

The goal is simple: help runners keep training, with fewer setbacks and more longevity. No back flips required.

No-BS Stress Fracture list:

To avoid:

- Big spikes in load

Volume, intensity, frequency or racing. Especially within a single run.

- Only running

Lash out, get creative. Strength, mobility and variation are non-negotiable. The purist training of ‘just running’ is repetitive bone overload.

- Ignoring pain

Especially pelvic pain. Night pain, pain on hopping, NSAID-reliance or gait changes = get checked.

- No rest days

Runners hate rest. Learn to love it. You’ll be in the game longer.

- Running streaks

Not heroic. Not physiological. Just risky.

- Multiple marathons every year

Bone load accumulates, even when fitness feels good. If you love to race, choose a variety of distances and terrain.

- Under-recovering

Sleep, nutrition, mobility and life stress all count. Recovery must match output.

If you get a bone stress injury:

- See a clinician

Not Google, not a coach, not chat. An actual professional.

- Rest properly

Genuinely stop. Pause cross training. Initiate a healing spike.

- Keep movement low-impact

More is not better. Quality is key

- Choose Joy

You’ll heal faster. You do not have to keep training if you don’t want to. Use free will. Know the off period is temporary, find a fun hobby.

- Load in the right order

Low load strength first. Walking volume next. Impact last.

- Eat, sleep & rest more than you think

Good fuel heals. Rest and sleep is an underrated super healer

- Remember: Bones heal

“This shall pass” helps. You WILL come back (& a stronger and more resilient runner at that.)