Samantha’s Journey to Hyrox Worlds: From Stress Fracture to World-Class Performance
Samantha, a personal trainer and competitive athlete, presented to our clinic after a massive spike in training load. She had just completed a Melbourne Hyrox event, a backyard ultra, and a string of other high-volume endurance comps—culminating in persistent left-sided shin pain and calf tightness. Initially brushed off as shin splints, her symptoms progressed to bone tenderness and altered running gait, especially under fatigue.
We conducted a thorough clinical assessment and referred her for imaging, which confirmed a left posterior tibial stress fracture—a high-risk site due to limited blood supply and loading mechanics. She was also dealing with Achilles tightness, tibialis posterior overload, and significant gluteal under-recruitment on the left.
Initial Phase – Load Management & Deloading
The first step was to halt all impact loading and initiate a strict deload. Sam was placed in a moon boot and given a structured isometric loading program to maintain tendon capacity and foot strength without aggravating the injury.
Tib post, tib ant, and intrinsic foot muscle isometrics
Glute bridges, clams, and pelvic control exercises
Bike erg and upper body work to maintain conditioning
Pain was rated 2–3/10 on palpation and with hopping, so our focus remained on managing symptoms while maintaining global strength.
The Psychological Battle
For an athlete like Sam, who thrives on performance and progression, being told to stop was incredibly tough. There were moments of frustration, tears, and the mental load of watching her team prep for international events while she was stuck doing rehab in a boot.
What stood out was her resilience and coachability—even when things felt uncertain.
Mid-Rehab – Rebuilding Mechanics
As her pain decreased and imaging confirmed healing, we began reintroducing plyometrics and a graded return to run protocol.
Box jumps, squat jumps, and single-leg landings for neuromuscular control
2x5x50m run/walk intervals on grass
Foot drills, glute med/min retraining, and seated plyo work
Dry needling to medial/lateral gastroc, tib ant/post, and peroneals
Active release to hip flexors, QL, ITB, and glutes
Her running cadence, footstrike, and left ankle stiffness were closely monitored. We also liaised with a sports dietitian to address underlying energy availability concerns—crucial given the link between RED-S and bone stress injuries in female athletes.
Final Phase – Load Tolerance & Race Prep
Once cleared to return to full training, Sam began building back toward high-intensity intervals, Hyrox simulations, and progressive strength testing of her posterior chain.
Despite a few niggles along the way—tight tibialis anterior, impingement at the front of her left ankle—she responded well to regular soft tissue work and targeted mobility.
On her final session before flying to Chicago for Hyrox Worlds, Samantha reported:
No bone tenderness
Full running volume tolerance
Confidence in her lower limb strength and movement patterns
No pain post-run, even with 3-minute intervals
The Result
Sam competed pain-free at Hyrox Worlds, representing Australia with pride. For us, this wasn’t just a rehab win—it was a complete athletic rebuild. From stress fracture and moon boot to international competition in under six months.
Clinical Takeaway:
Bone stress injuries are complex and multifactorial—often linked to poor load management, biomechanics, and nutrition. This case highlights the importance of early diagnosis, a structured return-to-load plan, multidisciplinary support, and the athlete’s own mindset in achieving a successful outcome.
We’re incredibly proud of Sam for not only trusting the process but embodying the grit it takes to come back stronger than ever
Struggling with an Injury That's Holding You Back?
Whether you're an elite athlete or simply passionate about staying active, injuries like stress fractures don’t have to be the end of your progress. With the right plan, expert guidance, and a team who understands the demands of performance, full recovery—and even stronger returns—are absolutely possible.
At Elite Health & Performance, we help athletes like Samantha overcome setbacks, rebuild confidence, and get back to competing at their best.
Get in touch with Elite Health & Performance today and take the first step toward your comeback.
