18 weeks ago today, I broke my hip

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THE REBUILD

“I was still an athlete, just a recovering one.”

By Emma O’Toole

Hi everyone,

18 weeks ago today, everything changed in a single moment.
One minute I was flying towards a marathon PB… the next, I couldn’t even walk.

I went from chasing splits on the streets of London to lying in Guy’s and St Thomas’ Hospital with a fractured hip.

For an endurance athlete, it’s the nightmare scenario.

If you want the full breakdown of what happened, I wrote about it here: From fairytale to horror show.

Today’s not about that though. Today, I want to share the other half of the story: the rebuld.

Because 18 weeks later, here I am:

• Up to 14-hour training weeks,

• Running 7+ miles in a single run,

• Two time trial races completed,

• Rode 100km out on the road again.

And let me be clear: this didn’t happen by chance.

The first days

Being in hospital for 5 days and unable to walk was a shock to the system. One minute I was fit, strong, and independent… the next, I needed help just to go to the toilet.

There was one amazing thing in all of this: I avoided a hip operation. I was prepped for surgery when the consultants decided against it after another scan. And that wasn’t luck. Years of strength training, solid bone density and muscle mass from consistent resistance training meant that the fracture was stable enough to heal without surgery.

That gave me confidence straight away: all the boring, unglamorous strength sessions I’d stacked up over the years (and bleat on about) were now paying me back in the most important way possible.

Sunday 11th May: Aqua jogging instead of a long run

That Sunday should’ve been a long(ish) run, my first real long run post the marathon. Instead, it was my first aqua jogging session.

Now, I’ll be honest, aqua jogging isn’t glamorous; I felt pretty ridiculous. It’s basically running up and down the deep end of a pool trying with a massive float tied around your waist trying not to get in anyone’s way and avoid going ass over tit getting into the pool on crutches. And to rub extra salt into the wound, while the UK was having its best summer in years, I was stuck in a gloomy pool.

But it was something I could do.

And that became the theme: don’t obsess over what you can’t do, double down on what you can.

Routine kept me sane

The real danger for any runner and cyclist after an injury isn’t just losing fitness, it is losing your training routine.

Your training, and the structure it gives your week, becomes part of who you are; you make decisions that are all built around it. Take that away and everything feels out of whack.

So I created a new routine:

• Turbo sessions with crutches propped up beside me.

• Upper-body strength work from a seated position.

• Unilateral strength training on my left leg (more on this to come)

• Endless laps of aqua jogging.

My training had certainly changed, but I kept routine, momentum and my sanity.

And that stopped me feeling like I was “just an injured person.” I was still an athlete, just a recovering one.

The training

Looking at my training log* over the past 18 weeks, the numbers don’t tell the full story:

• May → 30 hours, 47 activities. Basically all pool work and strength. The month I learned patience.

• June → 38 hours, 56 activities. Zero hours outdoors. Just consistency.

• July → 40 hours, 54 activities. 398km. Finally a taste of proper endurance again.

• August (so far) → 53 hours, 63 activities. 777km, 47 personal records. The comeback starting to show.

On paper, it looks tidy, but the reality is that this was crutches, seated exercises, upper body strength work, hours running up and down a pool, a fair bit of swearing and a few tears.

Strength training & cross-education

In my new found routine, home-based strength training really came into its own.

Instead of my usual 2x sessions per week, I was doing shorter 15-20 minute home based sessions 5-6 days a week. I focused on my upper body, training in a seated position as I couldn’t weight bear on my right leg, and again focused on what I could do.

One important thing here is that I could still train my left leg, and thanks to something called cross-education, training one side helps the other. It’s a neurological phenomenon basically, when you lift with one limb, your brain and nervous system adapt, and some of that adaptation carries over to the untrained side.

So doing what I could with my left leg, substantially helped my right leg during my recovery, and in particular with my rehab. There were some of my regular exercises certainly off the cards, like any type of plyometric work and that’s been a 18-week process building those back in safely.

Strength was the non-negotiable thread through all of this.

When I first got back on the bike, my left-to-right power balance was shocking: 55% L / 45% R. Thanks to the consistency of strength work, it is now back at 50% L / 50% R.

That’s evidence, you can see it for yourself below.

Strength training gave me symmetry, focus, and a faster road back to doing the things I love.

Getting the green light

After weeks of “don’t load it,” the day finally came. The consultant looked me in the eye and said: “You can start loading it now.”

It was music to my ears, I still wasn’t ready to run but the rebuild could now begin.

Roll on a few more weeks and I had my first run back.

Well it was a run/walk progression.

For all the rehab, strength, and pool work… nothing touched the nerves of that first run.

I’d never felt that kind of anxiety before a run and I’d completely overlooked feeling it then. But the last time I’d run, I ended up in hospital. So tying my laces again felt heavier than any marathon start line.

I was surprised as it reminded me of what I tell my cyclists after a crash: get back on the bike as soon as you safely can, so your brain rewires from fear back to familiar. That’s exactly what this was.

Each run/walk helped me to build trust and confidence in my body again forcing me to listen to exactly what it’s trying to tell me, be patient and again focus on the athlete I was at that very moment in time and what I could do.

I leant more into the bike because I could build up fitness without my body dealing with the impact of running. I rode outside on my own and with the support of my friend Lee before heading out onto my first group ride 10 days ago where I held on for as long as I could with this lot!

Today

Writing this today, 18 weeks on, and going through this journey has been one of the hardest things I’ve had to do. It has pushed and tested me physically and emotionally. I’m blessed to absolutely love my job as a coach and be supporting some incredible endurance athletes and all-round great humans. I’ve also had the chance to get lost in the weeds of a new strength training course I have written for Strength and Conditioning Education that is soon to be released!

Setbacks will happen. Injuries, crashes, life… no runner and cyclist gets away with them.

I hope my story has shown you that the answer isn’t to give up.

The answer is to adapt: do what you can, with what you’ve got.

Sometimes that’s aqua jogging, sometimes it’s unilateral lifts, sometimes that’s just keeping your routine.

The goal is progress without setting yourself further back. I know younger Emma would have pushed harder way too soon, have been scratching at the walls to run and not listened to her body’s feedback when it has been saying “slow down”.

And this is where having a coach matters, that lived experience of someone who has been exactly where you are right now, who knows how you can come back from that and not just to the version of you that you were before, but an improved, more-rounded runner and cyclist.

When you’re on your own in struggling with an injury or a niggle, it’s really hard to see the bigger picture for yourself- it can be easy to let the negative emotions and self-loathing win, rather than grab life and the athlete you are at that exact moment in time by the horns and run with it (or aqua jog!).

If you’re in that place right now and need some support to help you rebuild, please reply to this email; I’ve been there, and I know how to get you through it.

This week in our brilliant free community, we talked about rest days and how challenging they can be to take! Check it out for ongoing support with your training.

Thank you for your time reading this!

Emma x

*This training log consists of the activities I recorded which, to the best of my knowledge, is the vast majority. I have been working closely with a team to support my return to sport. This return has been possible because of my expansive training history with endurance sports. If you’re returning from an injury, please make sure you consult with a medical specialist prior and during your return to sport.

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