From Pool to Pavement: How a stress fracture taught me more than just patience

by Mitch Campbell

Specialist MSK & Sports Physiotherapist

Running & Swimming Specialist

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A few years ago, I never would’ve imagined that I’d become the kind of person who enjoyed running, let alone make it my entire personality (according to my friends). As a competitive swimmer growing up in New Zealand, my world was defined by spending as little time on the ground as possible. Hours of staring at a blue line, flip turns, interval sets, and the smell of chlorine. Running? That was something I did very reluctantly and tended to hate every minute of it. 

But something changed, after retiring from competitive swimming and being stuck in my house for months in 2020 (remember that?) I found myself craving something new. Something simple, outdoors and ultra accessible. I didn’t have access to a gym during lockdowns in New Zealand so running slowly took over, and before long, I was chasing PBs, running marathons, joining community run groups, and talking cadence and mileage to anyone who will listen. It’s safe to say that running has just about taken over my life. 

Running into injury: a lesson in loading

Everything was going great - until it wasn’t.

Earlier this year, I was diagnosed with a right posteromedial tibial stress fracture. As much as I hate to admit it, I know exactly what I had done wrong and when I had done it. Initially I was disappointed in myself for going against my better judgement and felt that I had failed myself as a physio. In November 2024, for the entirety of the month, I ran 10km every day and raised a fairly decent sum of money for men’s mental health, something that I am still incredibly proud of. In the months leading up to the November challenge, I felt confident that I could complete the challenge but what I had failed to factor in was the accumulative load I had sustained in the months prior leading up to the Melbourne Marathon (and all the training it entailed) just 2 weeks earlier.

Midway through the month, still enjoying the runs, a pain started as a dull ache that would settle quite quickly, easy to brush off. The occasional niggle is part and parcel of high volume running. A few days passed, and that pain became more persistent, lingering after I finished a run or stepped off a curb too hard. I tried to ignore it (yes, sometimes we physios do it too), convinced it was just an irritated tibialis posterior tendon. But when running started to feel mechanically “off” and I found myself limping after what should’ve been an easy 10k, I knew it was time to take it seriously. I liaised with a Sports Doctor friend and we organised an MRI. 

Getting the diagnosis was humbling, I guess I just thought I was bulletproof. As a physio, I spend my days helping others navigate pain and injury. Now, it was my turn.

Being on the other side of the table

This experience has fundamentally changed how I approach stress injuries, not just in runners, but in anyone dealing with cumulative load issues. It’s one thing to understand a stress fracture clinically; it’s another thing entirely to have lived it. I had to adjust my own expectations, balance my identity as a “runner,” and learn to sit with the discomfort of not being able to move the way I wanted to. This was (and still is) perhaps the biggest thing I have taken away.

Through this, I gained a renewed respect for what my patients go through. The uncertainty. The disappointment. The fear of losing progress. I get it now on a deeper level, and I believe it’s helped me become a better clinician.

The science of stress injuries

So what actually is a stress fracture, you ask?

In simple terms, bones adapt to load just like muscles and tendons do. But when that load exceeds your body’s ability to repair and adapt; whether from increased volume, intensity or poor recovery it can lead to bone stress, microscopic breakdown of bone tissue. Over time, if no changes are made to manage your load, small cracks can accumulate and eventually develop into a fracture. 

The management of bone stress is simple in theory. It involves reducing your load (the stimulus that caused the tissue breakdown) to allow healing, then gradually reintroducing movement to build back stronger. The psychological aspect, managing motivation, staying mentally engaged, trusting the rehab process, is just as important.

Learning to run smarter

In the past, I’d run for freedom and fitness, but without a structured plan. Often smashing out consecutive threshold/interval sessions without any real respect for recovery. Now, I’ve become more cognisant with programming, increasing load, scheduling rest and recovery days, strength work, and sleep (after I stop doom scrolling).

Bridging clinician and athlete

Injuries of all forms suck, let’s be honest. But it can also be a turning point. For me, this stress fracture was a wake-up call, not just physically, but professionally.

I’ve come to believe that rehab isn’t just about becoming pain free so that you can do the same things again - it’s about returning smarter and more in tune with your body. And that applies whether you’re a sub-3-hour marathoner or someone just lacing up for their first park run.

This experience has reminded me why I love being a physiotherapist. We’re not just here to hand out exercise sheets or tell you to rest. We’re here to walk (and sometimes limp) beside you as you navigate your rehab journey. 

Trust the Process!

Progress in running, or any pursuit for that matter, is rarely linear. It’s easy to focus on pace, distance, and personal bests, but resilience, adaptability, and patience are what keep you in the game long-term.

To anyone dealing with a setback right now: I see you. I’ve been you. And I promise, with the right support, smart rehab, and a bit of humility, you’ll come back stronger.

Whether you're dealing with a stress injury, building back from time off, or simply trying to run with fewer niggles: I’d love to help. Book an appointment with me and let’s get you back on track.

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Whether you're a runner dealing with injury or a swimmer feeling something’s not quite right, we’re here to help. Our team of sports physiotherapists at LDN PHYSIO specialises in:

• Running injury rehab

• Stress fracture management

• Swimming performance & shoulder care

• Rotator cuff injuries

• and many others

Book an appointment today in our Old Street, Elephant & Castle, Hackney Central and Kentish Town clinics.

You can also book into the best Running Analysis service in London! Check out our Running Clinic page for more info.