Paula Radcliffe's hopes of Olympic glory hang in the balance. Britain's leading contender for athletics gold in Beijing has just arrived in France on crutches to begin rehabilitation after being diagnosed with a stress fracture of her femur. At the age of 34, the marathon world record holder is desperate to win an Olympic medal, but has only got 14 weeks to recover. What is her injury, what are the recovery processes and will she be ready to race in August? BBC Sport spoke to Mike Antoniades (speed and rehabilitation coach at Speed Dimensions who works with top footballers and athletes), and doctor Kalpesh Parmar (sports physician at Pure Sports Medicine). WHAT IS THE INJURY? Radcliffe became aware of problems in April during training at her base in the Pyrenees and although it was originally thought it was a muscle issue, MRI scans now show a stress fracture with her femur (the long bone that extends from the hip to the knee). It is still unknown where exactly the fracture is and how bad it is, but these types of stress fractures in the bone are a result of heavy workload, often over a long period of time.  | OLYMPICS BLOG |
Doctor Parmar says: "You need to see the bone like a plastic ruler. A big impact can cause it to break, and bending it continually will put it under huge stress. It will weaken with repetitive loading and can eventually break. "These fractures are either stable or unstable. An unstable fracture will need an operation, although I don't think this is the case with Paula." HOW CAN THIS INJURY HAPPEN? It's been a busy two years for Radcliffe. After having a baby at the start of 2007 it's been a story of niggling injuries (lower back, toe and hip in particular), occasional glory (winning the New York marathon) and race withdrawals (London Marathon in 2008). "Long distance runners are very susceptible to these types of injuries," Antoniades says, "especially because of the mileage they do and the subsequent stresses that puts on the legs. "Paula's endured a few problems over the last few years and any injury - even a small one - can really affect the way you run. "With just a minor injury, you tend to continue running and your body then adapts and has to compensate. When you start changing the bio-mechanics then the problems will kick in.  Radcliffe won the New York marathon in November last year |
"You can run 30-40 miles a week if you're healthy, but when you start making minor adjustments and you end up making 10,000 wrong footsteps a day, then this produces stress on different parts of the body. We have seen this with Paula. "Paula's body has gone through big changes. She had a back problem after she had her baby and then a toe injury led to pulling out of the London Marathon. After all these problems she has still carried on running. "Paula has an amazing capacity to take pain though. The body makes the adjustments but the body will soon says it's had enough." WHAT HAPPENS NOW? Radcliffe has said she will do everything she can to increase the bone healing, such as submitting herself to a programme of magnetic healing and using a gravity-reduced treadmill. She hopes to be running after two weeks. Antoniades adds: "Paula will be on crutches for two to three weeks before she'll be able to start putting weight on it again. In the meantime, she can still do things like running in the swimming pool or cross-training on a bike. | 606: DEBATE |
"Elite runners also need to incorporate strength - like her core strength, upper body and legs. Paula will obviously not be able to do this yet but there are ways to get this back with less stress on her body. "I get people to run backwards. Doing that makes you work three to four times harder than normal running, but is three to five times less stressful on the joints." Dr Parmar says the bone healing process depends on the extent of damage. "It could take up to six weeks for the bone to knit together and then up to another six to eight weeks to build fitness to be race competitive. "Paula will lose race fitness during the healing process and she will also lose muscle while she's on the crutches." CAN SHE DO IT? Radcliffe has 14 weeks to get ready. Her medical experts think it is impossible she will compete, but Radcliffe - for now - thinks she has a chance. She said she needs to "take a few risks, be very smart and have a little bit of luck". Dr Parmar thinks she has an outside chance if the fracture is not too bad, and Antoniades believes she can do it. "No one knows her body better than Paula," Antoniades says. "Her team is the best around and she'll do exactly what she knows her body can do. | What makes Paula really special is her mental strength Mike Antoniades, Speed Dimensions |
"Sporting stars are different, like Chelsea's footballers. Michael Ballack got injured last season and said he wouldn't play again until he was 100% fit. Someone like John Terry would run through a brick wall - regardless of injury. "What makes Paula really special is her mental strength. This plays a huge part and her determination will really help her. "She has clearly got a huge problem and even if she gets fit there is a massive jump to being race competitive. There are still many more questions than answers and you don't know how the stress fracture will pan out, but Paula's level of pain intensity is high. "The good thing is that she will have already put in plenty of miles of training and Paula trains at race intensity so she could make it. It's just a question of how hard and how fast she can train when she has healed. "If she's training hard within four weeks she should be OK. There is plenty of work to put in but don't underestimate how mentally strong she is."
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