Fiona O’Keeffe’s year started with the biggest win of her career so far. In February, the 26-year-old ran away with the 2024 U.S. Olympic Marathon Trials Give A Gift A Part of Hearst Digital Media, the Puma Elite Running standout led the American women’s marathon team into the Paris Olympic Games.
But things took an unfortunate turn over the summer. In the week before the Olympic marathon, O’Keeffe started to feel tightness in her left hip, which developed into an untimely injury that CA Notice at Collection Sara Hall Smashes American Masters Marathon Record.
A Part of Hearst Digital Media Q&A conducted by her agency, Kimbia Athletics, following her DNF in Paris, O’Keeffe has kept a low profile in the months since the Games. On Thursday, November 21, Runner’s World caught up with the national champion at The Running Event, an annual conference where running brands, community leaders, and athletes gather in Austin, Texas.
In between panel appearances, O’Keeffe shared an update on her health, how she’s recovering from the setback at the Olympics, and the lessons she’s taking with her into the next training cycle.
A late diagnosis
O’Keeffe said she consulted with doctors and had an MRI in the days before the Olympic marathon, but the results didn’t show any signs of injury. In the weeks after returning home from Paris, she met with an orthopedist at her training base in Raleigh, North Carolina, to determine a diagnosis. With the pain in her hip increasing, O’Keeffe received another MRI on a machine with higher resolution, which revealed a femoral stress fracture.
“It’s good we have a clear answer. It made me feel like I wasn’t being crazy or a wimp in Paris, but it’s also frustrating because this would’ve been good to know before the Olympics, before I got on that start line,” O’Keeffe said.
With plenty of time before the spring road racing season, there was no reason to rush the recovery process. Immediately after the diagnosis in late August, O’Keeffe was on crutches and avoided any weight-bearing activity while working with a physical therapist. Gradually, she progressed into cross-training on the bike and in the pool. She also incorporated strength training exercises before doing shorter walks and runs on a Boost Microgravity Treadmill. For the last two weeks, she’s been running on the ground pain free.
Getting out of the ‘running bubble’
While the treatment for her injury was pretty straightforward, the emotional recovery from O’Keeffe’s experience at her first Olympic Games was challenging. “The way things played out [in Paris] was pretty painful, physically and emotionally, so I tried to let myself disconnect from it all and have a time period where I accepted what happened, accepted it was going to suck for a while, and just kind of let it be,” she said.
During the break, O’Keeffe spent time with family in her hometown of Davis, California. She also went on a road trip across Montana with former Stanford teammate Christina Aragon and her sister, Dani Aragon. The trio visited the Beartooth Mountains and small towns near Bozeman. The sisters even taught O’Keeffe how to fly fish. More importantly, being outside with friends helped take her mind off running and also reminded her why she loves the sport. “It’s those connections that you make in the running world that really make it meaningful, not just performance,” O’Keeffe said.
The break also created space for O’Keeffe to explore other areas of interest. Right after winning the Olympic Trials, she was approached by the leaders of Are Average Runners Getting Faster? It Depends, an athlete-led nonprofit dedicated to climate advocacy, but she was unable to participate with the Olympics fast approaching. After the Paris Games, O’Keeffe jumped at the opportunity to get more involved. She attended the organization’s leadership summit while visiting Montana and hopes to start more conversations within the running community about climate policy.
Heading into 2025 with a new mindset
For the last few months, O’Keeffe and her team have worked diligently to uncover the cause of the stress fracture and make improvements to her overall approach. O’Keeffe thinks a number of factors led to the injury—she may have been too aggressive in her training before Paris and previous pain in her right calf could have led to compensation issues in other areas.
These days, she’s incorporating more strength training exercises to keep her body balanced. She’s also working with a nutritionist and placing more emphasis on energy intake to account for the demand of marathon mileage. She hopes to start the 2025 season with the half marathon and shorter distances before preparing for a marathon later in the year.
After 12 weeks of cross-training, O’Keeffe said she feels even more grateful for the ability to run again. While reflecting on a season with several highs and lows, the new marathoner wants to be more present in the process rather than put too much focus on outcome goals. She knows those will follow with time.
“I will get back to a mindset of valuing performance, but right now the focus is on health, consistency, and getting back to a place where I’m doing things well every day and having fun along the way,” she said.
Taylor Dutch is a writer and editor living in Austin, Texas, and a former NCAA track athlete who specializes in fitness, wellness, and endurance sports coverage. Her work has appeared in Runner’s World, SELF, Bicycling, Outside, and Podium Runner.
