Hoskin underwent surgery three weeks ago to remove a cervical rib in her shoulder that was pressing on a nerve and restricting an artery, causing her arm to go weak and numb.
The symptoms of thoracic outlet syndrome first appeared just over a year ago, affecting her build-up to the world championships in Italy last August.
Hoskin changed her training, breaking her hour-long sessions on the water into one-minute segments so she could still find her power over a 90-second race.
“I just couldn’t do multiple races, one after the other,” she says. “Our team adapted our warm-up slightly so we could get my arm to the start line in a good place. Once that gun went off, I knew I had 90 seconds in me.”
But late last year, it reached a point where a frustrated Hoskin was unable to do any physical activity – including paddling.
For months, she agonised over whether to have surgery, knowing it would be invasive, the recovery lengthy and success far from certain.
“I told my team, I’m 100% sure I’m going to get the surgery, but I’m only 80% sure I want it. I knew it was the right thing for me, but I was still scared,” she says.
Now in the early stages of her recovery, the Aucklander is taking a philosophical view of her situation.
Dame Lisa Carrington and Alicia Hoskin celebrate winning gold in the K2 500m final at the Paris Olympics, one of Hoskin’s two gold medals at the Games. Photo / Getty Images
“The timing could be bad – or it could be extremely good. I’m just so grateful I could do the most training I’ve ever done leading into the Paris Olympics, because dealing with this during that period would have been a nightmare,” she says.
“It makes what I’ve done [in paddling] and my medals feel even more special. I’m grateful for what my body has allowed me to do over the last 10 years.”
Hoskin has a rare congenital condition, diagnosed when she was 9, where her ribs sit higher than normal. The troublemaker was a rib growing from a vertebra in her neck.
She’s no stranger to health challenges. In 2017, Hoskin was diagnosed with a rare heart condition that required ablation surgery, and last September she had an operation on her knee.
“But I knew this was a lot bigger than I’d experienced before. And with such an uncertain outcome, I continued to have thoughts of, ‘what if I can never paddle again? What if I don’t see any improvement?’” she says. “The lifestyle I’ve lived for the last 10 years has all been around performing at the highest level.”
Hoskin was 9 when her mother discovered an odd lump on her shoulder while giving her a massage after gymnastics.
“The next day we went to the doctor – Mum’s first thought was maybe it was some kind of tumour, because it was only on one side. We were pretty worried,” Hoskin says. “I was in hospital for a couple of days while they ran all these tests, then someone counted my vertebrae and realised there was a rib coming out where it’s not supposed to. But of all things it could be, a cervical rib was a good outcome.”
Hoskin’s case was more unusual, though. “Most people with a cervical rib can go through life without even knowing it’s there,” she says. “But mine is structured so that my whole set of ribs are attached to vertebrae higher than they should be.
“Then my cervical rib was actually fused to my first rib. Then add 10 years of training, and it becomes quite a rare situation.”
Doctors told 9-year-old Hoskin she shouldn’t have problems with the condition unless she built muscle around the cervical rib. “So I built a career around building up those muscles,” she laughs.
It wasn’t until a year ago she started to have “mini flare-ups” that would last days. “I’d get really tight muscles around my shoulder and a really fatigued arm,” she says.
Her doctor and physio got her to do tests, including raising her arm and moving her hand for as long as she could.
“It would be up there about 10 seconds before the whole thing went dead,” Hoskin says. “It was pretty clear I had thoracic outlet syndrome, but at that point, there was a lot of hope because there are many options to manage it. And my paddling technique was contributing to it.”
So Hoskin made changes to her style, trained differently and worked closely with High Performance Sport New Zealand physio Jane Knobloch. “I had to get creative. I even got Botox in my neck muscle that feeds that space,” she says.
Dame Lisa Carrington and Alicia Hoskin with the second Olympic gold medals they won together in 2024. Photo / Photosport
Hoskin’s fiance Elliot Snedden bought a massage table and set it up in their lounge, learning to massage her shoulder every night after sprint training.
“He said, ‘As long as you’re trying to make this work, I’ll keep helping’,” she says of Snedden, a data analyst for HPSNZ. “I was also sleeping in a splint to keep my arms straight.
“But it wasn’t until we hit a dead end on every single option that I actually started to get scared.”
At the world championships in Milan, where she raced in the K4 boat, she relied on her team and then coach, Gordon Walker, to make changes so she could still compete at her best.
“It’s a testament to who we are as a team – we know what it takes to win and there are multiple ways to achieve that. This was almost a tool for my coach and me to find new ways to train and compete,” she says.
The team of Carrington, Hoskin, Tara Vaughan and Lucy Matehaere finished fourth at the world champs (Carrington was a late call-in after Olivia Brett had to return home with an arm injury).
But when she returned home, Hoskin realised she couldn’t sustain that effort if she wanted to continue performing at the highest level and defend her Olympic titles in 2028. She decided to give it one last push.
“We had a meeting with my partner, the coaches, physios and doctor, and brainstormed how I could get to LA. We put everything on the table,” she says.
“We had to treat it like we were investigators working together on a research project, because there was no other case out there of an athlete experiencing what I was. We spent three or four weeks trying different things until we realised unless the anatomical structure changed, the rib would continue to press on the nerve and close my artery.
“I completely stopped training for two months to see if I could get the symptoms to zero, but it continued to get worse.”
So Hoskin saw a surgeon and decided to have the rib removed. “He said the surgery needed to be my last resort, and I had to make that decision myself because it might not work,” she says.
“So I took my time because it wasn’t just about me. I’m part of a team, a family member, and it became more than just about paddling.
“It was extremely clear that for my future family, I wanted to be able to run around at the playground, swing on monkey bars, carry a backpack on my shoulder, and lift my babies. I had to envisage the life that I wanted to live. And that helped me make my decision.”
Hoskin worked with a HPSNZ sports psychologist to prepare for the two-hour surgery to remove the rib, the attached muscles and scar tissue. “The surgeon was really happy with it, so all in all it was good,” she says.
She’s now feeling “a bit more like myself” as she manages the pain. It will take about six months to move her arm normally again, and up to nine months before she can fully train at the level she was at before her problems began.
Hoskin is grateful for the ongoing support she’s had from HPSNZ.
New Zealand’s Alicia Hoskin, Tara Vaughan, Dame Lisa Carrington and Olivia Brett after winning gold in the women’s four final at the Paris 2024 Olympics. Photo / Iain McGregor / www.photosport.nz
“When I met with them early on, they said, ‘You’re a person before a paddler, and there’s so much you’ve given us, and will continue to give us, we want to make sure you have everything you need’,” she says. “It’s been really cool to have females in that support team, who make me feel understood through it all.”
Unable to do any demanding physical activity, she’s become “creative” – finding projects she can do one-handed. “I’ve just had to stay super-disciplined and focus on things I’m loving outside of paddling and training,” she says.
Some of those projects revolve around her future wedding – she’s started growing flowers, sewing and making name tags for potential wedding guests.
“I’ve done watercolour painting, made kombucha and grown a vege garden – I’m not normally in New Zealand long enough to grow a cucumber,” she laughs. Carrington has made regular visits with her dog, Colin.
Hoskin has also taken on some extra university papers, after graduating with a Bachelor of Sport and Exercise.
Even if she can’t compete in elite sport again, Hoskin is determined to be in Los Angeles. “Whether it’s in the boat, in a coach boat, or in the grandstand, I’m going to be there supporting the team. It’s still my priority for the next three years.”
This story was originally published at Newsroom.co.nz and is republished with permission.