Mariana Pajón is one of the world’s most accomplished BMX riders, and she can quickly recount some of her career totals: 18 world championships, two Olympic gold medals in racing (in 2012 and 2016) and one silver, in Tokyo in 2021.

But Pajón, a Colombian, can also rattle off the much more painful totals of the cost of so much riding: 25 fractures, 12 screws, eight surgeries and countless tears of ligaments and tendons. The medical hardware in her left arm and knee included so much metal that she used to travel with her X-rays. Opening a door or serving a glass of water hurts.

“My joints are of an 80-plus-year-old,” Pajón said with a laugh. She is 32.

Pajón, who has been racing competitively since she was 4, wasn’t lamenting her injuries during a recent conversation. They are simply a fact of life for an athlete.

Wear and tear naturally degrades human bodies, even the most talented ones. But performing at the elite level, especially in high-impact Olympic sports such as wrestling, rugby or gymnastics, inherently has more risks. Shoulders give out. Ligaments tear. And, for some, metal screws and titanium plates become just more hardware in the lifelong pursuit of gold, silver and bronze.