A woman–who is among only a handful of females to do so–has been seriously injured during the annual running of the bulls in Pamplona, Spain.

The woman, identified only as J.E., is a 23-year old from Australia. She was hit from behind while hanging on to the wooden barriers that surround the bull pens and suffered injuries to her ribs and right lung, which required an operation. She is only the third woman in the event’s recent history to be injured, as most of the runners are men.

This year’s event sent around 23 people to the hospital, most of whom had minor cuts and bruises. However, a 19-year old man was crushed by a wall of people and had difficulty breathing on his own; he is now recovering. A 35-year old man from Cleveland, Ohio is recovering from a rectal perforation that affected his kidneys, and a a 20-year old Utah man had to have his spleen removed after being gored.

The Miura bulls–which can weigh up to 1,530 pounds–are revered in Spain as the largest and fastest, yet retain their grace and stamina. For that reason, there’s a Lamborghini named after them.

The bull run is an ancient tradition and is part of the San Fermin festival, which honors the patron saint of the city. You can see photos here.