The Unlikely Runner, Jay Fain Jr.

Fain works on the treadmill at Bulow Biotech Prosthetics in Columbia, South Carolina. Photograph courtesy of Bobby Latham.

In 2007, on the day before he was scheduled to fly home from Iraq for a two-week break, Army Sergeant Jay Fain Jr. woke up in a hospital and realized he had lost his right leg at the hip. Hours before, he was on patrol, buckled into a Humvee, when an improvised explosive device detonated under the vehicle. His life was instantly changed. As he was recovering in the military hospital, Fain, who has since retired, wasn't thinking about being able to run again. In fact, if he had asked the medical professionals around him if he would be able to run again, there's a good chance they would have said no. Because much of the literature published on outcomes of hip disarticulation amputations indicates that individuals with these high-level amputations tend to have limitations in walking, climbing stairs, and even sitting, many medical professionals encourage individuals with hip disarticulation amputations to work on achieving a functional gait-they don't encourage them to run.

Fain was transferred from Iraq to Brooke Army Medical Center (BAMC), Fort Sam Houston, Texas, where he underwent rehabilitation. He says he found BAMC's staff of physicians, physical therapists, occupational therapists, and prosthetists to be very supportive of him in his recovery. "They were a huge help to me and the other wounded guys," Fain says. "We had such a great camaraderie there, which made us feel like a huge family."

Fain's own family was also a strong support system for him after his injury and into the new life he's created. In fact, his father was working a government contract job at the time of Fain's accident and was able to be with him in the hospital in Iraq. "I was born and raised by a strong, tough family," he says, "and they accept me. I'm still the same guy; the only thing that's different is that I'm missing parts now."

At the Center for the Intrepid (CFI), San Antonio, Texas, Fain learned to walk on his first prosthesis, which included a mechanical hip joint with the Össur Total Knee® and a basic foot. Even while learning to walk, Fain had his eye on mastering a running gait. "I sought it out," he says. "I consulted with a lot or clinicians who had dealt with highly active amputees, teaching them to run. There were a few false starts, but I was finally successful [in achieving a running gait] in early 2013."

Emily Harvey, Fain, and Harris, at Bulow Biotech Prosthetics, Denver, Colorado. Photograph courtesy of Zach Harvey.

One of Fain's most beneficial undertakings was the work he did with gait-training expert Robert Gailey, PhD, PT, a professor with the Department of Physical Therapy, Miller School of Medicine, University of Miami, Florida, who has worked with hundreds of athletes with limb loss. Fain was able to work one-on-one with Gailey for two days. He taught Fain the basic techniques needed for someone with a high-level amputation to have a successful running gait. Fain took these ideas and practiced them consistently. He also attended several Össur Amputee Running and Mobility Clinics, hosted by the Challenged Athletes Foundation. At those clinics, he worked again with Gailey and Peter Harsch, CPO, both of whom often run the mobility clinics jointly.

Fain's next stop was to visit Bobby Latham, CP, BOCO, Bulow Biotech, Columbia, South Carolina, whom he had read about during his research. Although Fain had learned many great techniques for running with a high-level amputation, Latham wanted to make sure Fain's socket fit didn't get overlooked and that it was consistently comfortable before they talked about him running. "He and I worked hard on alignment and socket fit for a while," says Fain, "and we finally got it perfect."

Then it was time to talk about a change in his knee. Fain had heard about the Össur POWER KNEE™ and wanted to try one. Latham arranged for Fain to meet with several specialists, including prosthetists from Bulow and bionics experts from Össur Americas, Foothill Ranch, California. In the end, he was fitted with an Ottobock Helix hip joint, a POWER KNEE, and an Össur Re-Flex Rotate™ foot. He adapted so well to his new knee that Össur soon asked him to become one of its product champions, traveling around the country, demonstrating the device to prosthetists and technicians. Next it was time to figure out the mechanics, practicalities, and best-suited components for running. Fain and Latham tried many combinations of components and finally decided the best option was a fixed hip joint, the Össur Total Knee 2100, and an Össur Flex-Run™ foot.

Fain with former President George W. Bush at the 2013 Warrior Open in Dallas, Texas. Photographs courtesy of The Bush Center.

Running poses interesting challenges to prosthetic components, such as keeping the swing phase flexion for toe clearance yet ensuring a locked extension for weight bearing. Many adjustments were made, tested, then tweaked again. Fain spent many days at the track with Latham, where they ran side by side. "Bobby took videos and I went over my notes from Dr. Gailey," Fain says, "and we just trained until my technique got pretty natural."

Not only is Fain running despite have a hip disarticulation amputation, his walking gait is so smooth people often don't realize he uses a prosthesis. "Every time people [who know he uses a prosthesis] see Jay walk, they are mystified that he's missing his leg at the hip disarticulation level," says his friend and fellow Össur product champion, Whitney Harris. "He has walking skills, to say the least!"

"To be able to run with a hip disarticulation amputation is a significant accomplishment," says Latham. "Jay is one of only two people in the United States with an amputation at this level who can pull off this feat. The majority of people with this level of amputation choose to use a wheelchair or only use their prosthesis occasionally. It's difficult to have a fluid walking gait, and running seems out of the question."

Latham adds that Fain's amazing progress comes from several things. "Jay has fantastic body toning, excellent balance, and unheard of drive," says Latham. "To get where he is today, he has fought hard every step of the way."

Latham says he was talking to a prosthetic sales representative recently and she asked, "Does Jay know what he's done? This is huge!" But Latham doesn't necessarily think Fain's accomplishments will open doors for many others with highlevel amputations to learn to run. "It's not a game changer," he says, "but it sure shows people what's possible."

You can't tell Fain's story without talking about the man himself. He has spoken to wounded warriors and visited children who have transfemoral amputations, telling them to get all they can out of life.

"He gets up every day and perseveres when others can't even imagine doing so," Harris says. "It takes courage to live in this society and be missing a limb, especially when you lost it for your country. It seems to Jay that this courage is just a part of his life that he doesn't bat an eyelash at."

Latham agrees. "It's been great to see his progress and how he's turned into a role model for other people." This is exactly what Fain wants. "Having this level of amputation and knowing there are others out there similar to me, I hope to pass knowledge on to other people with amputations and hopefully stir up the O&P world and let them see what can be accomplished with just some motivation and understanding of the products out there."

As for his future, Fain isn't done breaking barriers. "Now that I've learned to run, I would like to think about doing a 5K or a 10K someday. And possibly do one of those mud-run races."

Judy Johnson Berna is an elective amputee who enjoys keeping up with her husband and four children in their home state of Colorado. Her first book, Just One Foot: How Amputation Cured My Disability, was released in September 2012. She can be reached via her website, www.justonefoot.com

The Unlikely Runner, Jay Fain Jr.

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