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HIP, HIP, HOORAY! AMY IS BACK

by Dave Milner

On New Year’s Day of 2006, 48-year-old Amy Barrow was the first woman home at the Resolution Run 5K in Nashville, beating accomplished runners half her age. The Nashvillian clocked 19 minutes and 40 seconds over a tough course that incorporates two bridges over the Cumberland River. Not too shabby, huh? A great way to start the New Year. But it is not that speedy little trip around downtown Music City that is remarkable, but, rather, the four-year-long emotional odyssey that led to the starting line.

Some people’s stories make you realize that – however troublesome your plantar fasciitis might be, or how that Achilles tendonitis seems to take longer and longer to loosen up on your morning runs – as long as we are able to, free of pain, continue to put one foot in front of the other at a quick enough cadence to call it running, we are, indeed, fortunate. Some people’s stories are like a slap across the face – reality checks that make us acknowledge that we should just quit complaining and get on with it. Amy Barrow’s story is the kind that leaves your cheek stinging.

Barrow is not your typical speed merchant. She didn’t run in high school, nor did she run in college. In fact, for the first thirty-two years of her life, she never participated in any sports. For years, she smoked a pack and a half of cigarettes a day. But after graduating from seminary at Emory University, and shortly after making a New Year’s resolution to quit smoking, she went for her first jog in 1990, at age 32.

“I remember that first run very vividly. At the time, I had gotten into Aerobics,” Barrow remembers. But when her class was cancelled one day, she would up at a track in Atlanta convincing herself that she could, she should, give running a try. “I ran twice around the track and thought I’d run two miles,” she recalls, with infectious laughter.

While she never worked as a minister after seminary, Amy’s transformation was as inspirational as any sermon. Over time, and with the determination of a champion athlete, Barrow went step-by-step from couch potato to national-class runner.

She completed a half-marathon only three months after that first half-mile jog around the track, and just two years later, she completed the Rocket City Marathon in Huntsville,AL, clocking 3:50. The next year, 1993, Amy met husband-to-be, Scott, one of the best masters runners in the region at the time, and a founding member of Greater Nashville Athletic Club.

Amy now had a new “high.” Having kicked nicotine to the curb, she was now completely hooked on running. Helped by Scott, she began running more seriously, upping her mileage and adding structure to her training.

Amy and Scott got married in 1995. Their wedding incorporated a 5K run in which a condition of participation was that the bride and groom were not to be beaten to the line. The race/wedding attracted a vertitable ‘who’s who’ of the Nashville running scene, but everyone ran by the rules. Amy and Scott got their victories, and each other, for better or worse.

Amy gradually chiseled her times down over the next four years, and eventually became a national class masters runner who routinely raced sub-18 minute 5Ks and clocked a 37:05 10K. She received all-expenses-paid trips to road races around the country. In February 1999, she ran the Las Vegas Marathon in 2:55, at age 41. Things were going great. She was running straight into her own fairy tale.

And then, just as Amy began to set her sights on trying to qualify for the 2000 U.S. Olympic trials, the rug was pulled from beneath her feet. Imagine her “low” after being told that she would now need both hips replaced or be confined to a wheelchair for the rest of her life.

Her problems began, in earnest, in the spring of 2001, when she realized she was having trouble getting in and out of her car. It was her hips. “It wasn’t that painful; it was just that my legs couldn’t quite accommodate that kind of angle anymore,” she recalls.

Scott remembers it differently. “She was in excruciating pain,” he says, “but she wouldn’t complain.” We runners don’t want anyone telling us we shouldn’t be running, so we act tough, play it down, hope the problem will just go away. “Well, I guess there was some pain,” she now concedes, “but I thought it was simply a by-product of all the running I was doing.”

She became a little more concerned when she could no longer raise her leg to get in or out of the bathtub without assistance. “Heck, I was running 80-mile weeks. What do you expect?” she thought at the time. “I remember asking myself ‘What could be happening to my body?’ I began to stretch more after my runs. That must be the key, I figured. Stretching. But that didn’t make any difference.”

Still hoping it would just sort itself out, Amy carried on running, but both her racing performances and her hips were in steady decline. On August 30, 2001, she called her primary care physician to schedule her annual physical exam. As an afterthought, she asked if she could have her hips x-rayed. The prognosis? Not good. Advanced Degenrative Osteoarthritis of both hips.

With little cartilage left to track and protect the bones at her hip joints, the bones were essentially grinding away on each other and cysts and bone spurs had eroded her range of motion to the point where she couldn’t put on her own shoes and socks. She could still run at a pace that would leave most runners her age eating her dust, but she couldn’t dress herself.

“I was blindsided,” Amy recalls. Overnight, what seemed to her to be normal running aches and pains had turned into a chronic condition. A visit to Dr. John Bruno confirmed the inevitable. “Mother Nature is sometimes rough on us, and it seems that she has not smiled down on Amy’s chief love,” Bruno said at the time. She asked Bruno the $25,000 question: “Would this have happened had I never run at all?” He replied, “It’s hereditary… it just would have happened to you at age 54 instead of 44.”

Amy did not take the news well. “Fisrt, I laid around and cried for a while, feeling terribly sorry for myself,” she remembers, “and then – typical Amy – I pretended it was all a tragic misunderstanding, got out there and ran, faster and faster, pounding that bone on bone until the pain began to radiate from ankle to shoulder and back again.” But in the end, she rolled over and gave in to cross-training.

She probably could have meandered along in the cross-training world for quite a while, having a little physical therapy at Baptist Sports Medicine in Nashville once a week. However, in January 2002, a curious development occurred. She began to trip and fall – usually while climbing stairs. She couldn’t understand why, until she started doing some research on the internet. “I discibered that cartilage is what tracks the hip joint,” she said. “since I had no cartilage in my hip joints, the joint could pretty much do what it wanted.”

The turning point for Amy occurred in August, when she fell stepping onto a curb, hit her head and ended up riding in an ambulance for the first time in her life. “Thirteen stitches later, I began lifting weights in earnest, realizing that I would soon be getting around for a while with my upper body alone,” she says, able to smile about it now.

A few weeks later, she met with Dr. Stuart Smith, a respected surgeon at the Tennesee Orthopaedic Allliance. After examining x-rays that day, he was left slack-jawed by the degeneration of cartilage, as well as the array of bone spurs and cysts as the bones had struggled to put distance on each other. Smith asked Amy, point blank, how soon she would like her hips replaced. At his suggestion, she chose the titanium spike and ball combo and the fancy new plastic cups. “It felt strange picking parts for my body,” she remembers.

The left hip was to be replaced on September 23rd. The surgery involved – you might want to stop eating at this point – making a four-inch incision in the hip, severing the muscle and tendon, removing (i.e. sawing off) the ball from the femur, drilling a tunnel through the top of the femur where the metal spike would be placed, fitting the cup, and sewing it all up.

The Amy would be on the walker for four weeks, progressing to the cane for two weeks, and back to the hospital on November 5th to have the same procedure done on the right hip. Shuffling along on a walker, complete with split tennis balls, constituted a great fall indeed from being just 5 minutes away from qualifying from the Olympic Trials marathon.

“In retrospect,” she admits, “I should have faced reality and gone in for the hip replacement when I was first diagnosed. Then I wouldn’t have lost so much strength in my surrounding muscles and tendons.” When the joint starts failing, all the surrounding tissues atrophy as well. Those tissues are attempting to make up for the weakness of the bones. “I could have avoided all that,” she says, “by getting over my attitude and biting the bullet instead of trying to run through the pain for a hole year.”

Every year, Amy must visit her surgeon for an examination. When Dr. Smith originally performed the surgery, he placed a benchmark in the top of the titanium hip replacement to track whether, with use, it would telescope into her femur. At her first post-op check-up, Smith would examine the mark critically to evaluate the effect of the pounding associated with Amy’s return to running.

He also assessed any damage from friction caused by the repetitive movement of the titanium ball against the plastic cup of the hip joint. He compared the current x-rays to the ones from the previous year. Such rubbing can cause the plastic to wear and throw off plastic particles into the body. Not good.

Thirdly, he checked to see if the bone was growing into the porous metal surface of the implant, making it a permanent part of Amy’s leg. Amy’s new hips were doing fine on all three counts, and Dr. Smith cleared her to run a maximum of 20 miles per week.

Twelve months later, when Amy returned for her next check-up, she was asked to walk while Smith observed, in order to analyze her biomechanics. Smith said he was taken aback. “Seriously,” he said, with a glance toward Scott, “How much has she been running?” Amy told him, “Just check the x-rays and tell me what you think.”

After close examination, he announced: “Your hips look as new as the day I put them in… they are in the perfect position and there is no telescoping or wear in the cup. Your bone is attaching to the implant better than most patients I see. The bone density is good, I suspect because you are exercising.”

This was all music to Amy’s ears, and Scott’s too. Amy’s injuries had taken a toll on her mental health and had put a tremendous strain on their relationship; after all, it was running that had brought them together in the first place.

It took six months for Amy to learn to walk again properly. In the summer of 2003, Amy started running again. Slowly, in fits and starts, she experimented. “I absolutely could not stand the treadmill,” she recalls, “but running outside, with uneven surfaces was hard and dangerous for me.” Dangerous in that, because the muscles, ligaments and tendons around her hip were still not ‘tight,’ she could fall and quite easily dislocate a hip. Hard because she was acutely embarrassed at being reduced to a 12-minute mile pace.

Amy’s self-esteem was at an all-time low. Going from being ranked the 48th-ranked female over-40 marathoner on the planet to hobbling on a walker for 12 weeks was tough. The social network that was founded on running was coming apart at the seams. “Running friends were falling away,” she remembers. “This wasn’t just a pulled muscle – the kind of injury you can wear like a badge of courage around your cronies. I was broken. And when you are as injured as I was, no athlete that isn’t wants to be around you. It might rub off. My social and physical lives, which had turned on the axis of running, were Closing Doors.”

With the only other option involving the very real risk of face-planting on asphalt and heading back to Dr. Smith’s office, Amy broke down and began running on the treadmill at her local YMCA. “At first I was unsteady on the moving surface, not being very coordinated to start with, and I was terrified of falling off and risking a dislocation.”

Amy was strong – she had been lifting – but her aerobic fitness was at an all-time low, and unlike when she first started running thirteen years earlier, progress was glacial. “It was a very short trip to max out the old heart rate,” she says, laughing. “I felt like the proverbial duffer. It took a lot of false starts and frustrating workouts, but the treadmill was the only way I could get going again.”

Amy loves to run outdoors. She never saw the point of running indoors. However, under the circumstances, she was restricted to the treadmill’s level and forgiving surface, the structured pace, and the comfort in the fact that if she did fall, someone would, hopefully, be around to pick her up.

One thing that did improve quickly was Amy’s form. “I really do believe my form improved as a result of having to run on that narrow strip of rubber,” she says. “You’ve just got to stay on board. Monitoring your pace and varying your speed keep your attention centered on your workout.”

After a few months, Amy was able to dip under 7-minute pace. Not for long; just for short intervals. “I remember actually managing an 8-minute pace for six minutes and being happy with that. There was some soreness in the muscles of my legs as they began to remember what it was like to move beyond a snail’s pace, but the hip joints were pain-free.”

One year after starting running again, in May of 2004, Amy found the courage to toe the line at the Strawberry Stride 5K in Portland. It was the first time she had pinned on a race number for almost four years. She finished in 23:39. While her comeback was remarkable, the former 17:29 5K runner was still six minutes off where she used to be, and it was a slap of reality across the face that left her in what she describes as “a downward spiral of depression.”

In the winter of 2004, she made a decision. “I weighed the risks and decided to go ahead and run as much as I wanted to run,” Amy said. “The depression and the risk to my mental health had grown to the point of threatening my life and I decided that I could could cope with the [potentially negative] physical consequences better.”

So, in the fall of 2004 and into the following winter, Amy gradually went from running the 20 miles a week to which her surgeon had restricted her, to logging 40-mile, and then 60-mile, weeks. As Amy’s fitness began to improve quickly, so too did her self-esteem and her general outlook on life. She found silver linings where, in months past, everything was black.

In May of 2005, returning to the Strawberry Stride, Amy was three minutes quicker over the 5K, clocking 20:22. And then, in July, she ran an impressive 19:57 at the Firecracker 5K in Brentwood, winning the female masters title.

After Labor Day’s Franklin Classic 10K, in which she clocked 40:52, was third overall and led the masters home again, Amy decided to train for a marathon. She trained six days a week on the treadmill and did a weekly long run on the roads in Percy Warner Park.

At the Team Nashville Half-Marathon in Goodlettsville, she clocked 1:33:33 to notch her first overall win in six years. At Huntsville’s Rocket City Marathon, where she had made her 26.2-mile debut in 1992, she clocked an impressive 3:25:13, “with absolutely no ill effects and no pain in my hips,” she adds with a cocktail of relief and pride. And at the Resolution Run, just three weeks later, she notched her second overall win with her ‘new parts.’

And she is now taking aim at the Tom King Half-Marathon in March. It is a distance she never really contested when she was running so well in the late 90s, so she expects to run an actual PR, not just a best for her new hips. “Presently, I am building mileage and running 7 days on the treadmill – averaging 10 miles a day,” she says. “Tom King will be my next race, and hopefully the summer will be filled with more outdoor running and a chance to cultivate more friendships with other runners.”

“It’s never too late for anyone,” Amy says. “Anyone who wants to do something can do it if they have the desire and want it badly enough. Right now, all of this is just gravy for me.”

Everything has changed for Amy. “Not running like I once did has changed my relationship to my family and with my husband, my work ethic, my friendships and, in fact, my entire life. I have had major gears to shift. But I also acquired a new way to look at my life.”

She found an Ernest Hemingway quote that sums it up -- “The world breaks everyone, and afterward, many are strong at the broken places.” Amy’s resolve to make the most of her running is stronger, as is her relationship with Scott. Running, rather than being the focal point of her life, is now something that fits into a rosier, more balanced landscape.

Although she has expanded her training beyond the confines of the ‘Y’ to include tracks and well-maintained roads occasionally, Amy is still forced to run on smooth, even, and – where possible – forgiving surfaces. She misses the daily contact with the outdoors and the feeling of the earth moving under her feet. However, she is still quite afraid of falling and dislocating a hip outdoors. On the treadmill, the time slides away as she concentrates on footfall and form. “The sweet spot used to refer to a place on my foot,” she says. “Now, it is a place my head goes when I run.”

Editor's Note: Amy clocked 1:26:32 at the 2006 Tom KIng Half-Marathon to set a state record for 48-year-olds. That year, she also added single-age state records at 5K (18:39), 4 miles (24:56), 8K (31:52), 10K (39:43), and 15K (1:01:25).

Amy was featured in the March 2009 edition of Running Times. Click here to view the article

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