A conversation with an elite ultramarathoner on what running after a leg amputation is really like

On May 23, 2015, Dave Mackey went for one of his regular runs, 13 miles up three mountains that skirt Boulder, Colorado: South Boulder Peak, Bear Peak, and Green Mountain.

The two-time Ultrarunner of the Year was training for the Western States Endurance Race in California, one of the premier 100-mile races in the country. His ultrarunning resume also includes several course records, and he once set the fastest known time of Rim-to-Rim-to-Rim, a run from one rim of the Grand Canyon to the other, and back, that covers 41 miles and more than 10,000 feet of elevation gain. The run is a bucket list item for many endurance athletes. Around 12 hours is considered an impressive accomplishment — Mackey did it in under seven.

On that May run high up on Bear Peak, Mackey stepped on a boulder that dislodged under his foot. He fell from the ridge and the boulder pinned his left leg. Nearby hikers heard Mackey’s calls for help and were able to get the 300-pound boulder off. And though he suffered compound fractures in his left tibia and fibula, it appeared that his leg could be saved.

But for the following year and a half, Mackey was waylaid due to constant pain and endless surgeries. Anxious to get back to competing, one of the world’s best runners decided in October 2016 that he would be better off having his leg amputated from the knee down.

Mackey, at 48 years old, has come back strong. Since June 15, 2018, he has been competing in the Leadman — a five-event competition that includes a trail marathon, a 100-mile mountain bike ride, a 50-mile trail run or mountain bike ride, a 10-kilometer trail run, and a 100-mile trail run, all on extreme terrain and elevation that exceeds 12,000 feet. On August 18, he’ll line up for the final race, the Leadville Trail 100 Run. He’s currently in 14th place.

Like Mackey, I’m a below-the-knee amputee runner, though not nearly at the same level (perhaps nobody in the world is). I focus primarily on marathon distances. We both live in the Boulder area, which is home to an incredible running community that at times feels like a small world. Mackey and I actually met for the first time bumping into each other at the prosthetist office.

Mackey’s story is well known around Boulder and in the ultrarunning community, but the extent of his accomplishments deserves a wide audience. When we read about athletes with physical differences, they tend to be portrayed as “inspirational” and celebrated for simply doing an activity. And sometimes that’s good, but sometimes the extent of their athletic excellence gets overlooked. That has been the case for Mackey’s performances since his injury.

That’s why I reached out to him.

This is a conversation between two adaptive athletes, Mackey and me, about some of the things — big and small, from perception within our community to knee abrasions — that adaptive athletes deal with in their respective sports.

This interview has been edited for length and clarity.

Steve Hinson: I wanted to start things off by talking about Leadman and what it means for you to just be doing it and the fact that you’ve been performing really well. You had mentioned that you had thought about it from before your accident and immediately afterwards, and so is it enough just to be doing it, or did you expect to be running as well as you are?

Dave Mackey: I feel like I did well in the marathon, I was only 30 or 40 minutes off my time from three years ago. Total surprise as far as that goes. But definitely slower. I’d done the 50-mile bike and the 50-mile run, and the 50-mile run definitely took it out of me. And that was no surprise. The bike went pretty well. I’d been putting the hours in and I thought I did OK. I was still about 40 minutes slower from when I had my leg and that was three or four years ago. And yeah, I’m pleasantly surprised overall. Again, the 50-milers hurt. I had a skin abrasion on my leg. But that was more making a mistake. The abrasion came more from not securing my leg as well in my socket as I should have.

[Author’s note: There are two main components to the running prosthesis, the socket and the foot, which is also commonly called a blade. The socket contains the limb, which is cushioned with a silicone liner and secured through various systems. Over the course of a long-distance run, and especially on a trail run, anything less than a perfect fit in the socket can cause parts of the stump to rub. Like with a poorly fitting shoe, that friction will eventually cause abrasions or blisters.]

SH: What was the mistake?

DM: Just getting the pistoning. The rain came later in the race and getting some abrasioning from that with the leg moving around in the socket. It just knocked me out after the race, but I just definitely felt it. It was definitely more muscle — my muscles were toast for the last 15 miles of the 50-mile run.

Overall I’m happy. I just don’t want to have any catastrophes, and coming into the 100-mile bike on Saturday I don’t think I’ll have any catastrophes compared to other racers. I just think having a mechanics failure or crashing, but I don’t think my situation with one leg really lends itself to technical issues on a bike. The 10k run, that should be no problem on the next day, so it all comes down to the 100-mile run.

[Our conversation took place before those two events. Mackey ended up 12th among Leadman finishers in the 100-mile mountain bike ride and 32nd in the 10-kilometer trail run.]

SH: Last year I shifted up to the marathon and I found for my running that the learning curve for adding on that distance led to some learning by mistakes. How much of getting out for training has been just learning how your body is going to adapt?

DM: Yeah exactly. It’s absolutely true. I’ve been through a 50k in January and another one in May. (Down in Texas, in Michigan, and New Mexico.) I planned on doing a 100k in February but I had a little gluteal muscle pull, so I had plenty of time between those 50ks. So the trail marathon distance-wise wasn’t that hard since I had already put in two 50ks. But then the 50-mile run is a leap and the adaptation to it is kind of like I’m where you were with running marathons, re-learning how to run ultras.

There’s physiological changes and the mental aspect is there for the 100 miles. Of course, dealing with the mechanical stuff that’s associated with the leg is a total learning curve. For the 100-mile, I don’t know what’s going to happen honestly. I just might not make the turn around at 50 miles. I just don’t know. Stuff can happen, I’m at more risk of it. So it’s going to be a big day.

SH: So is that something that you are taking to into account with your drop bag, just having Allen wrenches and extra tools around?

DM: Yeah, I’ll carry with me anything that’s reasonable to have for anything that might go wrong with the prosthetic. You know like the Allen key you mentioned, some lube, some Leukotape. And then in the second half I’ll have a couple of pacers, like most people do, and they’ll carry that stuff for me. Actually my prosthetist is coming out too, I talked him into it.

SH: It’s one of the cool things about the area here, the adaptive athlete community is pretty awesome. There’s so many incredible athletes in the professional community, but even among the adaptive athletes. You know, us bumping into each other at the prosthetics office. I was scrolling on Twitter the next week and saw an article about you on Runner’s World so I was like, Who was that guy? Then saw your races and was like, Dang it, I can’t even be a good one-legged runner in this town.

It doesn’t really seem like you’ve really looked at yourself as an adaptive athlete at this point. That you’ve mostly been comparing yourself to how you were running before your injury.

DM: Yeah, I guess coming to terms with who I am after losing my leg. You kind of summed it up, for sure. For me, it’s just like an injury. It happened, I’m dealing with it, and still moving on. You know, like anyone who blows an ACL. When the accident happened I had the open tibial fracture and when it happened I thought we’re going to fix this. Even seconds after it happened, when they lifted the rock off I looked at it and was like, OK, this is totally fixable. I’ll be able to race next year.

But I guess I’m still in that mindset, I don’t see myself as an adaptive athlete. That I just had an injury and am working through it — in an extreme way, I guess. I haven’t really engaged myself wholly in the adaptive community yet. Just mentally, I want to see what I can do. I don’t feel like I’ve really used all that many resources so far, just the prosthetist. I probably could start benefiting from the adaptive community, though. There are a lot of resources and people out there that I could learn from.

SH: One of the things I’ve found interesting with the way you’ve talked about it is — well, for me, I’ve been an amputee since I was a kid. So you kind of get these phrases that I use which is that the prosthetic is just a tall shoe. Hearing you talk about some of your running legs, you’ve equated it to a shoe in a lot of ways. Is that how you look at it?

DM: Yeah, I would consider the running blade a big cumbersome pain in the ass. Definitely way more extreme than a shoe. The physical parts of it are the same, there’s an outsole, the cushioning, some dynamic action to it. It’s a little more extreme for me. It’s an extreme tool to get there.

The metaphor as far as the foot and having to adapt to a socket, the fit is definitely key. But a lot of what there is with the foot are shoe-like, for sure. They’ll get a blister if they have a normal leg or foot, the same for us is true with the socket. The blade I haven’t had any trouble with, but the socket is a bitch.

[The socket is made to fit each amputee, but it’s made of a rigid material, so every time the running foot goes over technical terrain or steps on a rock, the socket will rotate with the foot while the stump inside moves downward in stride. This almost always leads to friction of some kind for every one of approximately 800 steps per mile. Over a 100-mile trail race, that could mean 80,000 rubs in the same spot. That’s why the socket fit is so crucial.]

SH: For the first marathon I ran, I ended up getting a blister on the tip of my stump at Mile 17. The thing was huge, those last nine miles were really long. It was one of those things that helped me realize I needed to toughen up my stump a little more for the extra mileage.

DM: Did you pad it afterwards or tape it where that blister was? What did you do for it?

SH: The race was in Indianapolis, the support there wasn’t really much in the way of moleskin or something that I could put directly on it. I had some of those cheap cotton gloves, so I tore them up and stuffed them down there. I was basically just shoving anything I could at the base of the socket, trying to give it some extra cushion. And then prepping for the Boston Marathon, I just upped my weekly distance so that the long run was less of an anomaly. My last two marathons, my body held up way better. So now at this point I can go out and get a big milage day and trust that my stump isn’t going to break down like that again.

DM: A friend of mine, I talked to him after the 50-mile run. I had some abrasions in a couple of places and he’s dealt with that. He’s not an amputee, but he’s an ultrarunner who has a lot of great connections. He suggested a certain way to pre-tape over where the abrasion surfaces are, which I’ve found works really well. Tegaderm and Leukotape, I’ll probably tape myself pretty significantly with that stuff.

SH: So your Strava [a popular app that tracks physical training], it’s unreal, especially the kind of vertical gain you’ve been doing. You’re over 400,000 feet of vert for the year so far.

DM: Oh, I haven’t looked. Already? By August?

SH: Yeah!

DM: Well, a lot of those are bike miles. On biking you get the vertical and can cruise down. Yeah, on foot, that’d be super impressive.

SH: Where I was going with that, I’ve heard you say with your training that you’ve been casual about it, not quite pushing as hard but you’ve been putting in some miles. How much of it has been getting back to the point of being an elite athlete and how much has been just for the enjoyment of going out and running? Or just getting back to the point of seeing what your body’s capable of now?

DM: I’m definitely not trying to be an elite athlete or an elite runner anymore. It’s more just putting in the hours or the miles or the vertical in the altitude to get through the Leadman series and then to carry through to finish the year off with a couple of races. But definitely not an elite. It’s definitely putting in the time and the effort versus the quality runs and bike rides. Well, I guess I have some quality bike rides in.

But it’s really hard to climb with the amputee leg to push really hard because you’re getting held back by the leg. You can’t run downhill super fast on it in the technical terrain. I sort of get through it by dabbing through the rocks and toppled stuff, but not nearly what I did before. And that’s fine. But yeah, it’s kind of just logging the hours, which I like doing a lot. It’s better than working.

I get my time in by sacrificing for training. It takes some time away from the family. I’m heading up to the mountains for Thursday to Sunday and Ellen’s [Mackey’s wife] going to be home with the kids. But it’s seasonal, it’s temporary. I make the time up, for sure.

SH: You referring to yourself as not an elite athlete, I think that’s kind of a demographic thing because you’re still comparing yourself to before your injury and the ultra running community as a whole. But in terms of the adaptive athletic community, you’re probably the best distance runner out there. Do you have any thoughts on the difference between a congenital or childhood injury compared to an adult who loses their leg, and for that to happen when you’re running at a really high level?

DM: For me, I’m just putting in the time to figure out how to be most of what I was before. The hardest part of it has been figuring out the socket and the fit. I thought I’d be running way sooner than I did. Then I did start running within four months and I was impatient. Like, Ok, I want to get going. I still was sponsored and I like the lifestyle. I wanted to get back on my feet and working my regular job, but I wanted to try doing events again and racing.

For me, part of the reason I decided to have the amputation was that all of the other ideas were unlikely to work. They may have, but it was extremely unlikely. I didn’t want to sacrifice years of waiting to try to do what I did before. So I knew it takes this many hours per week on whatever terrain and on bike or on foot to do these things.

I’m still who I was before, just with a different leg. Like you were saying, it’s a big old blocky foot, but luckily I’m below the knee and not above. Even though people who are above-the-knee amputees still do similar things, or some people who have both legs gone do similar things.

[The reason I was particularly interested in Mackey’s perspective on this is that his is rare: very few amputees were elite athletes before their injuries. Most adaptive athletes aren’t aware of what their potential is, particularly in sports like distance running in which there are few adaptive competitions. The longest track event run in our classification in the Paralympics is the 400-meter.]

SH: For sure, having the knee is a big advantage for us, though. Makes it so it’s less of an impediment. That’s not to take anything away from above-the-knee amputees, it’s just definitely a benefit still having it.

Have you thought about what your upper limit is and what you’re capable of? Have you set any ultimate goals or are you just getting out there and pushing yourself?

DM: I’ve definitely thought about future stuff. Getting through the next two weekends, if I get through them I’ll be so happy. This coming weekend with the bike race, I don’t think that’s going to be catastrophic. The running could be. The 100-mile run.

But after that I’m planning on running the New York City Marathon, the JFK 50-mile, and I mentioned the World Marathon Challenge. I might add a little twist to that if I can. I don’t want to say what it is yet, though. And that’s seven marathons in seven continents in seven days. That would take a lot of things to fall into place including a ton of money to go do it — it’s expensive.

I can only do so much because I have a regular life outside of sports and I’m committed to that. If I had all of the resources in the world, I would go try to climb some big mountains and ski down them. Actually skiing was awesome this winter. I had a blast skiing. Skiing turned out to be an incredible surprise with how well it went. I used to be a really good skier and I still am. It was the exact same stuff as it was before. Except instead of stuffing my leg in there it was just stuffing the prosthetic foot into the exact same boot. Instead of telemark skiing, I skied alpine and it’s been great. And without any adaptive equipment, so I’m thrilled.

That was my goal, to be whatever I was before because this is what I love. I can ski with my family. My kids are eight and 10 and we ski all over the mountain, every bit of terrain. So I’ll try to do what I did before and just not win stuff.

SH: You mentioned climbing some big mountains. Are you thinking rock climbing or hiking them?

DM: I don’t know. I used to rock climb and guide before in Boulder, Flatirons, and Rocky Mountain National Park, so I’d kind want to do that. I’ve done some mountaineering. It sounds fantastic to go out and climb some peaks somewhere. I don’t know what, but I could do that. I’ve got to get myself down in reality though, because I’m still a family person and my wife works full time as a teacher. During the school year, I can’t go away and do something like that. Unless someone pays me to do that, which won’t happen.

SH: The thing I appreciate about that is the idea of it being unrealistic is family commitments rather than physical limitations, so that’s cool.

Leading up into this coming weekend and then going into the hundred-mile, are you going to take the approach of getting through it or do you have any numbers in mind?

DM: I do based on marathon and 50-mile. If you multiply my 50-mile time, which was 9:45. At the Leadville 100, if you run 19:30, you’re pretty close to top five. That won’t happen. I’m fine with that. 24 hours is reasonable.

But my goal is to get through the first 50 and not have any kind of chafing, then just see how it goes. And that’s actually good because I think every runner, whether they have two legs, I still think they should go to the first half through whatever slow pace and make it up on the second half. That’s just smart running for any kind of distance.

That attitude of conservation of energy and making sure your stomach isn’t shutting down is important. If going four miles per hour, if you’re going to walk four miles per hour, you’re going to get a 24 or 25 hour finish. So avoiding catastrophe, that’s what I want to do with the first half and do the second half about the same way, avoiding catastrophe. There are so many variables. I’ve got to keep my leg locked in the socket. I mean, even the tiniest bit of — like you had with your marathon when you had that blister — the tiniest force would have been at work there. Friction causes that. Multiply that distance by four, and it’s probably more by eight, it can get exponential and would just be debilitating on a 100-miler.

SH: Absolutely. Those 26 miles on a flat road in Indianapolis are a lot different than a trail in Leadville. Did you say you were planning on getting the New York City Marathon next year?

DM: Yeah, this fall.

SH: Do you have a marathon goal time?

DM: No, but I was talking to a friend who works at Össur and he was saying sub-three would be really cool. And that sounds fine. If I could run three hours, that would be great. Finishing it would be fine, I can do that any time. But I just have to do speedwork. I don’t know, three hours — what’s that mile pace? Seven minute miles or so, I’m guessing? Maybe a little faster than that.

SH: It’d be a 6:52 pace. Oh my gosh.

DM: Yeah? I don’t know if I can do that.

SH: Cheering for you, I hope you can crack it. For what it’s worth, 3:30 is the fastest I’ve ever heard of for a lower-limb amputee marathon.

DM: Really? Oh. Huh. OK, maybe that’s something to go for!

SH: Yeah, go crack three hours and set some new milestones for our demographic.

DM: OK! I’m going to try. Three hours, I have a goal.

Mackey’s 100-mile run on August 18 can be tracked at the Leadville Trail 100 Run’s website.