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Trail Runner Dave Mackey Enduring Long Road to Recovery

Two and a half weeks after falling on a mountain run in Boulder, Mackey remains hospitalized.

Dave Mackey has undergone five surgeries since suffering a compound fracture of his lower left leg on May 23. Photo: Bob Africa
Dave Mackey has undergone six surgeries since suffering a compound fracture of his lower left leg on May 23. Photo: Bob Africa

Dave Mackey has been through all sorts of ultra-distance endurance events during the past 20 years, but nothing quite like this.

As a world-class trail runner and adventure racer, the 45-year-old resident of Boulder, Colo., has endured some amazing challenges all around the world—some have taken several hours, some have taken several days—and he’s completed most with a very high level of success. His current challenge of recovering from a horrific compound fracture of his left leg while trail running in Boulder, Colo., on May 23rd figures to take at least several more months.

But his typically positive mindset and understated calmness have so far shown that he’s up to the task.

“I have a long road ahead, but for now it’s just one day at a time,” Mackey said recently. “I know I’m very fortunate and very lucky to be alive.”

The good news is that, after numerous surgeries during a three-week hospital stay, doctors have said his progress is moving along as well as possible for now. A bigger concern for the time being is that he’s facing a growing mountain of medical bills that won’t nearly be covered by insurance and, because he works as a contract physician assistant, he won’t generate any income until he works again in a few months.

On June 13, three weeks after suffering a brutal leg injury while trail running on one of his favorite mountain trails in Boulder, the three-time U.S. ultrarunner of the year finally returned from the hospital. He’s undergone seven surgeries aimed at repairing his badly injured lower left leg and, if things go well, he will continue physical therapy and then have at least one more surgery in about six weeks.

RELATED: Boulder Trail Runner Dave Mackey Survives Gruesome Mountain Accident

Mackey, a Hoka-sponsored pro runner, has won U.S. trail running championships for 50K, 50 miles and 100K distances and won the Montrail Cup trail running series in 2004 and 2011. He’s known as one of the toughest, strongest and most humble athletes in Boulder. He has set numerous speed records on the trails and mountains around Boulder and previously held the Rim to Rim to Rim record for the 42-mile double-crossing of the Grand Canyon (6:59:57 in 2007). He is also an accomplished rock climber and formerly competed on the international adventure racing circuit.

Most recently, Mackey placed 12th at the six-day, 156-mile Marathon des Sables across the Sahara Desert in Morocco in April, took second at the Black Canyon 100K on Feb. 14 in Mayer, Ariz., and finished second in the Leadman multisport competition last summer in Leadville, Colo. (Leadman includes five off-road events during a six-week span, including a trail marathon, 50-mile mountain bike race, 10K trail run, 100-mile mountain bike race and 100-mile trail run.)

But as with all of his other races and adventures in life, Mackey says he has never been out there alone and neither is he on this one. He’s been quick to express his immense gratitude for his supportive family (including his wife, Ellen, and their two young children, Ava and Connor), dozens of close friends who have visited him repeatedly and the thousands of well-wishers who have reached out in numerous ways to show their love and support. (California trail runner and videographer Billy Yang compiled a video of runners offering up messages to Mackey.)

“I really shouldn’t be intact or even alive perhaps,” Mackey wrote in a Facebook post on June 7th while recovering in intensive care. “Thank you so much for words of encouragement, visits, jokes and the good gallows humor over this. What I am going through though is nothing compared to (what’s happening in) millions of people’s lives every day. Some friends have told me of their struggles and accidents which helps immensely. Thank you again to Ellen, close friends and my kids for pulling me through. Don’t take for granted what you have, value it.”

Mackey was injured on the morning of May 23rd while on a fairly routine trail run in Boulder. He left his house in South Boulder with the intent of running up and over the tallest peaks of Boulder’s western skyline as he has hundreds of times in the past 15 years or so. While he attempted to scramble off the summit of Bear Peak, a large rock gave way that resulted in him falling 20 to 30 feet in a series of uncontrolled crashes over rocks and the branches of small mountain shrubbery. A massive rock estimated at weighing between 150 and 300 pounds came to rest on Mackey’s leg, although it is believed the compound fracture to his lower left leg occurred earlier in the fall based on the nature of the injury.

After an elaborate mountain rescue that took more than five hours, he was rushed to Boulder Community Foothills Hospital where orthopedic surgeons inserted a metal rod, several plates and numerous screws into his leg. He underwent another surgery two days later in which doctors re-opened the wound to do a more extensive cleaning of debris. Five days later, after being transferred to Denver Health, Mackey underwent a procedure known as a gastroc flap, in which a portion of the gastrocnemius muscle in his left calf was removed and placed over the tibia on the front side of his shin to ensure greater blood flow via more extensive vasculature. He also underwent the first of two skin graft surgeries as doctors removed a large layer of skin from his left thigh to help cover the exposed bone and soft tissue in his lower left leg.

While recovering over the next few days in Denver, Mackey became lightheaded and feverish and on June 2nd doctors decided to disassemble the original orthopedic work—removing the plates, rod and screws—to clean out the injury and eliminate any possible infection from debris and microorganisms still trapped inside the wound. But while they were inside the injured leg, doctors determined some of the bone and muscle tissue still wasn’t growing as well as it should, possibly due to limited blood flow attributed to the lack of soft tissue vasculature adjacent to the bones. During that procedure, they removed a small piece of his tibia bone and replaced it with a synthetic spacer laced with antibiotics and then reassembled his leg with new hardware, then added a metal frame called an external fixator (commonly called an X-fix).

Three days later, during a seven-hour surgery on June 5th, doctors removed a piece of his gastroc muscle that hadn’t started to regrow and also harvested a flap of muscle from his left thigh and placed it over the injured tibia. After that, doctors did another skin graft—this time removing skin from his right thigh and placing it over the bone in his lower left leg. He spent parts of the next three days in the intensive care unit—in a room heated to 88 degrees for the first 40 hours—to assure the optimal healing environment.

On June 10th, he underwent another surgery during which doctors went back into the injured leg to once again clean it out, determine if the soft tissue and bone had progressed and adjust the X-fix support structure. That might have been his last procedure for a while, but he will likely undergo another surgery in about eight weeks to remove the synthetic spacer in his left leg and replace it with bone material doctors would have to harvest from his left femur.

“He’s one tough dude,” Stephen Price said after visiting him on Sunday. “It’s horrible to see him going through this, but he’s as tough and as strong as anyone I’ve ever met and he’ll get through this.”

Friend and running partner George Zack wrote a thoughtful blog about Mackey’s condition and continuing challenge.

Wrote Zack: “Seeing Dave creates a swirl of emotions: sadness for what he is going through, relief that he is alive, hope for what he can do, gratitude for the fact that he lives in a place with such amazing care and technology, concern for those around him, inspiration to see him make a smile for those who visit him, love for the community.”