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Inside the Pain Cave

Courtney Dauwalter, the world’s greatest ultrarunner, has a visualization method that helps her conquer hundreds of miles at a time. She’s won nearly every ultramarathon there is, but she’s still searching for the limits of the cave—and herself.

John Jay Cabuay

When she feels as if she is running on shards of glass, when her legs feel like they are about to split open, when she thinks she can’t possibly run one more mile, Courtney Dauwalter starts visualizing the pain cave. It’s a place she constructs in her mind with elaborate detail. She conjures every crevice of the cave’s architecture: a large space with different tunnels inside. The cavernous paths in her mind can be wide or narrow, depending on the length and duration of the race. But with Courtney, they’re usually impossibly long.

Dauwalter, 37, is considered the world’s best female ultramarathon runner. She might just be the greatest ultrarunner of all time, period. She races astonishing distances of 100- and 200-plus miles, even once attempting a 486-mile course. She is often on her feet for a mind-bending 24 or 48 straight hours, in the harshest environments imaginable, from steep terrain and high elevation to extreme weather.

Each race, she intends to go into the pain cave. She almost craves it. She warns herself, standing at the start line right before the gun goes off, that she is about to embark on another uncomfortable journey to the cave. “It’s not always going to feel great,” she tells herself. “But that’s going to make us better. We’re going to get better from visiting it.”

She has an aching desire deep within that drives her to push and push—to see what she is capable of—and she does it with a smile on her face. Even in moments of duress, she is surprisingly warm and chipper. Bubbly. Goofy. She often jokes, smiles. Dreams of what toppings she’ll drizzle on her nachos once she survives the race. Sometimes around 3 a.m., she is so amped, in awe of the mountains surrounding her, that she’ll squeal: “This is awesome!”

There is simply no one like Courtney. Her passion is palpable. She races in her signature baggy basketball shorts, often gray and baby blue with a loose T-shirt. She wants to feel comfortable. To feel like herself. Her approach is as unique: She has never been guided by numbers or a rigid training regimen. She gets antsy if she doesn’t run for two days, not because she’s trying to follow a strict mileage plan, but because she feels unparalleled joy just breathing on the course. Climbing higher and higher. She constantly asks herself: “What else is out there? What other distance is there?” She possesses a curiosity that is almost scientific in nature, coupled with an unbridled enthusiasm to test how far she can go. “When it feels scary or sounds too hard,” she says, “that’s the thing we should probably try to do.”

As a race rolls on, she goes deeper into the cave, hearing echoes of voices telling her that she can’t make it. She pictures running to the cave’s farthest corners, chiseling away at the walls to expand them. The most brutal stretches of multiday races can even cause her to hallucinate. Her hallucinations tend to be vivid and feel terrifyingly real. She once saw flying eels swooping down over her head in the middle of a race. Another time she saw a circle of bears hugging.

Deeper into the pain cave.

A trail covered in white cats.

A giant ice castle.

It usually takes her a few minutes to snap out of the illusion, but she’s thankful her visions aren’t as violent as those of some other ultrarunners she knows, who have seen corpses hanging from trees. (She thinks hallucinations have to do with what one watches the day before a race, so she tries to watch lighter things: a comedy movie or home renovation shows.)

Sometimes, to ensure that her brain is still working, she recites mantras or tells herself jokes or thinks of song lyrics, or dreams of the brownie toppings she’ll have on her ice cream—after she finishes her nachos—once the race is over. If she has been racing for more than a day, she occasionally forces herself to take a one-minute power nap off to the side of a trail. Sometimes, though, she is so amped she can’t power down, so she powers forward, even if that means, as unfathomable as it seems, nodding off while jogging.

The cave, in a sense, has normalized pain for her. It has changed the way she interacts with it.

She has learned that if she tells herself that she isn’t in pain—that she is fine, that everything is fine—and that this experience of pain is to be expected when she goes into the cave, it lessens the blow. “Digging into the pain cave is just pushing past the idea of pain being a negative thing,” says her husband, Kevin Schmidt, a fellow runner who often crews for her during races.

The beauty of the cave is that it is constantly being rebuilt as she redefines her limits. “Each time I’ve raced, and hurt a little more, and dug a little deeper, I’m actually making a bigger cave with different tunnels,” she says.

Outsiders can’t always understand why she would put herself through something like this—or why anyone would. If only they could stand with her on these mountains after a run, out of breath and full of fire, feeling the profound satisfaction that comes from putting one’s body on the line to see how strong one’s mind can be. Then they would understand why she is so intrigued to find out what makes someone persevere, what makes someone fold. Ultrarunning, to her, is a game of strategy, of problem-solving. She enjoys hypothesizing, testing, recalculating—a constant raising of her own bar; a constant chiseling of new tunnels.

ULTRARUNNER Photo by Joe Amon/The Denver Post via Getty Images

Dauwalter has won nearly every race there is. She rose to international fame when she not only won the Moab 240, a 238-mile trek along the Colorado River in Utah, in 2017, but completed the course a full 10 hours ahead of the first man. She won the Western States 100 in 2018 and then the prestigious Ultra Trail du Mont Blanc (UTMB) in 2019. “By winning UTMB as an American, I think that really raised her profile everywhere,” says Francois D’haene, a legendary French ultra-trail-runner and four-time UTMB winner.

“What stands out about her as an athlete,” D’haene says, “is how she is very humble despite all the amazing efforts she has done as an ultrarunner.” And the wins continued to roll in: She won Big Dog’s Ultra in 2020, where she set a new women’s world record of 283.3 miles in 56 hours, 52 minutes, and 29 seconds. She then won UTMB again in 2021. This past July, she won the 2022 Hardrock 100, one of the world’s most grueling 100-mile races, setting a new course record (26:44:36).

“She’s clearly the greatest female ultrarunner of all time,” says Mike Ambrose, a close friend who paced her at Hardrock 100. “I wouldn’t be surprised if in the short term she starts to beat previous men’s records that were thought to be unbreakable.”

She often outruns male competitors. Ultrarunning is one of the rare sports in which this is even possible. “She’s bigger than just the sport,” Ambrose says. “We’re changing our cultural expectations, society expectations, gender expectations.”

Kílian Jornet is considered the world’s best male ultrarunner. He admires the way she makes 100- and 200-milers look easy. “For her it looked like, ‘OK, let’s go for a walk in the park,’” he says.

“The longer it is,” Jornet says, “the better she is.”

“She’s really a pioneer,” Jornet adds. He is in awe of her mental toughness—the way she pushes through extraordinary circumstances. Once, during a race in Minnesota, when she had been running for about 20 hours, Courtney stumbled in pain. She didn’t want to show that she was hurting, but she had a blister on her pinky toe that rolled over onto the top of her foot, separating skin and toe. “It was just like a big water balloon,” Schmidt says. She kept running as if nothing was wrong. “It was just a wince for her.” Or take the 2019 IAU 24-hour world championships in Albi, France, in 2019. She was suffering enormous pain, and cried during many stretches of the course, but refused to stop running. “I’m not quitting,” she told her parents as she passed them along the course.

Sometimes it can be difficult to hold down food and she’ll vomit every few miles, as she did during this year’s Hardrock 100. Panic started to set in as her nausea worsened. The climbs were getting steeper. Ambrose, pacing her, was telling her to take it easy: Just stay upright, go slower. She was going to win the race, he reasoned. There was no need to rush. “No,” Dauwalter told him. “I don’t want to dog it. I want to get the best out of myself.” She sipped some chicken broth, which finally settled her stomach, and trudged on. “It’s unbelievable,” Ambrose says. “We went from self-preservation to, ‘Fuck it. We’re just going to push.’”

She is wired that way because she doesn’t ever want to wonder: “What if I didn’t give every last thing I had within me?” So, when she found herself temporarily blind during the Run Rabbit Run 100 in 2017, she didn’t even consider stopping. She was too deep in the cave. The walls had already pulled her in.

She had been running through the night when she started to feel her vision get blurry. Sunrise was approaching, and she wasn’t sure what was happening. Was her headlamp dying? She felt mist. Maybe it was fog? She moved her hand in front of her face, but couldn’t see it. She just saw … white. She knew something was severely wrong. She tried looking down at her feet, but could see only the arc of her sneakers. That was enough to keep her moving on the thin trail. With barely any vision, though, she kept tripping on rocks and tree roots. Schmidt, aware she couldn’t see, was trying to help her navigate the course. “Can we run faster?” she kept urging him.

At one point she belly flopped to the ground and hit her head on a rock. Blood gushed down her face. She touched her cheek, and felt something slimy. “It’s just sweat,” she told herself, unable to see the red liquid on her hand. “You’re fine.”

“Anyone else that happened to, they’d be like, ‘Well, I can’t see. Guess my race is over,’” Schmidt says. “And she’s immediately problem-solving, finding ways through it.”

That thrill of challenging herself has always driven her. In high school, she competed in track, Nordic skiing, and cross country. She was a four-time Minnesota state Nordic skiing champion. She went to the University of Denver on a cross country skiing scholarship. After college, she worked as a high-school teacher of biology, chemistry, and physical science for a few years, and then taught eighth grade science. While in the classroom, she felt that familiar urge to be outside running. She decided to quit her job and give ultra a genuine shot full time in summer 2017, because she didn’t want to grow old and look back with regret at what could have been.

As much as she’s achieved, she isn’t motivated by results. She rarely looks at splits during races, or cares much where she is in comparison to other runners. She has no rivals, only friends. She wants everyone to finish “the adventure,” as she calls races. She hopes everyone feels the joy that she feels when she’s pumping her arms, her legs. Faster and faster. She never feels as if she’s racing someone else. She feels like she’s racing the day. The course. Sometimes, herself. She spends a lot of time on her own. Just her and the trail. Even during the pandemic, when races were canceled, she woke up to run early by herself and see what her body could handle. The only pressure and the only expectations she feels are the ones she puts on herself: “I expect myself to give it everything I have in a race,” she says, “and that’s about where the expectations end.”

She thinks of the race she is most proud of. Without hesitation, her mind turns to a moment of falling short. A moment when she could not press on. A moment when she gave up. She knows now, from enduring that disappointment, what she is truly capable of.


“You don’t know if you can make it or not,” Dauwalter says, reflecting on how she feels before a race. On this August afternoon, she’s sitting at a patio outside of Silver Llama Market & Eatery, a café in downtown Leadville, a quaint, historic mountain town about two hours west of Denver where she and her husband reside. The elevation is 10,152 feet—the highest of any U.S. city. She turns her head, revealing a small peace-sign stud in her left ear. Her mother, Tracy, wears the right stud.

“It’s not a fear of failing. I don’t care if I fail,” she says. Though the distances she runs can seem otherworldly, and one might picture an ultrarunner as an infallible superhero dressed in athleisure, Dauwalter is refreshingly down to earth. Sincere. She isn’t afraid to say that she, too, has fears. She, too, doubts herself. “That’s just part of it to me,” she says. “There’s going to be things in life that I don’t do like I wanted to. It’s more just I want to put myself in there to see. Because what’s there to lose? I tried.”

“And if I fail, and don’t make it,” she says, “then I reflect on it and figure out what happened.”

She recalls her first 100-mile race, the 2012 Run Rabbit Run in Steamboat Springs, Colorado. She had been competitively ultrarunning for about a year, having completed a 50-mile race. She knew the 100 would be unlike anything she had faced before. “It sounded insane,” she says, “and I had to try.”

Around mile 50, she felt an unbearable pain in her legs and feet. She was dehydrated and calorie-depleted, and began to vomit. Because she had little experience at this distance, she didn’t know then that vomiting is normal, and even expected, in races of that length. But it was alarming to see her body react that way.

Negative thoughts flooded her mind. The pain cave had yet to be constructed.

Who are you kidding, to try a 100?

You can’t do this.

You should just quit.

During that first 100 race, she struggled. She didn’t know how to combat the negative thoughts, which seemed to multiply by the minute. Her body was screaming to stop. She quit around mile 60. “I convinced myself that I couldn’t do it,” she says.

Because she was in such a desolate area of the course, she had to wait hours for her crew to fetch her. She had plenty of time to sit and watch the other runners zoom past. She saw how much pain they were in. She also saw how they willed themselves to keep going. She was so disappointed in herself, knowing she wasn’t as mentally tough as they were. How had she surrendered so quickly?

That wasn’t her. It was humbling—and motivating—to process the disconnect between who she thought she was and who she seemed to be on that day. She thought of all the things she should have done. She wasn’t going to blame anyone but herself. “I’m going to be a person who finishes 100s,” she told herself. She might have to crawl, but she would find a way to better herself and push through next time. “It would have been super easy to be like, ‘Well, 100s aren’t for me, maybe I’ll do another 50, maybe not,’” she says.

Easy wasn’t what she wanted, but she had much to learn. What’s the difference between normal pain and injury in a race that long? All of this was uncharted territory for her. She started to fall in love with problem-solving; that curious, meticulous part of her wouldn’t let this challenge go. She realized ultrarunning was as much about the brain as it was the body, and that she would need to build mental toughness. Pushing through physical pain, she was learning, had as much to do with positive thinking as it did with being in peak physical shape.

She realized that mental toughness is honed not just in brutal races but in small daily practices. Never making excuses. Finding ways to train even when she doesn’t feel energized. And, when negative thoughts did surface, she learned how to respond to them. Counter them, as she dug deeper into the dark, wet tunnels.

Early on, perhaps around the time she quit that first 100, she had envisioned herself walking up to the pain cave and not going inside. “I used to get to the entrance [of the cave] and backpedal. Like, ‘Oh this is the limit, and now I’m going to get out of here as quick as I can. I don’t want to go there,’” she says.

Then she progressed to going inside the cave, but just seeing herself sitting in a comfy chair. “I’m here,” she’d think, “but I’m not actively doing anything. I’m just surviving it.” And now? This version of her? “I’m going in,” she says, “because this is actually where the work is done.”

She visualizes storing different strategies she’s learned in various compartments of the cave so that she can refer to them during difficult situations—when “wrenches,” as she calls them, are thrown her way. When it’s scorching hot, she visualizes popsicles or jumping into a lake. She tries to be as logical as she can when she faces difficult stretches, shrinking the course into digestible bits rather than getting overwhelmed by the daunting mileage ahead

She often remembers something her mother gave her before her second attempt of the 100: a card with a coin-sized peace sign on it. “I’ll be with you the whole way,” Tracy wrote. “You’re stronger than you think.”

Since then, Courtney has run with the peace sign in her pocket. She doesn’t take it out during races, for fear of losing it. She’ll feel it with her hand, though, during various points of an event, to make sure it’s there. Then a calm will wash over her.

“You’ve got your peace sign,” she thinks to herself. “You’re stronger than you think.”

Back in Leadville, the clouds look as if they are about to burst. The giant, fluffy white sheets swell and shift to gray, with bites of blue sky fighting through. A light drizzle comes down, but the sun still shines. Dauwalter is eager to keep moving, making her way through one of her favorite trails, Boulders. The air smells of cedar and pine. There are many trails to choose from, all with colorful names: Golddigger. Cold Feet. Wedgie. Giddy Up. Old Chub. She laughs, repeating the last one, brimming with excitement about which path to choose.

She doesn’t have a plan; she often doesn’t when she trains. There is nothing calculated about her approach. The greatest ultrarunner in the world just goes by feel, wanting to put one foot in front of the other and see where they’ll take her. That’s the fun part for her: getting lost in the green. Marveling at the tall trees surrounding her: lodgepole pines. Norway spruces. Douglas firs. They remind her that humans—our fears, our lives—are so small. And that tiny wonders should be appreciated, such as the red-and-white clusters of mushrooms that suddenly appear and remind her of Mario Kart. A few minutes later, a black-and-white winged butterfly floats past her.

It begins to rain hard. Dauwalter is soaked but unbothered. She cracks a wide smile. “This is so nice. So quiet and peaceful,” she says. “Do you want to keep going?” Soon she spots Mount Elbert in the distance, the tallest mountain in Colorado, at just over 14,400 feet. She pauses, taking in its beauty. Taking in the gift of being here. Of running—to have her legs and arms and muscles and bones all work together to propel her through excruciating races.

A father and son running whirl by. They recognize her. “Hi!” she quickly says to them. “Nice work! Have fun!” The more people ask Dauwalter about herself, the more she flips the questions on them. She is genuinely interested in other people’s stories. That’s part of the reason so many admire her. It’s not just because of her success, but because she is authentic. Comfortable with who she is. She doesn’t have a strict diet. She gushes about her favorite foods, such as candy (gummies like Swedish fish, jelly beans, Mike and Ike’s) and ice cream (with toppings like brownie bits swirled in).

She hasn’t abandoned her basketball shorts for more tight or tech-centered attire the more famous she has become. All her life, she had worn basketball shorts and felt most comfortable in them; she didn’t think twice about wearing anything else for races. When she first signed with the brand Salomon, she asked them for men’s medium shorts. “The longest shorts you have,” she said.

“They didn’t bat an eye,” Dauwalter says. “And that was super cool, because in theory, they could have, you know?” She loves how welcoming the ultrarunning community is. She has seen people race in jean shorts and a flannel with sleeves cut off. In fact, the moment she fell in love with the sport was during one of her first 50-milers. A man was running in a giant black garbage bag with holes poked out for his head and arms. The weather was horrendous; hail was flying, rain was pounding. But the man was having the time of his life, running down the trail screaming: “WHOAAA!!!! YEAHHHHHH!!!! WE’RE LIVING!!!!!!”

She instantly felt invigorated, forgetting about the storm. “This is so cool,” she thought. What happened next wasn’t ideal: She tripped and splahsed into a mud puddle. The man heard the splash. Though he was 15 feet ahead of her, he turned around and ran to her. He yanked her out of the puddle, and they were off running again.

She was stunned. She had never seen competitors help each other like that in any sport. That’s when she realized what ultra is truly about: community. A bunch of strangers on an adventure, all trying their hardest. She loves not knowing anyone when she arrives, but by the race’s end everyone is swapping stories and sipping beers. It can feel like a family reunion. No matter how anyone has placed, they all shared this profoundly difficult but meaningful experience. There is an intimacy that passes between runners, a mutual respect that can come only from knowing what it is like to give every ounce of energy in one’s body and brain to reach some of the most remote edges of Earth.

She hopes others know the feeling that she does: the joy that comes way before the finish line, when she’s fatigued and throbbing with pain, but soaking in the extraordinary views around her. In these moments her mind goes blank, but she’s still conscious enough to be in awe of her surroundings. It’s a blurred space between peace and pain. In the middle of the Colorado mountains. The French Alps. Sunrises, sunsets.

During July’s Hardrock 100, she found herself trudging through a rough stretch around mile 50. She was vomiting but paused when she saw a bed of wildflowers. Giant yellow ones. Smaller purple ones. Tall green weeds almost at her calf-length socks.

She couldn’t stop looking at the flowers, beaming. The yellow and purple seemed to go on for miles, even to the gray-white mountains in the distance. She grinned and turned to Ambrose, who was pacing her:

“Would you look at this!” she said. “This is beautiful.”

Then that familiar voice tugged at her. The one that urges her to go faster, farther. She felt her stomach rumbling, her legs stiffening. “Everything’s fine. You’re fine,” she says to herself, calmly. She is back in the pain cave. Ready to dig.

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