By the end of the appointment, his gray t-shirt bears the sweat-stained marks of his effort. Still, the Concord High School social studies teacher and assistant football coach manages a smile and a few self-deprecating wisecracks with Smith, who notes his increased strength and ability to bear weight on his left leg.

“Any pain?” she asks.

“Nope, just resting,” he says. “We’re going in the right direction.”

Considering prosthetic options

Runyon’s left leg was amputated in 2015 following a diagnosis of malignant sarcoma behind his knee. The surgery left him with a relatively small residual limb after the amputation, which made it hard to get a good fit with a prosthetic socket, the traditional way a prosthesis attaches to the body.

“Imagine every day that your foot can be in a different spot. How hard would it be to walk? That's what you go through with a prosthetic,” Runyon said. “Then, coaching football in August, during two-a-days, it's 100 degrees out, my leg would be almost baking in there, it was so hot. I would keep an extra towel in the freezer just to cool myself down.”

While doing research before his amputation surgery, Runyon heard about another prosthetic option. Osseointegration is the name for a surgical approach that connects a prosthesis directly to the bone in the amputated limb. (The same approach is used for dental implants.)

Although Smith regularly sees patients with lower-limb amputations, Runyon is the first to have osseointegration. She remains in frequent contact with Runyon’s surgeon, Dr. Jonathan Forsberg, as well as Horne and the staff at Independence, to make sure she’s addressing any issues that are unique to osseointegration patients.

“There's a connector piece that actually runs through his bone so now he can feel much more when he's walking. We call it proprioception, so when he hits down he can feel his heel on the ground,” said Smith, who has been working with Runyon for five years, starting after his amputation. “We have to watch out in terms of progression of exercise. He might not feel pain right then but he can feel it later on.”

Runyon keeps his cell phone in his pocket to make adjustments to his prosthetic leg as needed. He makes a joke out of twisting his prosthesis in unusual positions, but the predictability of the artificial limb is a welcome change after the past few years.

Now that he’s feeling stronger, he hopes to return to the football field. He wants to use his own experiences to help athletes maintain control of challenging situations.

“Is my life exactly like it was before? Of course not, but I think of things as challenges,” he said. “I have to find a new way to do whatever it is I do. And sometimes I can do it. And sometimes I can't do it. And that's just frustrating - there's no doubt about it. But it's nice to be able to problem solve and see if I can adapt.”