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FWIW, I ran the Pikes Peak marathon... hmm... must be at least 12 years ago.
Once you get above the tree line, it really is mostly a glorified fast march with a little hopping from boulder to boulder for good measure. If I were given the choice today, I would MUCH rather run up Pikes Peak again than run down it. That's what really kills your legs.
I trained in St. Louis and found one long hill for repeats. The legs held up fine. There was no way to train my lungs for the altitude, though, short of buying an altitude tent for sleeping--so it did make the miles near the top significantly harder than normal.
Good luck.
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