Depending on the year it shouldn't be to difficult. I just cleaned the contacts on my 98's starter and i could get at everything from underneath without even jacking the truck up.
All you should need is a good quality swivel for your ratchet and a couple of different sized extensions. I didn't really look to see if there was enough room to wiggle the starter out around the exhaust but that is always the tricky part.
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1998 EB Expedition 4X4 200,000+, 1999 Windstar 200,000+ (Needs Head Gasket), 2008 Chev Colorado (Company Truck, Really sucks but it's free)
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