Running Injuries and the Alter-G (Altered Gravity Treadmill)

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Having been in practice for 14 years and predominately treating ruSDRI's Alter-Gnners and their injuries during most of that time I have seen my fair share of rehab tools, gadgets and devices come and go.  Some actually have stood the test of time and became ingrained into the running community at large.  A good example of this would be a foam roller.  While foam rollers may have been around since the 1990’s they began to become prevalent in the running community around 2004.  It seems now every runner has one whether they know how to actually use it or not!  During the last 14 years I have seen sticks, wheels, rollers, knobbies, balls made of wood and plastic, compression suits, stretching devices,  detoxifier foot baths, insoles and more nonsense marketed to runners with claims that the product will either treat their injury or help them prevent an injury from occurring.  Most of this stuff is nothing more than a gimmick and in reality is designed to alleviate the runner of their money!  Recently an amazing machine became available called the Alter-G which stands for Altered Gravity Treadmill.  This is an ingenious device that was invented at the Ames Research Center in Mountain View California with the intent of creating a gravitational environment in the space station to help prevent muscle atrophy and bone mineral loss while astronauts were in space.  Without gravitational stress human connective tissue will deteriorate resulting in permanent damage to the body.

Originally invented in 1992 the first prototype of the Alter-G did not become available until 2006.  The first facility to receive one was the Nike Oregon Project with the program supervised by former Olympian Alberto Salazar.  I was able to finally “test drive” an Alter-G in 2013.  I was excited because I had read some research regarding the device and wanted to see what it felt like first hand.  I met the Alter-G rep at the agreed location and eagerly changed into my running clothes.  He had me slide the Alter-G Tri-style compression shorts on over my own shorts and step into the altered gravity chamber that seemed to be part of the treadmill.  I stepped up onto the treadmill, standing within the circular ring of the chamber and he proceeded to raise the chamber up so that it was about even with my waist.  He then fastened the chamber to my Tri-style Alter-G shorts and instructed me that he would pressurize the chamber that now surrounded my lower body.  I stood still as the chamber pressurized first taking me to 20% of my body weight, then rapidly bringing me back to 100% of my body weight.  He then turned on the treadmill and asked me to run at a comfortable speed.  I set the speed at 6.0 mph and began to run at conversation pace with the Alter-G set at 100% my body weight which is 180 lbs.  After roughly 2 minutes he reduced my body weight by 10%.  I could barely feel a difference.  Two minutes later he reduced my weight by 20%.  WOW!  Now that I could feel.  After another 2 minutes he took my body weight down by 30%.  Holy S&%$#*T!  I was running weighing the equivalent of 126 pounds!  I felt light as a feather and instantly the 6.0 mph felt way too slow.  I sped the treadmill up to 8.0 and ran effortlessly.  I felt none of my usual 43 year old pain or suffering from my feet, knees or hips.  I instantly knew that I could help thousands of runners achieve their goals utilizing the Alter-G!  In the past when a runner presented to me and I diagnosed them with stress fractures they were essentially stopped in their tracks.  Since stress fractures take 4-6 weeks to heal they could not run during that entire time.  Sure, they could bike or do the elliptical but every runner knows that there is nothing like running!  Now  I would be able to take injured runners with stress fractures, torn muscles and ligaments, ITB, bursitis…..any condition that was stopping them from running and I could have them run while their body was healing.  I turned to the rep and said, “I want one, when can you deliver it”.  He looked at me startled and replied, “Don’t you want to see everything the Alter-G can do?  Plus I will need to go over the pricing and financials with you”.  I said, “It does not matter, I want one.  I already know how I can help thousands of people, not only runners, with this device.”  One week later we had the Altered Gravity treadmill installed in our clinic.

That was 3 weeks ago.  In the last three weeks I have seen and also experienced first hand a giant step forward in the world of running and rehabilitation.  In fact, saying a giant step is an understatement.  This tool is the single most important piece of rehabilitation to be invented in my lifetime.  In the past 3 weeks I have seen cross country runners with multiple stress fractures run on the Alter-G with no pain whatsoever.  Three weeks ago we started them at 35% their body weight.  Each week has seen about a 15% improvement resulting them running at 65% – 85% their body weight depending on the athlete in question.  The significance of this is indescribable.  Imagine this situation.  Your child is a competitive cross country runner that competes at the highest level for their 4 years of high school.  They are slated to run nationals and have a great chance at getting national attention and earning a full ride scholarship to a school of their choosing…..and then they break and fracture 6 weeks before the event.  Normally this would have been a situation that would be near impossible to recover from.  Now enter the Alter-G under the supervision of myself, a long distance ultra runner and doctor.  Not only was I able to keep these athletes running while their injuries healed but with the help of the Alter-G we were able to speed up the healing time by stressing their bones and muscles beneath the threshold for injury!  By stimulating their bones and muscles beneath the threshold we actually stimulated their connective tissue to grow and repair while at the same time keep their cardiovascular gains intact!  I also can not stress the emotional and psychological component that was at work during this time.  Normally when runners can not run due to injury there is a period of depression that accompanies the realization that they will not meet their goals.

I even had a personal experience with the Alter-G in the last 3 weeks.  I reinjured a torn plantar plate ligament in my foot.  Two years ago I partially ruptured this ligament which almost resulted in surgery.  Five months in a walking boot and 6 Prolotherapy injections later I was out of the boot and began hiking, then moderate running, then I trained and ran a 50K, 50 miler and finally a 100 mile endurance run.  Out of nowhere a couple of weeks ago I aggravated the injury by stepping on a sharp rock.  I have been able to run on the Alter-G pain free at 75% my body weight at 9 mph.  In three weeks my foot is remarkably better and I will commence normal running next week as I have a 50K Ragnar Relay in November.

Populations in addition to runners that can benefit from the Alter-G

Orthopedic – The ability to progressively load connective tissue using differential air pressure technology (DAP) allows injured patients to protect healing tissue after an injury or surgery, while encouraging normal walking or running mechanics. The results are faster return of strength and range of motion.

Neurologic – The amazing support of the Anti-Gravity Treadmill allows for longer balance and gait sessions, so patients can practice standing, balance exercises, or walking longer. Longer practice sessions equates to more muscle memory and greater opportunity for motor learning.

Sports Performance – The ability to decrease body weight and train and higher speeds may allow athletes to train their body to perform at a higher level.  By training at a % less their body weight athletes can still stress their muscles, ligaments, tendons and bone but decrease their risk of injury or of aggravating an injury.  Since human connective tissue grows and adapts in response to stress it make sense that by stressing their tissue beneath the injury and pain threshold runners and athletes can not only train on the Alter-G while injured but will most likely heal at a faster pace and return to sport sooner.

To see the Alter-G in action

If you live in San Diego and would like to try the Alter-G my clinic has packages available for both injured and non-injured runners.  To make the experience more enjoyable we have installed a 55 inch television with Netflix to make the normally boring treadmill experience more enjoyable.  Call 858-268-8525 to reserve your Alter-G time.

By | 2013-10-02T13:18:51+00:00 October 2nd, 2013|Gear & Equipment, News & Announcements, Running Injuries, Training|2 Comments

About the Author:

Dr. Runco is a U.S. Navy and Gulf War Veteran. He began private practice in 2000 primarily treating and fixing running injuries. He has been a professor of Anatomy, Physiology, and Biomechanics at various colleges and continues to teach continuing education in the fields of rehabilitation, custom orthotics and athletic taping. He is also a member of the American College of Sports Medicine, National Strength and Conditioning Association and is a Certified Strength and Conditioning Specialist. He has completed over 15 Marathons in 15 states and has run 11 50 mile Ultramarathons.


  1. Patrick March 18, 2017 at 12:39 pm - Reply

    Do you find the Alter G good for treating high hamstring strains? Any suggestions on using one for this type of injury? I live in NJ

    • Dr. Runco March 20, 2017 at 1:32 pm - Reply

      Yes it can be effective assuming it is used correctly. There are a few variables besides body weight. Incline or decline and speed. The main goal is to allow you to run as the injury heals. For this to happen you can have no increase in pain while running. We know incline and faster speeds will normally make it worse so start slowly and 0% incline

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