The 5 Ways the Alter-G Can Help Runners

 In Running


The Alter-G Treadmill is a revolutionary device enabling reducing loading during walking and running. The treadmill uses differential air pressure to reduce percentage of body weight, enabling walking or running at anywhere from 20% to 100% bodyweight. This can be used for numerous conditions to help ensure safe, yet quick return from injury or surgery whilst maintaining cardiovascular fitness. The Alter-G can also be used to improve performance with high intensity interval training. Let’s explore how it can improve your running.

The Alter-G can also be used to improve performance with high intensity interval training. #performbetter @pogophysio Click To Tweet

1. Faster Return To Running

The AlterG anti-gravity treadmill is indicated for the rehabilitation of lower limb injuries from the spine and hips to the knees and ankles. It is positioned greatly for athletic rehabilitation of all levels due to its unique ability to reduce ambulatory lower limb forces (1) by directing upward body pressure on the user (2). This allows the user to maintain normal pain-free ambulation during each session by reducing the amount of force sustained through the injured part on the AlterG anti-gravity treadmill. Evidence from Jensen and colleagues (3) has shown that vertical ground reaction forces are decreased with weight support but horizontal ground reaction forces are maintained. This leads to normal gait patterns at all levels of support and therefore normal running patterns can be facilitated whilst in the Alter-G. So with reduced levels of joint loading and normal running mechanics safer and earlier return to running can occur. Now if you’re wondering if your injury is suitable, here are some injuries which have been successfully utilised the Alter-G during rehabilitation;

  • Metatarsal Stress Fracture
  • Chronic Patellofemoral Pain (anterior knee pain)
  • Complex Regional Pain Syndrome
  • Fibula Stress Fracture
  • Lumbar Disc Herniation
  • Knee Osteoarthritis
  • Plantar Fascia Tear/Plantar Fasciitis
  • Ankle Sprains
  • Tibial Stress Fractures
  • Navicular Stress Fractures
  • Muscle Strains

2. Faster Recovery From Surgery

Unfortunately some injuries, require surgical intervention, which for the injured individual often means a long, slow recovery and time with weight bearing restrictions. For tissue healing after surgical procedures early mobilisation and controlled loading are crucial. This extends from people in hospital in the ICU through to ACL reconstructions and Achilles Tendon repair. Healing tissue moves through 3 phases acute inflammation, remodelling/repair and tissue remodelling. Early mobilisation after surgery can improve orientation of healing muscle fibers, encourage resorption of scar tissue, and decrease muscle atrophy/ weakness and minimise loss of movement (1,2,3,4).  The Alter-G has been used to facilitate early mobilisation for surgical procedures, where loading can be closely monitored and controlled without risk of damaging the surgical repair. Weight bearing can be gradually progressed as rehabilitation continues and enable safer return to normal running. For example individuals can perform closed chain walking and jogging early on in the postoperative period after Achilles tendon repair, maintaining a training effect in spite of partial weight bearing (5).

Surgical procedures that can benefit:

  • ACL and Medial Meniscus Tear
  • Knee Arthroscopy Microfracture
  • Arthroscopic Partial Medial Meniscectomy Rehabilitation
  • Total Knee Replacement (6)
  • Total Hip Replacement
  • Total Ankle Replacement
  • Below the Knee Amputation (BKA)
  • Hip FAI Arthroscopy
  • Hip Labrum Repair and Microfracture
  • Bilateral Hip Resurfacing
  • Femoral Fracture: Intramedullary Rod
  • Lateral Ankle Reconstruction
  • Multiple Lower Extremity Fractures
  • Lumbar Spine Disc Surgery
  • Slipped Capital Femoral Epiphysis Surgery

3. Improved Physical Capacity and Performance

An Alter-G treadmill has numerous benefits for running performance, importantly you don’t have to be injured or an elite athlete to see great benefits. If you are looking to increase mileage leading into event, perhaps you haven’t had the best lead in or want to add an extra session or two, jumps in volume carry an extra injury risk (the old too much, too quick, too soon). Utilising a session or two with the Alter-G can reduce the load throughout the lower body (bone, muscle, joint, ligament and tendon) without carrying the same injury risk. Alternatively longer session can be performed to assist in training for distance, speed and /or cardiovascular fitness. A 2015 study used a high intensity interval training program to assess improvements in running speed in trained high level runners. Participants were randomised to standard treadmill training vs 10% body weight support on the AlterG. The 4 week HIIT protocol improved field performance, VO2 max, and submaximal heart rate. Additional research studies have also shown the AlterG anti-gravity treadmill is effective in improving athletic performance (7). Several papers have shown that high intensity training on this device has been shown to improve field performance, VO2max and other indicators of effort, whilst reducing impact forces on the lower limb. (8, 9,10).

Utilising a session or two with the Alter-G can reduce the load throughout the lower body. #performbetter @pogophysio Click To Tweet

4. Faster Running

If you are want assistance reaching a new top speed or maintain a faster pace, the Alter-G can help. With the ability to reduce body weight and lower limb loading, higher speeds can be maintained with reduced lower limb work. Additionally metabolic demands, such as VO2 (oxygen uptake) are reduced for body weight supported running. So putting mental effort aside, faster training speeds can be maintained due to lower respiratory and muscular work. A 2012 study using the Alter-G with subelite runners has also  shown potential for high-speed training in athletes, at 85% to 90% BW, because these settings provide equivalent maximal intensities for VO2 and heart rate. Athletes using the AG in their training or rehabilitation, for whom 85% to 90% body weight represents a good range that mixes pain-free running with a high specificity compared with overground running. Maximal cardiometabolic stimulation can be elicited at these settings, and the whole range of exercise intensities can be elicited as well, whether the goal is high-speed training or lower speed rehabilitation (11). In short it’s easier so you can run faster, for longer; helping you train for the pace you need with less cardiometabolic limitations.

If you are want assistance reaching a new top speed or maintain a faster pace, the Alter-G can help. #performbetter @pogophysio Click To Tweet

5. Weight Loss

The AlterG anti-gravity treadmill allows an overweight individual to experience what it is like to be of a lower body weight. Subsequently you can feel what it would be like to then run walk or run at this weight. There is evidence showing an overall significant improved effect for weight loss and fat loss for individuals who experienced a reduced weight on an AlterG anti-gravity treadmill prior to starting their exercise program over those who did not (12). In addition the AlterG anti-gravity treadmill has the ability to reduce an overweight individual’s body weight, so that pains and injuries that have previously limited walking and running can be overcome. For example people with moderate knee osteoarthritis can reduce their pain levels while receiving treatment on this device and allow them to exercise more effectively (13,14).

The AlterG allows an overweight individual to experience what it is like to be of a lower body weight. #performbetter @pogophysio Click To Tweet

So whether you want to get into running, make your way back from injury or surgery or simply want to improve performance and run quicker, the ALter-G can help. For booking and more information HERE is where to go.

Lewis Craig (APAM)
POGO Physiotherapist
Masters of Physiotherapy

Lewis-craig physiotherapist Gold Coast


  1. Patil S, Steklov N, Bugbee WD, Goldberg T, Colwell CW Jr, D’Lima DD. Anti-gravity treadmills are effective in reducing knee forces. J Orthop Res. 2013 May; 31(5):672-9
  2. Raffalt PC, Hovgaard-Hansen L, Jensen BR Running on a lower-body positive pressure treadmill: VO2max, respiratory response, and vertical ground reaction force. Res Q Exerc Sport. 2013 Jun; 84(2):213-22
  3. Jensen, B.R., Hovgaard-Hansen, L., Cappelen, K.L.: Effects of Lower Body Positive Pressure on Muscle Activity and Joint Loads. (University of Copenhagen, Denmark) Presented at The International Society of Biomechanics meeting, South Africa, July 2009
  4. Quillen WS, Magee DJ, Zachazewski JE: The Process of Athletic Injury and Rehabilitation. In Zachazewski, JE, Magee DJ, Quillen WS (eds): Athletic Injuries and Rehabilitation. Philadelphia: W.B. Saunders, 1996, pp 4-8.
  5. Saxena, A., Granot, A.: Use of an Anti-Gravity Treadmill in the Rehabilitation of the Operated Achilles Tendon: A Pilot Study Presented at American College of Foot and Ankle Surgeons Annual Conference, Las Vegas, Nevada, February 2010
  6. Eastlack RK, Hargens AR, Groppo ER, et al. 2005. Lower body positive-pressure exercise after knee surgery. Clin Orthop Relat Res431: 213–219.
  7. Gojanovic B, Shultz R, Feihl F, Matheson G. Overspeed HIIT in lower body positive pressure treadmill improves running performance. Med Sci Sports Exerc. 2015 Dec;47(12):2571-8.
  8. Grabowski A. Metabolic and biomechanical effects of velocity and weight support using a lower body positive pressure device during walking. Arch Phys Med Rehabil. 2010 Jun;91(6):951-7.
  9. Raffalt P, Hovgaard-Hansen L, Jensen B. Running on a lower-body positive pressure treadmill: VO2max, respiratory response, and vertical ground reaction force. Res Q Exerc Sport. 2013 Jun;84(2):213-22.
  10. Figueroa M, Manning J, Escamilla P. Physiological responses to the AlterG anti-gravity treadmill [PDF]. Int J Appl Sci Technol. 2011 Nov;1(6):92-97.) making it a viable addition to an athlete’s training regime.
  11. Gojanovic, B., Cutti, P., Shultz, R., & Matheson, G. O. (2012). Maximal physiological parameters during partial body-weight support treadmill testing.Med Sci Sports Exerc, 44(10), 1935-1941.
  12. Greenwood, M., Mardock, M., et al: Experiencing the Impact of Weight Loss on Work Capacity Prior to Initiation of a Weight Loss Program Enhances Success. Presented at International Society for Sports Nutrition, Las Vegas) Nevada, June 2011, and Published in: : J Int Soc Sports utr. 2011; 8 (Suppl 1): P2
  13. Moore M, Vandenakker-Albanese C, Hoffman M. Use of partial body-weight support for aggressive return to running after lumbar disk herniation: a case report. Arch Phys Med Rehabil. 2010 May;91(5):803-5
  14. Peeler J, Christian M, Cooper J, Leiter J, MacDonald P. Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength. Clin J Sport Med. 2015 Nov;25(6):518-23

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