Gone are the days of simplistic recovery tools. Innovative techniques are taking over contemporary rehab and quickly gaining in popularity.
This article was originally published in the July/August 2012 issue of Inside Triathlon magazine.
Sports medicine has come a long way since the days of menthol-soaked training rooms, filled with runners with taped shin splints and soccer players with iced sprained ankles.
In triathlon, advances in sports medicine are being adopted with great zeal, as triathletes attempt to master what many people call triathlon’s fourth sport: recovery.
The sport’s elite athletes are usually the first to try out new therapeutic techniques—whether for injury rehabilitation or routine recovery—often in the hope of gaining a competitive edge or extending a career. These techniques—if the elites find that they work—also quickly trickle down into the age-group ranks.
Indeed, just a few years ago “recovery” meant nothing more than a massage or a protein shake. Compression gear was confined to the medical industry and anyone wearing hip-to-heel inflated moon-boots would raise an eyebrow. Now, recovery boots are yesterday’s news. Intricately patterned kinesiology tape decorates mountains of skin at any swim start. And muscles are compressed by the thousands with über-tight socks, shorts, shirts and arm sleeves.
So what’s on the cutting edge today? What are the pros using that, given some time, you might find yourself turning to for recovery? And what will it take for you to get on the cutting edge and try out some of these techniques yourself?
Ever wonder how it would feel to walk—or run—on the moon? The AlterG Anti-Gravity Treadmill simulates that experience. While it resembles a traditional treadmill, it is outfitted with an airtight capsule into which the user is zipped at hip level, wearing lightweight knee-length neoprene shorts. The runner’s weight is calibrated, after which the compartment is pressurized to lift the individual, progressively reducing his weight by up to 80 percent (enabling him to run at a weight as low as 20 percent of his normal body weight). This reduction in weight causes a subsequent reduction in impact, allowing an injured runner to keep running—thus preserving his natural gait and muscle firing patterns—while giving his body an opportunity to heal. Today, elite athletes also use it to get in extra miles at a lower physical cost, or to practice running at a pace they couldn’t manage at full body weight—thus allowing their bodies to experience neuromuscular firing patterns they couldn’t otherwise.
Previously only available to elite athletes, the AlterG’s presence is now growing as more and more physical therapy clinics and chiropractic offices are offering the high-tech treadmill. (The machine costs $32,400 or $75,000, depending on the model.)
“We went to the AlterG because we have a lot of patients who resort to water running or the elliptical machine, but they really are unable to mimic the true run motion,” said Bob Cranny, a Boulder, Colo.-based physical therapist who recently purchased AlterG treadmills for two of his clinics. “Although you’re utilizing the same muscles as running, it’s not in the same capacity. And there are a lot of injuries or issues that people are dealing with—even from a recovery standpoint—where you do want some kind of impact.”
Cranny describes the body as “an incredible adaptive machine.” As long as the stresses on it are consistent and gradual, it will adapt to almost anything. But because water running is completely non-weight-bearing, the body doesn’t get the impact it really needs for active recovery from injury or hard efforts.
“Take a stress fracture,” he explained. “While with your standard stress fracture doctors tell folks to take six weeks off running altogether, we’ve been able to put people—with a physician’s approval—on the AlterG at four weeks at 70 percent of body weight. So they have two weeks of true running under their belt before they go back outside.”
This gives athletes a more gradual build back to full-force running, in addition to minimizing the time lost from training.
“I’ve done a fair amount of water running over the years and I think the AlterG is way better,” said pro triathlete Julie Dibens, a former 70.3 and Xterra world champion. “It’s more realistic, plus I think you get more benefit from it psychologically. In the water I’ve never felt like I was actually running. And anybody that’s done water running would agree that it’s boring as hell!”
The AlterG is equally appealing as a recovery tool, Cranny says, as athletes can use it to gain the mental satisfaction of running yet refrain from inflicting more muscle damage and joint stress on a body that’s already in need of a rest.
And because the AlterG does not entirely eliminate impact, it allows for normal muscle contractions and is therefore more effective in flushing the body’s metabolic waste than non-weight-bearing activities.
Former professional triathlete and elite age-group runner Joanna Zeiger, 41, says the AlterG was instrumental in her placing second overall in the masters division of the 2012 USA Cross Country Championships, only three weeks after she ran the U.S. Olympic trials marathon.
“Between the marathon and nationals I ran on the AlterG two days a week and ran three days a week outside,” Zeiger said. “It was about recovery and trying to get in some speed workouts without the heavy load of running outside. I did all the hard workouts on the AlterG, except for a four-mile cross-country race two weeks after the marathon trials. When I first started off I was running at 80 percent [of my body weight], and I would just build a little more each week so at the end I was running at 90 percent or so.”
If you’d like to try the AlterG for yourself, Cranny says that the time you spend on the device and the weight you run with will depend on your conditioning, injuries and the way they feel during the AlterG session—all variables that should be worked out under the guidance of a professional, he said.
He also cautions against an over-eager need for speed.
“I have seen people become a little overzealous in situations like this,” he said. “Because they’re unweighting themselves, they’re able to run at a pace they normally wouldn’t be able to run, and that can impact them adversely. Their body is not accustomed to the shift in biomechanics due to running at a higher speed.”
As a general rule, runners using the AlterG should run their normal pace. Cranny warns that this is especially true of athletes coming off an injury. They need to progress steadily—not suddenly run faster than ever before. The exception would be the uninjured, non-fatigued athlete.
“Say their maximum pace is an eight-minute mile, and they just want to get a feel for what it’s like to run at a 7:30 pace. That’s fine. It would be like drafting in a pace line on the bike—a chance to get that neurologic feedback of running a 7:30 pace and reeducate those adaptive muscles. But don’t go overboard,” Cranny said.
While the AlterG may not be intended for running at warp speed, it can be an invaluable outlet for the high-mileage runner. Legendary running coach Alberto Salazar is reported to use the treadmill to lessen the load on his long-distance disciples.
“He’ll have them do their two-hour runs at 80 percent body weight,” Cranny said. “So they unload their bodies by 20 percent and they reduce the risk of injury. They’re still getting the physiological impact—they’re still getting the normal running motion—and yet they’re walking away after a two-hour run without all the damage that would normally be done.”
Ins & Outs of the AlterG
BEST FOR | Lower extremity injuries that may benefit from partial weight-bearing (under the supervision of a physician); recovery from intense physical effort
BENEFITS | Promotes active recovery; prevents atrophy post-injury; enhances healing; similar physical and psychological effects as regular running
WHAT TO EXPECT | Feels a bit odd initially, but after a short adjustment period it feels very similar to a traditional treadmill (albeit at your grade school weight)
SIDE-EFFECTS | Body image can be hindered by a post-run return to normal weight!
CAUTIONS | Overzealous use—running too fast on the treadmill or too soon following injury
PROS | Ability to return to running (post-race or post-injury) sooner than with full-impact exercise; precise control over progressive weight bearing, pace and incline
CONS | Running in neoprene shorts; it’s still running on a treadmill
COST | A nominal fee at any facility listed on the manufacturer’s website (with free initial demo)
FIND AN ALTER G | Alter-g.com
SCIENCE SAYS | The benefits of progressive, controlled loading and mobilization of healing tissue and bone are well-documented, as are the adverse effects of keeping injured tissue immobilized. A few studies have been published validating the claim that running on the AlterG helps a runner maintain normal gait and muscle firing patterns while decreasing joint loads. Clinical studies into the specific applications and treatment protocols associated with the AlterG are currently in progress.
BRETT SUTTON’S DIY ANTI-GRAVITY TREADMILL
In the 1990s, triathlon coach Brett Sutton held training camps in Jindabyne, Australia. While there, he created a do-it-yourself—and much cheaper, albeit less scientific—AlterG that anyone with engineering sense could put together. He believes it helped Loretta Harrop, the 2004 Olympic silver medalist, train through several stress fractures.
“We put a pulley in the roof, and I attached a rope to a mountain climbing harness,” Sutton said. “I would be on the end of it and I would take the weight by lifting her above the machine. It was all my guesswork how much we lifted her. I would say it helped her win at least eight World Cups with stress fractures. The new-fangled version I believe would be a terrific tool, but I’ll never be able to afford one.”