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Elite marathon runners experience only a slightly lower maximal aerobic power (VO 2max) at high altitudes than at sea level. Compared to good runners, elite runners maintain a higher percentage of VO 2max which ensures a consistently better performance. High altitude running varied also with respect to uneven paths and the mechanical work rate of breathing.

The costs of walking (Cw) and running (Cr) were measured on 10 runners on a treadmill inclined between −0.45 to +0.45 at different speeds. The minimum Cw was 1.64 ± 0.50 J · kg−1· m−1at a 1.0 ± 0.3 m/s speed on the level. It increased on positive slopes, attained 17.33 ± 1.11 J · kg−1· m−1at +0.45, and was reduced to 0.81 ± 0.37 J · kg−1· m−1at −0.10. At steeper slopes, it increased to reach 3.46 ± 0.95 J · kg−1· m−1at −0.45. Cr was 3.40 ± 0.24 J · kg−1· m−1on the level, independent of speed. It increased on positive slopes, attained 18.93 ± 1.74 J · kg−1· m−1at +0.45, and was reduced to 1.73 ± 0.36 J · kg−1· m−1at −0.20. At steeper slopes, it increased to reach 3.92 ± 0.81 J · kg−1· m−1at −0.45. The mechanical efficiencies of walking and running above +0.15 and below −0.15 attained those of concentric and eccentric muscular contraction, respectively. The optimum gradients for mountain paths approximated 0.20–0.30 for both gaits. Downhill, Cr was some 40% lower than reported in the literature for sedentary subjects. The estimated maximum running speeds on positive gradients corresponded to those adopted in uphill races; on negative gradients they were well above those attained in downhill competitions.