The Benefits of Altitude Training: Can You Bring Your Athletic Skills to the Next Level?

The Benefits of Altitude TrainingElite athletes often use altitude training to boost their performance for summer and winter sports alike. However, amateur athletes can also realize the benefits of altitude training as well. But getting the most out of altitude training can be tricky.

What is Altitude Training?

Working out at elevations substantially above sea level — or in conditions emulating elevations substantially above sea level — is the core of altitude training. The higher you go, the harder your lungs have to work to extract oxygen out of the air. For people who are out of shape, this added effort can have a training effect at elevations as low as 5000 feet (about 1600 meters), but most athletes do altitude training at elevations of 8000 feet (2400 meters) or higher. Let’s consider how altitude training works.

How Your Lungs Work at Sea Level

At sea level, your lungs can use atmospheric pressure to their advantage. As the C-shaped muscles of your diaphragm expand, they create lower air pressure inside your lungs. Air flows into the bronchioles, where the bloodstream can absorb oxygen and release carbon dioxide. As your diaphragm muscles contract, higher pressure inside your lungs forces air out.

How Your Lungs Work at High Altitudes

Mountain air contains the same percentage of oxygen as air at sea level. The difference at high altitude is that the muscles around your lungs have to work harder to create enough of a difference in air pressure to pull air in. At extreme altitudes, over 16000 feet (4800 meters), most people will not have the lung capacity to breathe in enough air for their bloodstreams to stay properly oxygenated.

Altitude Training Creates Changes in the Composition of Your Bloodstream

Your lungs never absorb all of the oxygen from the air that goes into them. There is oxygen in the air you exhale, as well as in the air you inhale. During several weeks of training at high altitude, your body creates more red blood cells so your lungs can absorb a greater percentage of the oxygen in the thinner air. Then, when you return to a lower altitude, your body can absorb more oxygen from denser air to provide more oxygen to your bloodstream.

Altitude training achieves competitive advantages for athletes. Athletes are allowed to pump up their red blood cell count by altitude training, but not by transfusions or injections. The effects of altitude training only last 10 to 14 days, but they can be extended by methods that emulate its effects.

Simulated Altitude Training

Athletes don’t necessarily have to relocate to high-elevation training sites to get the benefits of altitude training. Methods of simulating altitude training include:

  • Hypobaric chambers, also known as altitude simulation rooms. These room-sized, low-pressure chambers allow athletes to work out with restricted oxygen. They are much larger than the typical hyperbaric chamber, used to treat divers who come up too quickly and people with certain kinds of chronic health conditions.
  • Hypoxicators, also known as rebreathers. These are medical devices with a mask that fits over the nose and mouth that reduce the amount of oxygen in the air the user breathes while training. Usually, they are paired with a pulse oximeter (pO2 meter) that regulates flow so the user maintains a blood O2 saturation of about 88 percent. Most are programmed to deliver pulses of reduced-oxygen air with normal-oxygen air to avoid the user’s becoming seriously oxygen-deprived.
  • Altitude tents, which are tents with adjustable levels of air pressure. Mountain climbers who hike during winter use them to increase oxygen levels, but athletes can use them to reduce oxygen levels.

Advantages of Altitude Training

Practicing Altitude TrainingMost endurance athletes who participate in different types of skiing or different styles of snowboarding train at high altitude. There is objective, scientific evidence to back up the practice.

A Swiss scientist named Christoph Siebenmann and eight associates recruited nine male and female athletes to spend 28 days at 3,454 meters, which is 11,332 feet. They measured changes in the volume of red blood cells in the athletes’ bloodstreams, and did other blood tests to determine what was going in their bodies that made these changes possible. They found the month-long stay at 11,000 feet increased the volume of red blood cells in athletes’ bloodstreams by an average of 5.42 percent, but increases in red blood cell count always took at least nine days and sometimes took as long as 19 days to be measurable. This means that a few hours climbing in the mountains, while refreshing, won’t make a difference for training.

The researchers also found the effects of altitude training began to wear off immediately upon the athletes’ return to lower elevations and were completely gone in two weeks. But for those two weeks, there was up to a 5 percent increase in blood oxygen levels, enough to make a competitive difference in endurance sport competitions.

The Benefits of Altitude Training Aren’t All Physiological

Athletes participating in altitude training may also benefit from the “training camp effect.” Altitude training for elite athletes takes place in idyllic, mountain settings. Athletes get the opportunity to train and sleep while their trainers assure them they are making huge gains in fitness. Altitude training shields athletes from the stresses of daily life; it keeps them the focus of the whole community’s attention, so it’s only natural to make improvements in this uniquely supportive environment.

You don’t have to be a professional staying at a resort to benefit from altitude training. The more you can focus on fitness, the greater your gains.

Disadvantages of Altitude Training

Not everyone responds to altitude training. In 1997, a group of scientists at Southwestern Medical School in Dallas measured the effects of altitude training in 39 runners who ran 5000-meter races. After altitude training, 17 runners improved their 5000-meter times by an average of 36.6 seconds, seven runners had no change in their time, and 15 runners actually got slower by an average of 24 seconds.

In 2010, the Australian Institute of Sport’s altitude training group put eight runners through two three-week sessions of altitude training. They found four of the eight runners improved their times after both sessions of altitude training, two had better times after one altitude training session but not the other, and two had worse times after both three-week altitude training camps.

Not only does altitude training not always work, sometimes it has negative effects. Even if you respond to altitude training once, it’s a coin toss whether you will respond a second time. Sports scientists have been parsing the reasons altitude training sometimes fails for over 20 years.

Why Altitude Training Sometimes Doesn’t Work

Why Doesn't Altitude Training Always Work?There are some very basic problems for a few athletes in altitude training that are easy to fix. Sometimes, athletes are iron-deficient, but they can be treated with iron supplements. It’s important not to start taking iron supplements without having blood tests first. About 1 percent of the population has genes for hemochromatosis, an iron overload disease that can become symptomatic after taking iron supplements.

Sometimes, athletes don’t get the right balance of macronutrients, protein, carbohydrate, and fat when they work out at high altitude. Many serious athletes find the idea of sugary indulgences to be anathema to their training programs, but high altitude is the time to indulge in carbohydrates and fat, within reason. Burning sugary carbs generates carbon dioxide. The lungs have to work harder to clear carbon dioxide out of the bloodstream, and they take in more oxygen, with the help of more red blood cells, in the process.

Doctors at the Walter Reed Army Medical Center took 15 healthy volunteers aged 18 to 33 to an elevation of 15000 feet (about 4.600 meters). They had them fast for five hours, and then gave them a 500-calorie, sugar-sweetened beverage. Before the volunteers drank the beverage, they had an average pulsOx of 79 percent. After they drank the beverage, they had an average pulsOx of 84 percent. Informal studies have found similar results from consuming more fat at higher altitudes.

Iron supplements and relaxed diet guidelines are easy fixes. But the simple fact is, the more luxurious the altitude training surroundings are, the better the results. If you are going to be in a tent at 15,000 feet cooking over a campfire for a winter camping trip, you might get better results at a lower elevation.

Of course, one approach to altitude training is to live at high altitude and train at low altitude.

How Does “Live High, Train Low” Work?

Athletes and trainers have known some athletes actually do worse after altitude training for at least as long as they have known sometimes altitude training makes the winning edge in an athletic competition. Years of research have found most athletes get the maximum benefits of altitude by living at high altitudes (8000 feet/2400 meters or higher) but working out at lower altitudes (4000 feet/1200 m or lower). There is a simple reason why.

People who live at high altitudes develop additional red blood cells through the body’s natural response to breathing thinner air. But when they work out hard at higher altitudes, they risk hypoxic damage to muscles.

Muscle movement is powered by flows of calcium in and out of muscle cells. As every athlete knows, when muscles are worked hard without enough oxygen in the bloodstream, they generate energy with the production of lactic acid. This is the “burn” you feel when you push your aerobic limits.

If you exercise to the point of getting a “burn” too often, your muscles become less able to pump out calcium and relax. Athletes who train at high altitudes can develop severe stiffness in major muscle groups due to the accumulation of calcium inside muscle tissues.

The solution to this problem is to live at altitude over 8000 feet so your body makes more red blood cells, but to work out at an elevation below 4000 feet so your muscles do not accumulate more lactic acid than is necessary for maximum performance. “Live high, train low” takes care of both needs. This is the attraction of places like Park City, Utah, where athletes can spend most of their time at the lofty elevations of Park City but travel 30 minutes down the Interstate to the Great Lake Basin to do their workouts every day.

On days that travel from higher elevations is not possible, athletes may do their workouts wearing face masks delivering supplemental oxygen to imitate the effects of traveling to sea level or even lower. There is also a scaled-down version of live high, workout low that involves spending half the week at high elevation, doing light workouts, followed by several days at a lower elevation for more intensive training.

Why Is Altitude Training Controversial?

It is not really accurate to say altitude training is controversial. Sports scientists, specialists in physical medicine, trainers, and athletes all understand the general principles. The problems arise from younger athletes without adequate training. Here are the rules every athlete needs to know for successful altitude training:

  • Make sure you are training at an altitude that is high enough. Although altitude sickness can set in at elevations of just 5000 feet (1500 meters), benefits from altitude training are significant only at 8000 to 18000 feet (2400 to 5400 meters).
  • Take it easy for a few days, up to 10 days, when you first arrive at high altitude. When you arrive at high altitude, your body senses lower oxygen levels. Your kidneys send a message to your bone marrow to make more red blood cells. As your body makes more red blood cells, it has to make more plasma to carry them so the blood doesn’t get too thick. While this process is starting, you have less energy for everything else your body does, and working out too hard too soon can wipe out the benefits of altitude training.
  • Keep a gentle training session for the first month at high altitude. Even elite athletes need up to a month to work up to their usual intensity when they train in high-altitude locations.

Can the Average Person Benefit from Altitude Training?

Should You Use Altitude Training For Your Sports?You don’t have to be a professional athlete to benefit from altitude training. In fact, you don’t have to be an athlete at all. People who are not in shape can also benefit by pushing harder without the risk of injury to joints and tendons they would experience at lower levels. And because amateur athletes have lower levels of hemoglobin when they start altitude training, their improvements in oxygen carrying capacity are even more dramatic.

No matter your level of fitness, it is a good idea to make sure that your body is ready to make new red blood cells before you travel to high altitude. Make sure you eat leafy greens every day, as the nitrates in leafy greens help open your arteries for increased blood flow. Check with you doctor to make sure you aren’t iron-deficient. Iron supplements are seldom necessary, but a blood test can tell for sure.

When you first arrive at higher altitude, reduce your training runs as much as you need to feel the same way you do at the elevation where you ordinarily live. Most runners need to cut back about 25 percent.

During your altitude training, think effort, not pace. Training at high elevation is about increasing effort, not about improving your time. You will run faster when you return to a lower elevation.

Alternatives for Altitude Training

Don’t have a couple months off from your job to focus on altitude training? Can’t afford an oxygen-deprivation mask or a low-pressure sleeping tent?

You can get many of the same benefits of altitude training from training in hot, humid conditions. However, you need to avoid heat exhaustion and you need to keep up hydration and electrolytes, but keeping up your training program even in summer weather also improves your lung capacity and your red blood cell counts.

The Bottom Line

Altitude training is more about gain than it is about pain. It’s more about effort than it is about beating your best time. Use altitude training to take your fitness to new levels and win your races when you return home.