The million-dollar question: Does altitude training (AT) work?

From what I’ve gathered – from books to articles, to years of research, testing in labs and in the field, and sifting through countless studies and anecdotes…the answer is probably, yes.

Altitude training doesn’t work for everyone. Some athletes get sick when travelling above just 4,000 or 5,000 feet. And that’s before they even exercise. While others are able to exercise, their physiology may be so compromised that anything above low-to-moderate intensity feels like VO2 Max. In other words, easy training takes a toll on their body equivalent to that of their hardest sea-level training sessions.

On the other side of the spectrum, there are athletes who thrive at altitude. The best example of this is athletes who have lived at high-altitude their entire lives – athletes from regions in Kenya, Columbia, Colorado, for example. For these athletes, the amount of oxygen at 8,000 feet is normal; for those of us from sea-level, it can feel like we’re breathing through a straw.

So why do athletes spend the massive amount of time, energy, and resources to travel to an exotic, high-altitude location for weeks at a time? Because chances are, it will make them faster. I won’t dive too deep into the science behind AT here; that’s a heavy and complicated subject which elicits an entirely separate article (or book) itself. Basically, prolonged exposure to high-altitude for living and or training has been associated with increased levels of red blood cells, (natural) EPO production, and hematocrit. This means an increase in VO2 Max, aerobic capacity, and overall performance in endurance sports. [Power athletes have also used altitude training in the past, but I am not as well-versed in this subject, and there are fewer studies on high-altitude training for anaerobic performance as there are with aerobic performance. Leave a comment below if you know more about AT for power athletes].

I recently read a book which summarized nearly 40 years of study on AT and athletic performance. Below are the key takeaways, with notes and recommendations from the top universities, coaches, and athletic training programs in the world:

How high?

  • The optimal elevation for AT is 6800-8200 ft. High enough for the physiological changes of living at high-altitude to take place, but not so high as to compromise the athlete’s training.

For how long?

  • 4 weeks of AT is the minimum duration recommended to elicit significant physiological changes and performance benefits.
  • Performance benefits can last anywhere from 3 days to 4 weeks post altitude. This is highly individual to the athlete, their sport, and the event they’re competing in.

Training Recommendations

  • To avoid over-training, athletes must work closely with their coach to develop a solid AT plan, and practice patience and discipline, especially in the first weeks at altitude.
  • It is recommended during Week 1 of AT, training volume should be 80-90% of the athlete’s normal (sea-level) training volume. Training volume should increase by 5% each week thereafter, reaching 100% of the athlete’s normal training volume by the third of fourth week.
  • Athletes must cut their training intensity down as well, but not as greatly as their volume. During the first week of AT, (low,moderate, and high intensity) intervals should be completed at 93-95% of the athlete’s normal (sea-level) intensity. Intensity should increase by 2% each week thereafter, reaching 100% by the third or fourth week.
  • One of the biggest takeaways is the major increase in the amount of rest between intervals. It is often said that it is almost impossible to recover from intense efforts at high-altitude, and these training recommendations reflect that. Between intervals, rest periods should be 200% of sea-level during Week 1 – you need to double the amount of rest you’re getting! Rest periods should decrease by 25% each week thereafter, reaching 100% (normal) time periods by the fourth week.

Potential Physiological Changes

  • At athlete’s resting heart rate may be slightly elevated at high-altitude, but equal to or greater than their sea-level norm during sub-maximal and maximal exercise.
  • High-altitude climates are often dry and can quickly lead to dehydration. It is recommended that athletes drink significantly more than usual, an extra 4-5 L per day.
  • Metabolism may increase at high-altitude, as well as carbohydrate metabolism and substrate utilization. Put simply, it is recommended that athletes increase their daily caloric intake, and eat a higher percentage of carbohydrates than normal.

***As with all training recommendations, it is important to remember that athletes are unique individuals who will react differently to high-altitude, increased training loads, and altered nutrition. These recommendations have been supported by decades of research which highlight significant correlations and strong trends in trained and elite athletes***

Lastly, I put together a three-week AT program by combining the programs and recommendations from USA National Team coaches, as well as German and Norwegian Olympic Team coaches and sports scientists. This program is meant for sea-level athletes who will completing a 3-4 week period of altitude training, immediately followed by a period of competition at high-altitude.

3-week AT Program:

  • Acclimatization: 4-7 days
    • Primarily aerobic work. Very light training, never going above moderate intensity. Strength training should be completed at 80-90%of normal training load.
  • Activation and Stabilization: 7-10 days
    • First, high-volume low intensity workouts. 1-2 days’ rest (low-volume aerobic workouts). 
    • Second, endurance interval workouts (high-volume high-intensity). 1-2 days’ rest.
    • Third, race-pace efforts (low-volume high-intensity). 1-2 days’ rest
  • Competition Preparation: 4-6 days
    • Moderate aerobic training, single-day endurance workout, and then 1-2 days of sport-specific neuromuscular activation (i.e. openers).

References: Altitude Training and Athletic Performance, by Randall L. Wilber

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