// Up where the air is clear: Altitude training for clients

With its lower oxygen levels, altitude training stimulates the body to be more efficient at using oxygen and providing energy to active muscles, says Victor Popov.

Altitude training has been used by athletes to help them prepare for competition since the 1968 Mexico Olympics, where performances were significantly influenced by the altitude of Mexico City. If you ever go to places like Boulder, Flagstaff or Sierra Nevada in the US, or Font Romeau in the Pyrenees, you will see runners, cyclists, triathletes and even football teams taking advantage of what altitude has to offer for performance enhancement.

Most top-level sports institutes (AIS, NSWIS, QAS for example) and elite sports clubs (Collingwood, Carlton, St Kilda, Brisbane Lions AFL and Titans, Tigers, Storm and Manly RL) now also have simulated altitude training (SAT) facilities.

These SAT facilities are also now finding their way into commercial fitness centres. There are a number of locations in Melbourne, Sydney, Brisbane and Adelaide where SAT facilities are available for use by fitness clients for reasons as varied as sports preparation, general fitness, acclimatisation for altitude trekking, weight loss enhancement and rehabilitation. Certain cycling and triathlon indoor training studios also have personal use systems that are used in a 'spin' or 'ergo' (stationary cardio training) type class setting.

Why train at altitude?

The major effect of being at altitude is that there is relatively less oxygen available in the air: at sea level the O2 content of air is about 20.9 per cent, compared to 10 per cent at 5,800m. This lack of oxygen (or hypoxia) creates physiological responses when humans are exposed to this environment. Oxygen is fundamental to all energy utilisation and recovery processes, and a lack of it elicits immediate responses of increased heart rate and respiratory rate. The stress of hypoxia stimulates the body to be more efficient in using oxygen and providing energy to active muscles. Glycogen and fat metabolism is improved, and studies have shown a decrease in insulin resistance even after a three-week stay at 1,700m1.

So any exercise session at altitude elicits a greater cardiovascular response than the same exercise at sea-level, and the energy cost is also greater. For example, a VO2 max test done at 4,000m will be about 25 per cent worse for the same individual compared to a sea-level VO2 max test2. Training at altitude has also been shown to have benefits for sea-level performance3,4 and to improve local growth hormone and cortisol responses when doing resistance exercise in hypoxia5.

For a personal training client who wants more value for their exercise time, SAT sessions provide better cardiovascular responses, greater energy cost and other potential benefits such as improved glycogen and fat metabolism than the same duration training at sea level6.

Altitude training and rehab

Many of the clubs and institutes that use SAT integrate altitude sessions for all of their injured or rehabilitation group athletes. Given the exercise limitations in the rehab state, SAT training allows for the maintenance of cardiovascular fitness with lower musculo-skeletal load. This same principal can be applied to the exercise-impaired client: obese, post-surgical or physically impaired clients can get a greater outcome from the limited exercise they can do by training at altitude.

Similarly, post-game or post-event recovery sessions done at altitude have less musculo-skeletal load for the same cardiovascular response than a sea-level session, and many football clubs incorporate SAT sessions in the two or three days post-game training block.

SAT and acclimatisation

The popularity of altitude treks (Kilimanjaro, Machu Pichu, Everest) has opened up the application of simulated altitude training to this client group. Acclimatisation using SAT equipment is offered by a number of adventure companies, and is seen as high value in improving both the potential outcome (you will be more likely to make it!) and the relative ease and enjoyment of the experience.

  • Schobersberger W, (2002). Austrian Moderate Altitude Study. Eur J Appl Physiol 2003 feb: 88(6);506-14.
  • Martin, D. et al. (1993). Effects of acute hypoxia on the VO2 max of trained and untrained subjects. J Sports Sci (1993) Feb 11 (1); 37-42.
  • Millet, G. et al. (2010).Combining hypoxic methods for peak performance. Sports Med (2010) 40 (1): pp 1-25.
  • Czuba, M et al. (2011).The effect of intermittent hypoxic training on aerobic capacity and endurance performance in elite cyclists. JSSM (2011) 10, p175-183.
  • Kon, M et al. (2010). Effects of acute hypoxia on metabolic and hormonal responses to resistance exercise. Med and Sci in Sport and Ex (2010) 42 (7), p 1279-1285.
  • Weisner, S et al. (2009) Influence of normobaric hypoxic training on physical fitness and metabolic risk markers in overweight to obese subjects. Obesity. Doi:10.1038/oby.2009.193
  • Quintero, P et al. (2010). Impact of O2 availability on body weight management. Medical Hypotheses 74 (2010) 901-907.

There are a variety of protocols and ways of doing SAT for acclimatisation, varying from sleeping in an altitude 'tent' to solid active sessions in an SAT room.

Equipment and safety

SAT equipment comes in two main forms: individual mask-based systems (which can also power small tents) and altitude rooms or chambers. The mask-based systems can be used passively or when doing active ergo training (such as bike, treadmill or cross-trainer), and the rooms also allow for any ergo sessions as well as boxing, Pilates, strength training and even X-Box games at altitude.

The keys to safely using this type of equipment are;

1) understanding how to effectively use and integrate SAT into a training program

2) using pulse oximetry to monitor each session to ensure safe training zones are kept to. A pulse oximeter is a device that measures blood oxygen concentration and shows how an individual is responding to the altitude session. This is also one of the key points to the effectiveness of altitude training: every person responds differently based on a number of genetic markers, so monitoring is essential.

Fitness Australia-accredited Altitude Instructor courses are available from a number of Registered Training Organisations around the country (Level 1 is accredited for six CECs) and these education/certification courses give the potential instructor sufficient information to begin using SAT as part of their training toolbox. For more information on sourcing altitude training equipment, visit www.habdirect.com.au or locate other distributors using your web search engine.

The next few years will witness increasing exposure and research into the use of Simulated Altitude Training in the fitness and sports industries, as well as into medical rehab for obesity and diabetes management7. Keep an eye out for any developments in this sphere of training and consider whether adding SAT to your clients' exercise options could aid their training, rehabilitation and other health and fitness goals.

Victor Popov
Victor is a sports physiotherapist with over 20 years experience in helping elite athletes reach their potential, and has worked with many World and Olympic champions. He was also a member of the team which looked after the Brisbane Lions during their Premiership years. As the director of Altitude Technology Solutions (ATS), Victor advises many elite athletes, including Shane Watson (cricket), Mark Cavendish and Robbie McEwan (cycling), on altitude integration as well as physical preparation.