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It’s common for athletes to seek new ways to improve their athletic performance. One popular strategy is high altitude training, also known as high elevation training. This method involves training at higher altitudes, where it’s harder to breathe.

While it might seem unappealing, the strategy has physiological benefits. It can improve how your body responds to exercise, and therefore, increase your endurance. This could enhance your performance in competitions.

To learn more about high altitude training, read on. We’ll explore what the research says about the practice, along with training tips and precautions.

High altitude training is the practice of training at high elevations. In sports, high altitude typically means at least 7,000 to 8,000 feet above sea level.

At this elevation, there’s less oxygen in the air. Your workout will feel more difficult, and you’ll get tired more quickly.

The idea is that high altitude training forces your body to adapt to the lack of oxygen. In turn, this could improve your performance when you compete at sea level.

Athletes who commonly practice high altitude training include:

  • runners
  • cyclists
  • mountain bikers
  • cross-country skiers
  • swimmers

‘Live high, train low’ approach

One popular method of high altitude training is the “live high, train low” (LHTL) approach. It involves living at high elevations, which allows your body to get used to low oxygen levels. You can also lightly train at this altitude.

You do more intense training at low altitudes, however. The goal is to gain the benefits of high altitude adaptations while maintaining a high-intensity training routine.

Though research is ongoing, there are several benefits of high altitude training.

More oxygen flow to muscles

When you work out, your blood delivers oxygen to your muscles. The oxygen is used to produce energy, which helps your muscles move and perform activity.

But as you continue exercising, your blood won’t be able to keep up with the oxygen demands of your muscles. Your muscles will eventually become fatigued.

A 2016 study comparing effectiveness of altitude training versus sea level training, found that altitude training can help muscle fatigue by increasing erythropoietin (EPO) production.

EPO is a hormone that makes red blood cells (RBC), which carry oxygen to various parts of the body. Higher EPO production increases RBC, thus enhancing oxygen delivery.

Increasing EPO production is your body’s way of adapting to the low oxygen levels at high altitudes. According to this same study, the effect continues at sea level. This means you may benefit from improved oxygen delivery while competing at sea level.

Increased aerobic capacity

Along with improving oxygen flow, high altitude training can also increase your maximal oxygen intake, or VO2 max. This is the highest amount of oxygen your body can consume during intense exercise. The higher your VO2 max, the better your endurance.

This effect was observed in a small 2013 study involving seven elite distance runners. After 28 days of following the LHTL method, their VO2 max improved.

In another small 2020 study, 12 runners experienced increased VO2 max after 11 days of altitude training. The researchers noted that this could boost performance at sea level.

Better lactic acid capacity

As your muscles use oxygen during intense exercise, they produce a byproduct called lactic acid. Lactic acid can accumulate and lead to muscle fatigue. As a result, you’ll need to stop working out.

According to a 2018 article, altitude training could increase your tolerance to lactic acid. This means your body can handle higher levels of lactic acid before your muscles get tired.

A small 2020 study of adolescent runners also found that altitude training enhanced cardiorespiratory fitness and running velocity at various blood lactate levels.

Do high elevation masks work?

High elevation training masks are face masks that you wear during exercise. They decrease airflow to your lungs, which forces you to work harder to breathe. Allegedly, this mimics altitude training, allowing you to reap the benefits of the practice while training at sea level.

However, a 2016 study found that elevation masks don’t actually simulate high altitudes. They don’t reduce the pressure of oxygen, which is necessary to mimic altitude training. Instead, the masks only increase the resistance of airflow.

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To get the most out of altitude training, follow these training techniques:

  • Reduce exercise intensity. Due to the low oxygen levels, you’ll need to slow down and decrease your intensity while training at high altitudes. This will help you safely adapt and continue training hard at sea level.
  • Return to sea level training slowly. When you return from high elevations, ease into training to let your body adjust.
  • Increase elevation gradually. Allow your body to get used to high altitudes, and avoid going too high too soon.
  • Try interval hill training. Run up a hill, walk back down, then run back up again. This form of interval training with hills will improve your cardiovascular fitness and prepare you for high altitudes.
  • Practice breathing exercises. Regularly practice breathing exercises to improve your lung capacity.

Though altitude training may benefit your athletic performance, there are some potential downsides.

If you train too hard too soon when arriving at altitude, you may experience altitude sickness. This can also happen if you increase elevation too quickly.

The symptoms of altitude sickness include:

  • headache
  • tiredness
  • nausea
  • lack of appetite
  • vomiting

In severe cases, altitude illness can lead to high altitude cerebral edema (brain swelling) or high altitude pulmonary edema (lung swelling).

To reduce your risk of altitude illness, follow these precautions:

  • Reduce training intensity when arriving at altitude.
  • Climb slowly and gradually.
  • Stay hydrated, as you’ll lose more water through heavy breathing.
  • Check with your doctor before altitude training, especially if you have diabetes or a heart or lung condition.
  • Work with a dietitian to correct any iron deficiencies before training. Low levels can impair hemoglobin, the protein in RBC that carries oxygen.

High altitude training can potentially improve your endurance during intense exercise. It may increase your aerobic capacity, lactic acid tolerance, and oxygen flow to your muscles.

To prevent altitude sickness, climb slowly and reduce your intensity at high altitudes. If you have preexisting medical conditions, ask your doctor to make sure altitude training is safe for you.