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Have you ever taken your team to high elevation and seen their performance decline? Do you wonder if you could have done something differently to change the outcome?
As a performance coach, it is essential to understand the responses of our athletes to this new environment so that we can best prepare them for success. Therefore, this article aims to provide the coach with a practical guide to risks and performance enhancement strategies during acute altitude exposure.
Broadly, coaches can expect acute altitude exposure to cause a decrease in specific performance characteristics due to a lower partial pressure of oxygen in the surrounding air (Eckert, 2020). What follows is the knowledge I've learned and shared with my athletes over the past five years of training and competing at altitudes ranging from 1,000 ft. to 14,000 ft. above sea level.
A common phrase in sports performance is “an athlete’s best ability is their availability.” Accordingly, we must first understand our athletes’ risks when training and competing and higher elevations.
The most common pathological disorders associated with ascension to high elevation include acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE).
Acute mountain sickness (AMS) is the mildest form of acute altitude illness and can occur when unacclimated persons ascend to ≥5000 ft. Symptoms of AMS usually appear within 24 hours of ascension, and even the physically fit can still experience altitude sickness. Some signs of AMS include (The Cleveland Clinic, 2020):
Two severe forms of altitude illness, HAPE and HACE, occur less frequently but are more serious and can be life-threatening.
HAPE produces excess fluid in the lungs, causing breathlessness even when resting. Symptoms can include feeling very fatigued, weak, and the feeling of suffocation (The Cleveland Clinic, 2020).
HACE involves excess fluid on the brain, causing brain swelling. Symptoms can include confusion, lack of coordination, and possibly violent behavior (The Cleveland Clinic, 2020).
The performance effects from ascending to higher altitudes vary depending upon the nature of the event and the elevation achieved. The examples below show the expected outcomes for altitudes ranging from 6500 ft. to 9500 ft. unless otherwise noted.
The ascent to high altitude will least impact those competing in strength and power sports. Depending upon the sport, athletes might even achieve a small performance gain. For example, consider the golfer whose ball flight is affected by the reduced air pressure.
The performance of a single sprint is generally not negatively affected by acute exposure to altitude because enhanced anaerobic energy release compensates for the reduced aerobic adenosine triphosphate (ATP) production (Girard et al., 2017). Much like the example above, a sprinter might gain a performance benefit from reduced aerodynamic drag so long as the athlete’s fatigue level is managed correctly.
Performance in repeated sprint ability is more altered, with earlier and more significant performance decrements than the previously mentioned single sprint event. Coaches can expect a 5-10% reduction in peak or mean power output, as exemplified in repeated cycling sprints for 6-10 repetitions of 5-10 seconds followed by recovery of 20-30 seconds(Girard et al., 2017).
Team sports often involve intermittent physical activity. For example, the combination of jumping, hurdling, striking, sprinting, running, jogging, and walking. However, compared to repeated sprint ability, intermittent activity performance decrements are less clear.
Perhaps the best example of real-world intermittent performance quantification is in a study by Nassis in his Effect of Altitude on Football Performance: Analysis of the 2010 FIFA World Cup Data. In this case study, Nassis (2013) showed a 3.1% lower total distance covered by the teams competing between 4500 ft. and 5500 ft. in elevation.
Endurance performance is perhaps the most inhibited by the ascent to high altitude. Coaches should expect endurance sport performance to decline by about 1-2% for every 1,000 ft. of elevation gain, with noticeable decrement seen as training or competition eclipses the 5000 ft. mark (Eckert, 2020).
For athletes and teams living at lower altitudes, here are my recommendations:
Vasodilators may be effective tools to assist athlete performance during acute altitude exposure.
A tertiary consideration for ascension to high altitude is environmental temperature. When exposed to cold, the body loses heat through the combined effects of radiation, conduction, and evaporation. The effects of cold on exercise performance appear to be related to reduced core body temperature. Effects include:
The coaching staff should, therefore, consider the following when preparing athletes to train or compete in cold environments (Bullock, 2019):
Three types of athletes who might struggle to train and compete at higher elevations are those with asthma, sickle cell trait (SCT), or iron deficiency. Know who these individuals are ahead of time and develop a management plan.
Strength and conditioning coaches should understand the above considerations, educate their athletes, and apply these techniques as a blueprint for their decision-making processes when preparing for a trip to high altitude.
Bullock, J. (2019). Sport Demand Analysis: Freestyle Mogul Skiing. Unpublished. 12/23/21
Bullock, J. (2019). Training and Living at High Altitude: What Athletes Need to Know [Team Educate #41] [Presentation]. Center of Excellence, Park City, UT, United States of America.
The Cleveland Clinic. (2020, September 23). Altitude Sickness: Symptoms, Diagnosis, Treatment & Prevention. Cleveland Clinic. Retrieved December 21, 2021, from https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness
Eckert, R. (2020). The Effects of Altitude on Training and Racing Performance in Endurance Athletes. Personal Training Quarterly, 7(3), 8-10. 12/9/2021
Girard, O., Brocherie, F., & Millet, G. P. (2017). Effects of Altitude/Hypoxia on Single- and Multiple-Sprint Performance. Sports Med., 47(10), 1931-1949. 12/9/2021
Goods, P. S.R., Dawson, B. T., Landers, G. J., Gore, C. J., & Peeling, P. (2014). Effect of Different Simulated Altitudes on Repeat-Sprint Performance in Team Sport Athletes. Sports Physiology and Performance, 1(9), 857-862. 12/9/2021
Naeije, R. (2010). Physiological Adaptation of the Cardiovascular System to High Altitude. Progress in Cardiovascular Diseases, 1(52), 456-466. 12/9/2021
Nassis, G. P. (2013). Effect of Altitude on Football Performance Analysis of the 2010 FIFA World Cup Data. Journal of Strength and Conditioning Research, 27(3), 703-707. 12/9/2021
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