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					   A Guideline to Altitude Training for the Serious Long Distance Runner

       Many runners see significant improvements in their 5k times with altitude

training. These improvements can be up to 18 seconds off their previous best time. This

can be the difference between scoring points for your cross country team, or even a medal

at world championships, or going home empty handed. Altitude training is a good

addition to the little things many runners do to get an edge on their competitors such as

going to sleep early, having proper nutrition, and taking ice baths after workouts. A

study on elite middle distance runners by Saunders in 2009 confirms the benefits of

altitude training noting a 1.9% increase in race performance after altitude training.

Physiological Adaptations

       The effects of altitude training are seen at around 5000 ft. After that, every 3000ft

results in a 10% decrease in VO2 max. VO2 max is the highest oxygen consumption that

a person can achieve. According to recent physiology text by Wilmore and Costill, this

decrease in VO2 max means that the body must work harder at each pace the athlete trains

at. An increased effort leads to more dramatic physiological changes within the body.

These adaptations occur in the heart, blood, and the muscles that are working during

exercise. The walls of the heart will thicken and the size of the ventricles, or chambers,

increase. As explained by Wilmore and Costill, the thickening allows the heart to pump

with more force and supply the working muscles with more blood. Percentages of

oxygen in the air at both altitude and sea level are constant at 20.93%. The reason that

people have a harder time breathing and their blood doesn’t carry the same amount of

oxygen as at sea level is the lower barometric pressure. This lower pressure forces the
body to adapt in some way by stimulating the production of more red blood cells. A

higher red blood cell count provides the working muscles with more oxygen. The

muscles themselves develop more densely packed networks of small blood vessels called

capillaries. This allows for more blood and metabolic substrates like glucose to reach the

muscles. These adaptations can be attained through different altitude training methods.

HiHi and HiLo Training

        The two main training ideas for altitude are for an athlete to live and train at

altitude year round also called “live high train high” or HiHi. In HiHi training, the athlete

gets both the benefits from living full time at that height and also trains at that same

altitude. This type of training has been used since the late 1960s but a new training

method has emerged as well. This method is called “live high train low” also know as

HiLo, where an athlete lives at a higher altitude to receive the benefits of the conditions,

but trains at a lower altitude. The theory behind this method is that the athlete can run at

a higher intensity while at lower altitudes, yet still reaps the benefits of living at high

altitude. The HiLo method has been at the forefront of many scientific journal articles.

        The HiLo method has been proven effective and is supported by several studies

including one by James Stray-Gunderson and his lab partners in 2001. They conducted a

study with elite distance runners preparing for the U.S. track championships. These

runners lived at a high altitude, but then dropped down to lower altitudes for intense

training. Over the course of 27 days the participants saw dramatic increases in many of

the physiological variables that contribute to endurance. These increases include an

increased volume of the red blood cells. This allows each red blood cell to shuttle more

oxygen to the working muscles. The athletes also saw a 3% increase in their VO2 max
after completing their training regimen. Their time to exhaustion increased significantly,

allowing them to work out for longer periods of time at a given heart rate. Directly

related to their times, the male subjects saw a 5.8 second drop in their 3000m time and

females saw a 5.5 second drop over 3000m as well.

       In a combination of several studies, called a meta-analysis, recently done by

Bonetti and Hopkins, many positive increases in performance were noted. Applying

more to cyclists, yet still applicable to distance running, both HiLo and HiHi trained

athletes had an increase in power output of 3-7%. Another interesting finding of this

study was that HiLo training seemed to be more effective that HiHi training. Although

not discussed in their analysis, there have been several instances of elite running coming

from a HiHi training background. These circumstances are usually associated with the

East African distance runners.

       Many factors lead to the East African’s success in distance running and living at

altitude their whole lives is one of those factors. There have not been many studies

following these East African distance runners, but several studies conducted over long

periods of time have been done on other athletes. The results from these studies allow

exercise physiologists to reasonably say that living at high altitude for a lifetime

significantly increases endurance capacity. In a recent journal published in 2004 authors

Rusko, Tikkanen, and Peltonen, they studied a group of elite distance runners training at

2200 meters above sea level over the course of four weeks. During this short stay at

altitude Rusko, Tikkanen and Peltonen found a 6% increase in the volume of these

athlete’s red blood cells contributing to a greater oxygen carrying capacity. In the same

journal article they referred back to their previous work in 1996, to show that these
adaptations continue for at least six to eight months. Along with the red blood cell

volume increases, they found a significant increase in VO2 max, upon returning from a

period of HiHi training. Rusko went on to speculate that the adaptations that must occur

during a lifetime at altitude are significantly greater than these studies can even

demonstrate. These benefits can be seen to their fullest potential with a proper training


Training Plans

        In order to maximize the physiological adaptations of altitude training, you must

first construct an efficient training plan. The training plan detailed in Stray-Gunderson’s

study is an ideal plan for someone interested in HiLo training. In this plan the athletes

lived at 2700 meters above sea level, but anything over 2000 meters is sufficient. For all

their speed work and interval sessions, the athletes dropped down to a lower altitude of

1250 meters. Again, anything significantly lower than you’re living altitude is

acceptable. The advantage of going to this lower altitude is that the athlete is able to train

harder and faster. This means a runner will have physiological adaptations due to fast

training, as well as the altitude where they are living at. For HiLo training, the main

concept is to stay at that high altitude for as many hours as possible during the day, and

only go to a lower altitude for training sessions. The Stray-Gunderson study used a little

bit of a variation on this method, called the HiHiLo training method. This still falls under

the HiLo training plan, but dictates that the runner does all their recovery runs and

moderate runs at the altitude they live at. This does not allow one to train as fast, but on

these days fast running isn’t as important as recovery, or a sustained aerobic effort.
       HiHi training is similar to every day training done at sea level. For HiHi training

one would need to live somewhere around 2000 meters and train there for a period of

time ranging from four weeks, to several months. The main adjustment that needs to be

made at that altitude is that your training paces will be significantly slower, especially

when you first arrive. The first few weeks of training one should not include any intense

interval sessions, but instead you should center your training around easy runs to allow

the body to acclimate to being at altitude. Don’t worry about pace for majority of the

time at altitude either. Upon adding interval training, run these intervals at a pace slower

than race pace. Again, due to the fact of being at altitude, one’s normal training paces

will feel significantly harder. In order to maintain leg speed, you should incorporate four

to eight 100 meter strides after moderate runs. This allows your body to receive

neuromuscular stimulation at paces that will be too hard to maintain for a whole workout

at altitude. These strides should be at about 800 meter race pace. If speed is a major

concern, short intervals at race pace or faster can replace the longer intervals.

Locations for Altitude Training

       Unfortunately for residents of the east coast, all the high altitude cites lay in the

Midwest. On the east coast many cities do not have elevations over 4500 feet and these

are peak altitudes, not the city as a whole. In order to receive the benefits of altitude

training one will need to go to the Midwest. To accommodate a college student’s

schedule, such training would most likely occur during the summer, allowing enough

time for a full acclimation to altitude, and for all the physiological adaptations to occur.

The first option would be to travel to a known high altitude state such as Colorado. Most

places in Colorado are at a high enough altitude for a runner to receive the physiological
adaptations while living and training there. This is a great option for training, but finding

a place to stay all summer may be difficult. Colorado is known for being at a high

altitude, but isn’t the only option for altitude training.

        Another, more feasible option would be to spend the summer in Flagstaff,

Arizona, the training grounds of several elite distance runners. Not only is Flagstaff at

high altitude, but houses Northern Arizona University. This university, like many

universities, has several research options and summer classes. Northern Arizona

University’s research positions may include scholarships and other incentives that may

help support a student’s travel and living expenses for the summer. This would allow

you to continue your education and research in a new setting that includes the benefits of

living and training at high altitude. Some of people can not stand to spend too much time

away from home, but that doesn’t mean they cannot receive similar benefits that occur

during altitude training.

Altitude Tents

        For those who cannot afford to travel away from home all summer, a third option

is available. This option is the use of an altitude tent. This is more easily accessible to

elite athletes and may be a little expensive for a club runner not receiving money for their

races. An altitude tent works by reducing the amount of oxygen within the tent, creating

a hypoxic (low oxygen) environment. The body will undergo the same physiological

adaptations that occur at altitude. This is because the muscles and other tissues are

receiving less oxygen per breath, which is what happens at altitude.

        Altitude tents can be used in two different ways. The first way is to simply sleep

in the tent. This provides ideally an eight to ten hour exposure to hypoxic conditions,
while still allowing the runner to maintain their normal training and living routines. The

second option is a not as practical unless the tent is large. In addition to sleeping in the

tent, an athlete would spend as much free time as possible in that tent. Such an exposure

would allow the body to experience a few more hours a day in these conditions. Most

athletes who use this method have whole rooms in their houses set up in a hypoxic state,

making this much more plausible for them.

       For a college student, setting up a hypoxic room in a house or even dorm is not a

realistic option. This would be extremely expensive and most likely violates the

University’s housing rules. The prices to purchase an altitude tent range from $3200 to

$7000. A more cost friendly option would be to rent an altitude tent, an option is offered

by the Hypoxico, a hypoxic tent company. The cost to rent generator is $169 a week

which comes with a free tent to fit over a queen bed. For an additional $5 a week, you

can rent their deluxe size tent which can fit over a king sized bed. This option would

most likely be less expensive than a trip to the Midwest.


       With all the options available to altitude training and alternatives available, you

can easily lose sight of the main aspect of training. If you train smart and consistently

week in and week out, you will see results. Altitude training is a proven way to boost

performance, but in no means is a substitute for hard work. By putting in the miles over

the summer and incorporating hard workouts along with recovery days, you will

experience the physiological adaptations that improve their performance. However,

training at altitude greatly increases these adaptations and can result in break through

performances in the fall season. HiLo training, HiHi training, and sleeping in an altitude
tent all have shown performance increases over time. Any of these options would be a

beneficial addition to summer training, and give a runner an extra advantage over their



Bonetti, D.L., Hopkins, W.G. (2009). Sea-Level Exercise Performance Following

       Adaptation to Hypoxia: A Meta-Analysis. Sports Medicine, 39(2), 107-127. doi


       D. L. Bonetti and W.G. Hopkins are two exercise physiologists from New

       Zealand. This is a meta-analysis of the performance benefits of endurance

       training when an athlete returns back to sea level. This is the first meta-analysis

       done on the effects of altitude training and explores all of the physiological

       variables looked at in my paper.

Daves, B., Bailey, D.M. (1997). Physiological implications of altitude training for

       endurance training at sea level: a review. British Journal of Sports Medicine, 31,

       183-190. doi 10.1136/bjsm.31.3.183

       Both Daves and Bailey have been published over 700 times combined. They have

       done research on many various subjects ranging from performance enhancing

       drugs, to stem cells (Daves research). This is a review of a study on how

       endurance training at altitude affects sea level performance. Similar to Bonetti

       and Hopkin’s work, this explores many of the physiological variables and how

       they are affected during a stint of altitude training.
Higher Peak Altitude Training. (n.d). Products. Retrieved from

       This is where some prices of altitude tents were found

Hypoxico Altitude Training Systems. (n.d.). Hypoxico Altitude Training. Retrieved


       This is the company that rents their altitude tent equipment. Prices for altitude

       tents were also found here.

Northern Arizona University. (2010). Research. Retrieved from

       This is the link to Northern Arizona University’s research opportunity homepage.

Wilmore, J.H., Costill, D.L., Kenney, W.L. (2008). Physiology of Sport and Exercise.

       Champagne: Human Kinetics

       Jack H. Wilmore, a highly regarded exercise physiologist for the from the

       University of Texas in Austin, Ball State University’s David Costill, and W. Larry

       Kenney from Penn State University wrote this text book together. This text book

       dedicates chapter 12 to the adaptations of training at altitude. This chapter

       outlines many of the physiological adaptations with more lay person terms than

       the other sources.

Rusko, H., Tikkanen, H., Peltonen, J. (2004). Altitude and endurance training. Journal

       of Sports Sciences, 22(10), 928-945. doi 10.1080/02640410400005933

       Heikki Rusko, a Finnish exercise physiologist who has is the head of a high

       altitude training center in Finland, et al published this journal. This journal

       article compared HiHi and HiLo training. This journal also detailed some of the
       typical training methods and sought to see any performance differences between

       the two types of altitude training.

Rusko, H., Tikkanen, H. (1997). Normobaric hypoxia and hyperoxia in training and

       medical rehabilitation. Suomen La¨a¨ka¨ rilehti, 31, 3267-3273 (In Finnish)

       This journal article was cited in “Altitude and endurance training” by Heikki

       Rusko et al. It is a study examining HiHi training results.

Stray-Gunderson, J., Chapman R.F., Levine, B.D. (2001). “Living high-training low”

       altitude training improves sea level performance in male and female elite runners.

       Journal of Applied Physiology, 91, 1113-1120

       James Stray-Gunderson has been studying the effects of HiLo altitude training for

       12 years and is recognized as an expert in the field of anti doping. Both Benjamin

       Levine, an exercise science professor, and Robert Chapman worked on this

       journal article as well. This journal article details HiLo altitude training. The

       journal article gives detail into the training methods the athletes used, along with

               the physiological adaptations that happened to the athletes during this

training       stint.

Saunders, P.U., Telford, R.D., Pyne, D.D., Gore, C.J., Hahn, A.G. (2009). Improved race

       performance in elite middle-distance runners after cumulative altitude exposure.

       International Journal of Sport Physiology and Performance, 4(1), 134-138

       These authors are all exercise physiologists with hundreds of articles published

       between them. This journal article details performance increases in elite middle

       distance runners after altitude training. The article also gives a little insight into

       the some altitude training methods that these athletes underwent. *Abstract*