Lifestyle management at altitude

Altitude training is forming an important part of the training programmes of many endurance athletes.  Living at altitude can pose a range of challenges, however, and particular aspects of lifestyle may need additional attention, particularly in relation to preventing overtraining and boredom.

Athletes may become lethargic because of the boredom, and those who fail to embrace the local culture may regret missing out on potentially inspiring and enjoyable experiences.  It would be a shame to fly all the way to South Africa, and never to see and animal in the wild!

Conversely, those to try to fit too much in, fail to recover adequately from training.  Attempting to fill the time between training with some more training will lead to burnout.  You could get addicted to computer games (or sudoko, strib scrabble, or poker for training kit) and delay or skip training as a result.  Spending all day visiting sites and attractions, may result in sore feet, tight muscles and increased risk of injury.

If you fill all your spare time with sleep, and may generally lethargic, or become unable to sleep at night.  You will need more sleep than normal at altitude, and afternoon naps are not only acceptable, but generally recommended.  But oversleeping, or sleeping to kill time may be detrimental to your training.

Spending all your time sunbathing isn’t the answer either.  The sun’s UV rays are stronger at altitude, and you will be more susceptible to sunburn than at sea level. 

You could also dragged into other people’s routine.  Having other people around you is a good thing, but remember that everyone responds to altitude different, and you may need more recovery time than others.  Finally, spending too much time with your friends or training partners can lead you to getting on each other’s nerves.

Of course, these factors may be similar to the challenges that full-time athletes face in their everyday lives.  We will revisit the pros and cons of being a full-time athlete in a future post, but in essence, athletes become full-time athletes when they go away on training camp, and that can have positive and negative aspects. It isn’t all bad of course, but care must be taken to not slip into the many pit falls.

Don't miss out on the opportunities that training abroad can offer

The training camp mentality

Training camps can be a great way of injecting a new impetus into training.  A new environment can be energising and brief, intense spells of training can help athletes reach a new level.  Athletes tend to be more motivated when they are training in a group and have no other distractions.  Training camps are not without their pitfalls, however, and being over motivated can be particularly detrimental when it comes to training stints at altitude.

Taking time to acclimatise to altitude can be the key to a successful training camp.  Too often I hear people saying that they’ve done their hardest ever week of training or hit new ‘personal best’ mileage figures while training at altitude, or tweeted about how much running at altitude has ‘kicked their asses’.  

At sea level, training in a group can help stretch most athletes to achieve their best.  Occasionally trying to keep up with better athletes can sometimes reap results.  Training in a group at altitude, however, is generally a bad thing.  Every athlete respond to altitude differently, and in addition to risking your physical health by working too hard, competing and measuring yourself against others can have detrimental effects on your mental performance. 

Key advice

• Work out your own programme with your coach and follow it
• Monitor your HR, RPE and general wellbeing, and adapt your programme if required
• Remember that less is more.  Just because you’re away on training camp, doesn’t mean that you have to train all the time.  Recovery is part of training too.
• Don’t get dragged into the group mentality
• Avoid going away with training partners that are overly competitive in training

Rest and recovery

We’ve all heard that resting is training too, but nowhere is the sentiment more true than when training at altitude.  Most of the physiological adaptations that occur at altitude, actually happen at rest.  Living at altitude is far more important than training at altitude (unless of course your training to compete at altitude). 

Basic acclimitisation to altitude takes approximately 14 days, though this varies depending on the individual.  During this time resting and training heart rates will be elevated, recovery times between intervals will be significantly increased, and more sleep will be required.  Your body will be working hard to increase EPO secretion, build new red blood cells, and to respond to the acute effects of the lower air pressure and oxygen availability.  Sometimes it’s best to just let the body get on with that.

Key advice

• Reduce overall training volume by 10-20 percent during the first week, and increased gradually over the next three to four weeks.
• Reduce the intensity of interval sessions by 5-10 percent initially, and increased gradually.  Intervals should be shorter than normal, and recovery time between them doubled. 
• Take an additional recovery day between hard workout days.  Use resting HR as an indicator of recovery, and skip any planned workout if the HR is elevated more than normal.
• Remember that there are huge individual variations in response to altitude.  Listen to your own body and don’t measure yourself against others.
• Remember, with altitude training, less is more, particularly during the first two weeks. 

The Grand Canyon makes a great day out when training at altitude in Flagstaff

The boredom factor

Boredom can be an issue when training at altitude, and striking a balance between killing time, relaxing, and embracing the sites and culture of your training environment, can be difficult.  Boredom can lead to depression, so susceptible athletes should take particular care.

If you’re in charge of your own travel plans, choose somewhere that will cater for your entertainment needs.  If you don’t like sitting around all day talking and drinking tea, then Kenya may not be for you.  Choose a big city if you like to have lots to do; and smaller towns if you prefer to be close to nature.

Key advice

• Decide on one or two things that you would really like to do while you’re away, and then decide where those activities will best fit into your training programme.  A safari might be a good way to recover from a long haul flight and adjust to altitude, while a trip to the grand canyon might be a suitable activity for a rest day. 
• Have one worthwhile task to do while you’re away. Catching up with university work, doing an online course, writing blogs or magazine articles, or updating your website are just some of the projects that you could complete.
• Enjoy your mealtimes; it’s not every day that you can take your time eating food.  Dining halls are also a good way to meet new people, and to soak in the culture of your surroundings. 
• Not everyone loves to eat, sleep and breathe their sport.  Find what works for you and plan accordingly.

Chess or draughts can be a great way to pass the time and keep the brain active

Nutrition and staying healthy

Diet is very important when training at altitude, and adjustments may have to be made to ensure that you are getting all the nutrients that you need.  

Since more oxygen is required to break down fat than carbohydrates, 80 percent of calories should be derived from low glycaemic carbohydrates.  Meals should be taken every 4 hr.  Increased carbohydrate utilization may result in glycogen store depletion, so make a conscious effort to replace carbohydrates during and after training.

Reduced nutrient absorption in the gut at altitude results in greater faecal losses.  Maintaining a high proportion of carbohydrate, and ensuring that overall calorie intake is adequate may reduce or offset this faecal loss.  Basal metabolic rate increases for the first 4 days of altitude exposure, particularly in females.  After 4 days metabolic rate begins to return to normal, but remains above sea level values. 

Some individuals may experience reduced appetite.  Small but regular meals, and eating a variety of fresh products, may help.  Apples and grapes in particular have natural chemicals which increase appetite.

 Iron is also very important and depleted iron stores is one of the reasons why some people do not respond to altitude.  Iron is a mineral that is essential in the production of haemoglobin.  Haemoglobin is the part of the red blood cell which attaches to oxygen and transports it around the body.  As the body turns iron stores into additional red blood cells in response to the hypoxic conditions and subsequent increased erythropoietin syntheses, the demand of iron rises, and with it the risk of developing anaemia, even in health runners.

There is risk of immunosuppression, and a subsequent increased risk of upper respiratory tract infections and gastrointestinal infections, at altitude.  It is important that you listen to your body, have adequate vitamins (A, folic acid, B₆, B₁₂, C and E) and minerals (copper, selenium and zinc) in your diet, and replace carbohydrates quickly after exercise.

Because of increased ventilation, increased urinary water loss, and low humidity at altitude, the potential for dehydration is increased.  Caffeine-free fluid intake should be increased by as much as 4 litres per day.  Monitor morning urine colour to ensure that fluid needs are being met, and reduce caffeine consumption.

Dealing with Injury

If you are training at altitude, and get an injury that prevents you from carrying out your normal training, it is best not to panic.  Depending on the severity of your injury, how far you are into your trip, and on the duration of your planned trip, you have a number of options.

The most important thing is that you get treatment for your injury.  If you do not have support personnel with you, cannot find access to a suitable physiotherapist, and do not know what your injury is and how to treat it, you may be best taking complete rest.  If you have a long trip planned, you could look at shortening your trip.

Even if your ability to train is severely hindered by your injury, you will still benefit from sleeping at altitude.  If you would have to rest even if you were at home, you may still be able get some benefit from your trip, and the solitude of altitude may help with adherence to rehab exercises.

Cross-training may be particularly beneficial at altitude and cycling, aquajogging, or even just walking, may be sufficient to raise the heart rate to sea level easy exercise levels in some individuals.

If you are susceptible to injury, or have a recurring injury, ensure that you have access to physiotherapy, and/or medical backup, have access to cross-training facilities if required, and have investigated if the trails are suitable for you.

If all else fails, and if it’s not practical for you to go home early, consider that your injury may be your body telling you to take a break.  Consider if you actually need a holiday.  Make a conscious effort to make the most of the trip, and add in some extra sightseeing, make some new friends, and relax.  Make the most of the hypoxic air!

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My recently published book, Notes from higher grounds, is available through Amazon (click on image below).  It is essentially a travel guide for those looking to arrange a trip to altitude, and covers 15 different venues in detail, but also includes practical advice on how to deal with travel and training at altitude.