“Living High and “Training Low” and implications for the NFL – A Proposal for Altitude Training Interventions in American Football” – Part 2

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Hypoxico Altitude training systems provide the opportunity to train intermittently in hypoxic conditions. However this form of training should not be confused with “Live High” altitude training interventions which are largely associated with physiological changes necessary for improvement in aerobic performance.

In Part 2 of “A proposal to investigate the use of Altitude Training Camp Interventions for improved athletic performance in American Football”  we will examine the past research and build a foundation to help construct an effective vision and resource for the betterment of our athletes in regard to exercise performance.

“The more you know about the past, the better you are prepared for the future” – Theodore Roosevelt

     Paul Bert was a french physiologist who first reasoned that atmospheric changes at altitude resulted in physiological adaptations to those individuals who spent a period of time at certain altitudes (Levine& Stray-Gundersen,1997).  Years later scientists would identify the adaptations that take place at altitude as central to the improvement of performance when athletes return to sea level. Dr. Benjamin Levine and  Dr. James Stray-Gundersen were one of the first researchers to report that living at certain altitude environments aid to augment endurance performance through increases in red cell volume and associated enhancements to athlete’s ability to transport oxygen around the body. (Levine& Stray-Gundersen,1997).  Their work along with the dominance of altitude acclimatized athletes during the 1968 Olympic Games in Mexico City and early anecdotal training experiments in the USA in the 1970s, help to establish altitude training as an effective model for endurance athletes wishing to improve aerobic performance. Today, this form of training is being proposed as a resource for team sport athletes or those who compete in sports which cover a wide range of energy systems including the aerobic system.  Dr. Olivier Girard, Researcher at Athlete Health and Performance Research Centre in Doha, Qatar says “Athletes from different team sports worldwide are using altitude training more than ever before.” (Girard, Chalabi, 2013) 

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Athletes from different team sports worldwide are using altitude training more than ever before.”

What lies in the future of training for Team Sport athletics such as Football?

     Envision a setting where athletes saw improved cardiovascular function mediated through physiological changes within their blood simply from living and breathing the air of a specific environment.  Altitude training camps is a potential resource for many performance specialists and teams to utilize in their goal of providing the best environment for their athletes to succeed.  This form of training is  a common practice for endurance athletes prior to competition (Mclean, 2014). It is a performance tool which is increasingly being used in team sports from Australian Football to Rugby and Soccer.  Over the last few years researchers have increasingly reported  improvements in both aerobic and anaerobic measures of performance in team sports as a result of altitude interventions. In 2015, Researchers at the University of Lausanne, Switzerland found that altitude intervention improved physiological factors related to cardiovascular function and sprint performance in elite male field hockey players. In addition, these benefits lasted for three weeks after the altitude training intervention (Brocherie et al., 2015).   In another study, researchers at Victoria University published a study in 2015 where an altitude intervention was applied to fifteen Australian Footballers. The results showed  that after nineteen nights of an altitude training intervention athletes saw improvement in measures of performance as well as physiological measures associated with cardiovascular performance ( Inness, Billaut & Aughey, 2015).  Similar findings are reflected in a 2012 study where researchers in Melbourne Australia, investigated the performance and physiological measures of thirty elite Australian football players after a preseason altitude camp (Mcclean et al, 2012). Improvements in measures of performance and physiological factors associated with cardiovascular performance were also noted in these Australian football players. Interestingly enough, researchers demonstrated that the magnitude of improvements were similar to that of an endurance athletes undertaking an altitude training intervention (Mcclean et al, 2012). It has also been reported that the improvements in performance for these athletes lasted over 4 weeks (Mcclean et al, 2012).  The results reported in these studies leads us to a simple conclusion; Altitude training camps is a potentially valuable resource for preparing team sport athletes for the regular or competitive season.   

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What are the Traditional Models of Altitude Training Interventions available to Athletes?

     It is interesting to note that Altitude training interventions appear to be beneficial to athlete’s exercise performance despite the variation in models used in the aforementioned studies. For instance, one of the models used by researchers at the University Lausanne is known as the “Live-High”, “Train-High” altitude intervention as it requires athletes to live and train at altitudes more than 2000 meters above sea level. A more popular altitude training model used in past studies requires athletes to live at moderate altitudes but to train at sea level. This training intervention is known as the “Live-High, Train-Low” model. In addition to this model,  A number of studies have reflected the existence of altitude training interventions with variations in either frequency and/or duration of exposure to a range of altitudes or hypoxic ( low oxygen) environments  over a period of time.  However,  despite the array of altitude or hypoxic training programs, more traditional altitude models are commonly used by athletes and coaches such as the following models: “Live-High and Train-High (LHTH)”, “Live High and Train Low (LHTL)” as well as “Live Low and Train High” (LLTH) (Girard et al, 2013).

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Why “Living High” is necessary for improvement in athletic performance?

     The simple action of living high or maximizing exposure to altitude plays an integral role in the physiological and performance benefits associated with altitude training. Researchers report that hemoglobin mass or factors related to the function of cardiovascular performance increases at approximately 1.1% per 100 hours of altitude exposure at altitudes above 2100 meters (Girard et al, 2013).  It is also suggested that a greater than 5% increase in hemoglobin mass following altitude training is associated with an increase in exercise performance (Rasmussen et al., 2013). Hence, it is recommended that athletes should spend sufficient time at altitude to achieve a corresponding increase in hemoglobin mass to gain improvements in aerobic performance at sea level. These physiological changes associated with improved cardiovascular performance appear in both the LHTH and LHTL models because these models allow for a large duration of time exposed to hypoxic environments.  Therefore, both models provide an ideal environment for allowing the physiological changes necessary for improvement in oxygen delivery.   

Are improvements in oxygen carrying capacity the only benefit of altitude training interventions?

     It’s important to note that while improvements in blood factors such as hemoglobin mass have been associated with performance increases from altitude training, other studies have also mentioned improvements in physiological factors unrelated to oxygen carrying capacity of  blood.  It’s important to understand that in addition to hematological  factors there are also non-haematological mechanism associated with improved performance after altitude training or hypoxic exposure that may potentially improve exercise performance. Researchers at the Australian Institute of Sport suggested in a 2001 study that altitude or hypoxic exposure resulted in increases exercise performance as a result of improved muscle buffering capacity( Gore et al., 2001). Improvements in muscle buffering capacity may help to improve endurance performance, as well as efficiency of exercise and lead to greater performance in high intensity exercise.  

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Improved muscle buffering capacity is a potential adaptation from altitude training interventions.

What is the best altitude model to use for football altitude training camp?

     However, for the purposes of this proposal the “Live-High” “Train-Low” (LHTL) model will be discussed at length. The majority of findings reported by researchers have suggests that the “LHTL” is the most effective altitude intervention for improvements in sea level cardiovascular performance and the physiological factors associated with improved aerobic performance ( Inness,,Billaut  & Aughey, 2015).  In fact, some researchers have referred to this model as the “gold standard” for altitude training for athletic performance enhancement (Brocherie et al, 2015).  The LHTL intervention has been reported by researchers to contribute to improvements in running economy, and hemoglobin mass in elite endurance athletes compared to athletes living and training at sea-level (Saunders et al., 2004).   In addition the LHTL model has extensive history in endurance performance. Athletes have used this model for more than half a century, attempting to improve  endurance performance at sea level (Mclean et al, 2013). 

Why is “Living-High”, “Training-Low” a better model for improving athletic performance?

     Despite the similarities in exposure to hypoxic environments between the LHTL Model and LHTH model, the LHTL model appears to be more effective than the LHTH model.  Researchers performed an extensive analysis of altitude training protocols in 2009 and determined that an enhancement of maximal aerobic power output was only possible with natural LHTL models (Girard et al., 2013). The superiority of the LHTL model to other altitude training models can be attributed to two factors: the ability to provide athletes extensive exposure to hypoxic (or low oxygen availability) environments and the opportunity to train in normoxic (normal oxygen availability) environments. In providing athletes maximum exposure to a partial oxygen environment the LHTL models helps to  elicit changes and/or increases to physiological factors associated with improve aerobic performance such as the augmentation of hemoglobin mass. In allowing athletes to train at lower altitude this model helps to limit the reductions in exercise capacity that occurs at high altitude.  Remember, as altitude increases there is limited availability of oxygen to tissue resulting in a greater limitation to  reach high levels of exercise performance (Clark et al., 2007).  In other words, as we train in environments with limited oxygen availability our ability to reach high levels of performance diminishes. In fact, training at altitude exposures can potentially result in a 7% decrease in VO2 max per 1000 meter altitude ascended(Girard et al, 2013). It can also slow down the process of energy recovery during exercise (Girard et al, 2013).

     On the contrary, training at lower altitudes produces an environment that allows for greater oxygen delivery and therefore improved ability to reach higher levels of exercise intensity.  Hence, training at low altitude prevents against degradations in exercise performance during training and helps to preserve muscle structure and function as a result.   The LHTL altitude training model enables athletes the potential for physiological changes or adaptation during rest and also facilitates an environment that allows for maximum exercise performance during training.  It places the athlete in a position to adapt for low oxygen availability while also maintaining high levels cardiovascular and muscle function through sea level training.  Understanding the details of this environmental position however is integral to providing the best construct for the inclusion of Altitude training to  team sports such as football.  Thus, in addition to understanding the best model for team sport athletes it’s also important to gain insight in to parameters such as the most effective duration and level of altitude for improvements in athletic performance. Thus the next few paragraphs will be devoted to developing an understanding of effective guidelines for altitude training interventions and their application to football training camps.

     When it comes to duration researchers have suggested that the best method for garnering the physiological effects (increased hemogloblin mass) associated with the “Living High” models is to be exposed to a hypoxic or moderate altitude environment of 2500 meters above sea level for greater than 16 hours a day for a period of approximately three to four weeks (Levine, Stray-Gundersen, 1997).  Other researchers have suggested that altitude training should take place at an altitude of 2,000 – 2,500 m for at least 22 hours a day and a minimum of 4 weeks to optimize the blood oxygen enriching adaptations for exercise performance. (Rasmussen, Siebenmann, Díaz, Lundby, 2013). Thus, it seems that leading research requires athletes to spend a minimum  three weeks at 16 hours per day at an altitude of 2000 meters above sea level to mediate positive effects towards physiological change and performance.  Three to four weeks is typically the time frame that NFL clubs spend in Training Camps. In addition, through the course of a training camp, much of an athlete’s day athletes is relegated to relatively low activity requirements such as meetings, film study, eating, sleeping and leisure.  These activities can take well over 20 hours of an athletes’s 24 hour day. The result, is an itinerary of  relatively low intensity activities that can take place at moderate altitudes with relatively low impact to the athlete and helps maximize their exposure to a hypoxic environment. Hence, the common football training camp schedule placed within a moderate altitude setting allows for effective exposures for physiological adaptations.

Aren’t there NFL teams already situated at “altitude”?

     At this point,you’ve probably thought about the implications for football teams that are already situated at relatively higher altitudes compared to the majority of football teams at sea level. For instance, a location like Denver, Colorado and a football team such as the Denver Broncos might immediately come to mind in reflecting on altitude training in football . Interestingly enough, Denver while recognized as the mile high city is not a high enough location to be considered for traditional “Live High” “Train Low” altitude interventions.  Denver Colorado has an altitude elevation of 1609 meters above sea level and is thus considered to be a low altitude environment.  However, it should be noted that low altitude environments or those which are lower than 2000 meters above sea level have been reported to produce favorable responses to blood parameters (Garvican-Lewis, Halliday, Abbiss, Saunders, & Gore, 2015).  Researchers demonstrated low altitude exposure or an altitude of 1800 meters above sea level resulted in a 3% in crease in hemoglobin mass in elite distance runners (Garvican-Lewis, Halliday, Abbiss, Saunders, & Gore, 2015). Despite this favorable response to blood parameters at low altitudes, it’s important to remember studies on athletes which have demonstrated  a greater than 5% increase in hemoglobin mass following altitude training generally report an increase in exercise performance (Rasmussen et al., 2013). While there have been beneficial increases in physiological factors associated with performance at low altitude, the majority of literature reports improvements in both physiological factors and performance at altitudes greater than low altitude. While it may seem intuitive to increase altitude levels to maximize physiological changes and exercise performance it is also important that we do not get carried away in our attempts to “Live High”.

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Altitude in Calgary, Alberta is 1044 meters and is considered to be low altitude

What level of altitude training is considered too High?

     Researchers place caution on altitude interventions above 3000 meters as these hypoxic environments have not been well received by athletes acclimating to this level of altitude (Rasmussen, Siebenmann, Díaz, Lundby, 2013). Researchers report that athletes expressed a need for increase recovery periods and poor quality of sleep at altitudes above 3000 meters. In addition, this level of altitude has been associated with stressful side effects such as loss of appetite, muscle wasting, and the potential for mountain sickness (Girard et al, 2013).  It should follow that in constructing a Altitude Training Training camp Intervention we must look for the following factors: 

  • Location that can accommodate a large team at an altitude between 2000 – 2500 meters
  • A football schedule  that allows for a minimum exposure of 16 hours a day for a period of approximately three to four weeks
  • Access to a normoxic or sea – level altitude environment for practice and/or training. 

     These factors can potential help create a resources that can football teams move forward in the increasingly competitive field of performance. With the advent of GPS Technology and analytics in football, performance coaches are beginning to realize the shear distance of yards that football players often cover during a practice and/or game session.  These realizations are helping to shift the perspective of  football  training and conditioning. With such an aerobic and volume demand placed on athletes performance specialists are searching for methods to both monitor, control, and prepare for the large conditioning demands of football.  Aerobic conditioning has proven to be an effective strategy for diminishing risk of injury and preparing athletes for the demands of their sports (Princevero and Bompa).  In other words, endurance capacity is growing in  importance in a sport where performance coaches were chiefly concerned with Anaerobic ability.  Teams can benefit from a resource which has been proven to improve factors of both aerobic and anaerobic function as hypoxic training has been associated with improvements in maximal oxygen uptake, phosphocreatine resynthesis and muscle buffering capacity (Girad et al., 2013).  The purpose in improving factors of aerobic and anaerobic capacities serves to decrease relative exercise intensity and serves to improve their tolerance for the repeated sprint activity that is common to their sport (Girard et al, 2013).  In other words athletes would be better able to handle high sprint efforts. Researchers also acknowledge that skill performance is impacted by fatigue. It should follow then that minimizing potential for fatigue may help to maintain high levels of skill efficiency. Therefore altitude training can lead to improvements in aerobic capacity thus limiting fatigue, improving performance and skill efficiency (Inness, Billaut & Aughey, 2015). 

     To create an effective vision for the future, it helps if you have an understanding of history. History seems is rapidly growing with research that demonstrates altitude training may be a growing vision for the future – Especially in the Team Sport of Football.  In part two of this proposal , we help to establish an understanding of altitude training models through past research. We were able to gain insight in to the various guidelines and parameters needed for the construct of an effective altitude training model. We learned for instance that Researchers have referred to the “Live-High” “Train-low” model as the“gold standard” for altitude training for athletic performance enhancement. It’s effectiveness is likely due to the creation of a dual environment that enable athletes to gain the benefits of  both a hypoxic and normoxic setting. While improvements in physiological factors such as hemoglobin mass have been closely associated with exercise performance in altitude training there are also factors unrelated to oxygen carrying capacity that may promote improved performance in athletes.  This information provided in this post serves as the foundation of a vision that i will continue to illustrate for the future of our athletes and their performance.  In my next post, i will further elucidate the image of NFL altitude training years from today.

Top 8 Statements from this Article:

  1. Altitude Training is becoming more popular today than ever
    • Olivier Girard, Researcher at Athlete Health and Performance Research Centre in Doha, Qatar says “Athletes from different team sports worldwide are using altitude training more than ever before.” (Girard, Chalabi, 2013)
  2. The effects of some altitude training interventions can last for weeks
    • In 2015, Researchers at the University of Lausanne, Switzerland found that altitude intervention improved physiological factors related to cardiovascular function and sprint performance in elite male field hockey players. In addition, these benefits lasted for three weeks after the altitude training intervention (Brocherie et al., 2015).
  3. You have to spend time at altitude to gain physiological adaptations associated with improve exercise performance
    • Researchers report that hemoglobin mass or the factors related to cardiovascular performance increases at approximately 1.1% per 100 hours of altitude exposure at altitudes above 2100 meters (Girard et al, 2013).  It is also suggested that a greater than 5% increase in hemoglobin mass following altitude training is associated with an increase in exercise performance (Rasmussen et al., 2013).
  4. Altitude Interventions can also improve factors unrelated to blood for the improvement of exercise performance.
    • Researchers at the Australian Institute of Sport suggested in a 2001 study that altitude or hypoxic exposure resulted in increases exercise performance as a result of improved muscle buffering capacity( Gore et al., 2001).
  5. The Live – High Train Low model may potentially be the best altitude training method for improving exercisee performance.
    • Researchers have referred to the “Live-High” “Train-low” model as the“gold standard” for altitude training for athletic performance enhancement.   
    • Researchers performed an extensive analysis of altitude training protocols in 2009 and determined that an enhancement of maximal aerobic power output was only possible with natural LHTL models (Girard et al., 2013).
  6. Some researchers have demonstrated improvements in factors related to exercise performance associated with low altitude training interventions
    • However, it should be noted that low altitude environments or those which are lower than 2000 meters above sea level have been reported to produce favorable responses to blood parameters(Garvican-Lewis, Halliday, Abbiss, Saunders, & Gore, 2015).   
  7. Living at altitudes greater than 3000 meters can pose risks and challenges that may outweigh benefits
    • Researchers place caution on altitude interventions above 3000 meters as these hypoxic environments have not been well received by athletes acclimating to this level of altitude (Rasmussen, Siebenmann, Díaz, Lundby, 2013). 
  8. Aerobic and Anaerobic Conditioning  can help improve repeat sprint performance.
    • The purpose in improving factors of aerobic and anaerobic capacities serves to decrease relative exercise intensity and serves to improve their tolerance for the repeated sprint activity that is common to their sport (Girard et al, 2013).

References:

Brocherie, F., Millet, G. P., Hauser, A., Steiner, T., Rysman, J., Wehrlin, J. P., & Girard, O. (2015). “Live High–Train Low and High” Hypoxic Training Improves Team-Sport Performance. Medicine & Science in Sports & Exercise, 47(10), 2140-2149. 

Clark SA, Bourdon PC, Schmidt W, Singh B, Cable G, Onus KJ, Woolford SM, Stanef T,Gore CJ and Aughey RJ. (2007) The effect of acute simulated moderate altitude onpower, performance and pacing strategies in well-trained cyclists. European Journal of Applied Physiology. 102:45-55.

Girard, O., Chalabi, H.(2013). Could altitude training benefit team-sport athletes? British Journal of Sports Medicine, 47(1), 4-5.

Gore C.J., Hahn, A.G., Aughey, R.J., Martin, D.T., Ashenden, M.J., Clark, S.A., Garnham, A.P., Roberts A.D., Slater G.J. and McKenna MJ. (2001) Live high:train low increases muscle buffer capacity and submaximal cycling efficiency. Acta Physiologica Scandinavica. 173: 275-286.

Garvican-Lewis, L. A., Halliday, I., Abbiss, C. R., Saunders, P. U., & Gore, C. J. (2015). Altitude Exposure at 1800 m Increases Haemoglobin Mass in Distance Runners. Journal of Sports Science & Medicine, 14(2), 413–417.

Inness, M. W., Billaut, F., & Aughey, R. J. (2017). Live-high train-low improves repeated time-trial and Yo-Yo IR2 performance in sub-elite team-sport athletes. Journal of Science and Medicine in Sport, 20(2), 190-195.

Levine B.D., Stray-Gundersen J. (1997) “Living high-training low”: effect of moderate altitude acclimatization with low-altitude training on performance. Journal of Applied Physiology. 83: 102-112.

Mclean, B. D., Buttifant, D., Gore, C. J., White, K., Liess, C., & Kemp, J. (2013). Physiological and Performance Responses to a Preseason Altitude-Training Camp in Elite Team-Sport Athletes. International Journal of Sports Physiology and Performance, 8(4), 391-399. 

Naeije, R. (2010). Physiological Adaptation of the Cardiovascular System to High Altitude. Progress in Cardiovascular Diseases, 52(6), 456-466.

Pincivero, D. M., & Bompa, T. O. (1997). A Physiological Review of American Football. Sports Medicine, 23(4), 247-260.

Rasmussen, P., Siebenmann, C., Díaz, V.,  Lundby, C. (2013) Red cell volume expansion ataltitude: a meta-analysis and monte carlo simulation. Medicine & Science in Sports & Exercise. 45(9):1767-1772

Saltin B., Kim, C.K, Terrados, N., Larsen, H., Svedenhag, J.,Rolf, C.J., (1995). Morphology, enzyme activities and buffer capacity in leg muscles of Kenyan and Scandinavian runners. Scandinavian Journal of Medicine & Science in Sports. 5(4):222–230.

Saunders, P.U.,  Telford, R.D.,  Pyne, D.B.,  Cunningham, R.B.,  Gore, C.J.,  Hahn, A.G.,  Hawley, J.A (2004). Improved running economy in elite runners after 20 days of simulated moderate-altitude exposure. Journal of Applied Physiology, 96(3), 931-937 

 

DLLDan Liburd is in his ninth season as a NFL Strength and Conditioning Coach. Liburd has experience in designing, implementing and supervising Strength and conditioning programs for various athletic populations. Liburd also has experience in designing and overseeing team nutrition and dietary programs. Liburd is a Certified Strength and Conditioning Specialist who earned a Bachelor’s degree in Exercise Science from Boston University, A Master’s of Science from Canisius College in Health and Human Performance and is currently working towards a Phd in Health and Human Performance at Concordia University Chicago. Liburd has worked with several professional teams such as the Buffalo Bills and held various positions in Collegiate Strength and Conditioning programs. He has worked with the Boston University Terriers, Springfield College Pride, American College Yellow Jackets and held positions at Mike Boyle Strength and Conditioning as well as Peak Performance Physical Therapy. For more articles please checkout http://www.doyou-live.com

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