PE19: High Altitude Training
Training at altitude, physiological adaptations, benefits at sea level and limitations of this training method.
🏔️ What is High Altitude Training?
Definition: High altitude training involves exercising at elevations above 2,500 metres (8,000 feet) where the air pressure and oxygen concentration are significantly lower than at sea level. This hypoxic (low oxygen) environment forces the body to adapt.
At altitude, the partial pressure of oxygen in the air is lower:
- At sea level, the air contains approximately 21% oxygen and the partial pressure is about 160 mmHg
- At 2,500m, the partial pressure of oxygen is around 112 mmHg - roughly 30% less
- At 4,000m, the partial pressure drops further to around 87 mmHg
- Less oxygen pressure means less oxygen diffuses into the blood at the alveoli
The challenge: At altitude, each breath delivers less oxygen to the blood. The heart must work harder to deliver sufficient oxygen to working muscles, meaning the same exercise intensity feels much harder than at sea level.
🩸 Physiological Adaptations at Altitude
Erythropoiesis: The most significant adaptation. The kidneys detect the lower oxygen levels (hypoxia) and release the hormone erythropoietin (EPO). EPO stimulates the bone marrow to produce more red blood cells, increasing the oxygen-carrying capacity of the blood.
Key adaptations that occur during altitude training:
- Increased red blood cell (RBC) production: EPO stimulates the bone marrow to produce more RBCs, increasing the blood's oxygen-carrying capacity. Haemoglobin concentration increases from typical sea-level values of 14-16 g/dL to 17-19 g/dL.
- Increased haemoglobin concentration: More haemoglobin means more oxygen can be carried per unit of blood.
- Increased capillarisation: The body develops more capillaries around working muscles to improve oxygen delivery.
- Increased myoglobin in muscles: Muscle fibres store more myoglobin, allowing them to store and use more oxygen locally.
- Increased mitochondria: Muscle cells produce more mitochondria, increasing the capacity for aerobic energy production.
- Increased ventilation: Breathing rate and depth increase to take in more air and compensate for the lower oxygen pressure.
EPO and Red Blood Cell Production
When an endurance athlete trains at 2,500m for 3-4 weeks, their kidneys detect the lower oxygen levels and release more EPO. This hormone travels to the red bone marrow (in the sternum, ribs, pelvis and ends of long bones) and stimulates increased red blood cell production. The athlete's RBC count rises, increasing from roughly 5 million per microlitre to 5.5-6 million per microlitre. When they return to sea level, these extra RBCs allow their blood to carry more oxygen, giving them a performance advantage.
✅ Benefits at Sea Level
The key benefit: When an athlete returns to sea level after altitude training, they retain the increased red blood cell count and haemoglobin concentration for a period of time. This means their blood can carry more oxygen than before, improving endurance performance at sea level.
Specific performance benefits at sea level after altitude training:
- Higher VO₂ max: The maximum volume of oxygen the body can use per minute increases because more oxygen can be delivered to and used by working muscles
- Improved oxygen delivery: More red blood cells and haemoglobin mean each unit of blood carries more oxygen
- Delayed onset of fatigue: Working muscles receive oxygen more efficiently, delaying the point at which the anaerobic system must take over
- Improved endurance performance: Times in distance events improve due to better aerobic capacity
- Better recovery between efforts: More efficient oxygen delivery helps clear lactic acid faster
Altitude Training in Professional Sport
Many professional endurance athletes train at altitude camps. For example, Kenyan and Ethiopian distance runners live and train at altitudes of 2,000-2,500m, which partly explains their dominance in distance running. European and American runners often travel to high-altitude training camps in places like Iten (Kenya, 2,400m) or Flagstaff (USA, 2,100m) for 3-4 week blocks to gain these adaptations before returning to sea-level competition.
⚠️ Limitations of High Altitude Training
Despite its benefits, altitude training has significant limitations:
1. Cannot Train as Hard at Altitude
- The reduced oxygen means athletes cannot reach the same training intensities as at sea level
- Sprint speed, power output and training volume are all reduced
- Athletes may actually lose fitness in anaerobic components while at altitude
- This is known as the "train low" problem - you can't train at maximum intensity
2. Expense and Accessibility
- Altitude training camps are expensive (travel, accommodation, coaching)
- Not all athletes have access to high-altitude facilities
- Requires 3-4 weeks at altitude to gain significant adaptations
- Creates an unfair advantage for wealthier athletes and nations
3. Effects Are Temporary
- The increased red blood cell count begins to decrease within days of returning to sea level
- Most adaptations are lost within 2-3 weeks without continued altitude exposure
- The performance window after returning from altitude is limited
- Athletes must time their return carefully to peak for competition
4. Altitude Sickness
- Some athletes experience altitude sickness (nausea, headaches, dizziness, fatigue)
- This can prevent effective training during the first few days at altitude
- Severe altitude sickness can be dangerous (fluid on the lungs or brain)
| Benefit | Limitation |
|---|---|
| Increased RBC production (more oxygen carried per unit of blood) | Cannot train at maximum intensity (reduced oxygen availability) |
| Increased haemoglobin concentration | Expensive - requires travel to altitude camps |
| Improved sea-level endurance performance | Effects are temporary (lost within 2-3 weeks of return) |
| Increased capillarisation and mitochondria | Risk of altitude sickness |
| Delayed fatigue in endurance events | May lose anaerobic fitness during altitude stay |
🔄 The "Live High, Train Low" Approach
"Live High, Train Low": A strategy where athletes live at altitude (gaining the physiological adaptations) but descend to lower elevations to train (maintaining training intensity). This attempts to gain the benefits of altitude while minimising the limitations.
- Live at 2,000-2,500m to stimulate EPO release and increase RBC production
- Descend to below 1,000m for high-intensity training sessions
- This allows the body to gain altitude adaptations while still training at near-sea-level intensity
- Some facilities use artificial altitude environments (hypoxic chambers) to simulate this
❓ Practice Questions
Q1: At what altitude is high altitude training typically performed?
Q2: Explain the process of erythropoiesis and how it benefits an endurance athlete.
Q3: Why can't athletes train as hard at altitude as they can at sea level?
Q4: Describe three limitations of high altitude training.
Q5: Explain the "live high, train low" approach and why it is used.
Q6: Why are the benefits of altitude training temporary?
✅ Answers
- Above 2,500 metres (8,000 feet).
- At altitude, the lower oxygen levels are detected by the kidneys, which release the hormone erythropoietin (EPO). EPO stimulates the red bone marrow to produce more red blood cells. More RBCs means the blood can carry more oxygen, which benefits endurance athletes by improving oxygen delivery to working muscles, delaying fatigue and improving VO₂ max.
- At altitude, the partial pressure of oxygen is lower, meaning less oxygen diffuses into the blood at the alveoli. With less oxygen in the blood, the heart must work harder and muscles receive less oxygen per unit of blood. This means the same exercise intensity requires a higher percentage of maximum effort, and the athlete simply cannot reach the same maximum speeds, powers or workloads as at sea level.
- (1) Cannot train as hard - reduced oxygen means lower maximum training intensity, potentially losing anaerobic fitness. (2) Expense and accessibility - altitude camps are costly and not accessible to all. (3) Effects are temporary - increased RBC count decreases within 2-3 weeks of returning to sea level. (Other valid: altitude sickness, unfair advantage.)
- "Live high, train low" involves living at altitude (2,000-2,500m) to stimulate the body's adaptations (especially EPO release and increased RBC production) while descending to lower elevations (below 1,000m) for training sessions. This approach aims to gain the physiological benefits of altitude exposure while maintaining the ability to train at sea-level intensities, overcoming the main limitation that athletes cannot train as hard at altitude.
- The benefits are temporary because when the athlete returns to sea level, the kidneys no longer detect low oxygen levels, so EPO production decreases to normal. Without the stimulus of continued altitude exposure, the body gradually returns RBC production to normal levels. The extra RBCs have a lifespan of approximately 120 days, so the enhanced oxygen-carrying capacity diminishes over 2-3 weeks as excess RBCs are naturally broken down and not replaced at the same rate.
🎯 Exam Tips
- Know that altitude training is above 2,500m
- The key adaptation is EPO release → increased RBC production → increased oxygen-carrying capacity
- Always balance benefits with limitations in your answer
- "Live high, train low" is the smart approach - know why
- Effects are temporary (2-3 weeks) - timing the return is crucial
- Altitude = less oxygen pressure, not less oxygen percentage (air is still 21% O₂)
📝 Exam Technique
PE Exam Tips — High Altitude Training:
1. For High Altitude Training questions, use subject-specific terminology precisely
2. Support every point with specific evidence or examples
3. Show balanced analysis — consider different perspectives before reaching a conclusion
4. Link your understanding of High Altitude Training to real-world contexts where possible
5. For longer answers, plan your response to address all parts of the question
1. For High Altitude Training questions, use subject-specific terminology precisely
2. Support every point with specific evidence or examples
3. Show balanced analysis — consider different perspectives before reaching a conclusion
4. Link your understanding of High Altitude Training to real-world contexts where possible
5. For longer answers, plan your response to address all parts of the question
⚠️ Common Errors
Watch Out!
Students often think fitness and health are the same thing. Wrong: Fitness and health are the same thing Correct: Health is a state of complete physical, mental and social well-being (WHO). Fitness is the ability to meet the demands of the environment. You can be fit but unhealthy (e.g. a marathon runner with flu).
Students often think static stretching is the best warm-up. Wrong: Static stretching is the best warm-up Correct: Current evidence suggests dynamic stretching is more effective in warm-ups as it mimics sporting movements. Static stretching may actually reduce power output if held too long before activity.
Students often think no pain, no gain is a good training principle. Wrong: No pain, no gain is a good training principle Correct: Pain can indicate injury. Progressive overload should be gradual — the 10% rule suggests not increasing training load by more than 10% per week. Ignoring pain leads to overuse injuries.
✍️ Model Answer
Full-Mark Response
6 marks: Explain how high altitude training affects sporting performance.
High Altitude Training has significant effects on sporting performance. [Key concept 1]: explain the mechanism with specific detail. [Key concept 2]: how this applies in a named sporting example. [Key concept 3]: the relationship between this topic and overall performance. A grade 9 answer uses precise anatomical/physiological terminology, specific sporting examples, and evaluates the relative importance of different factors.
Mark scheme: 2 marks per explained point with specific evidence, evaluation for top marks
📊 AO Deep Dive
Assessment Objective Analysis
GCSE PE tests four AOs: AO1 (Knowledge, 30%) — recall facts about High Altitude Training including definitions, classifications and specific examples; AO2 (Application, 30%) — apply knowledge to sporting contexts and training scenarios; AO3 (Analysis and Evaluation, 25%) — analyse data (graphs, tables), evaluate training methods or strategies, and justify recommendations; AO4 (Practical, 15%) — demonstrate relevant skills. For grade 9, use precise terminology, support every point with named sporting examples, and evaluate rather than just describe. The difference between grade 5 and grade 9 is the quality of application and depth of evaluation.
📝 Exam Questions by Topic
🎬 Video Resources
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