Altitude Training: What It Really Means and How to Get Started

Altitude training isn’t a new fad, it’s been part of serious preparation for elite endurance athletes for decades. The basic idea is simple: by living or training where there’s less oxygen in the air, your body is forced to adapt.

That adaptation aims to improve how your muscles use oxygen when you return to sea level. There’s solid evidence that altitude training can improve aspects of aerobic work capacity and blood oxygen‑carrying capacity, particularly when done for consistent periods and in the right way.

But it’s also clear from the research that how you do it matters, how long you stay there matters, and altitude isn’t some magic bullet that automatically makes you faster.

What Actually Happens at Altitude?

At altitude, the oxygen pressure in the air is reduced, which means your body gets less oxygen per breath. This stimulates a range of responses: increased red blood cell production (via erythropoietin), increased capillary density, enhanced buffering capacity, and improved muscle efficiency.

In theory, these adaptations mean when you come back to sea level, your oxygen transport and utilisation systems are more effective. But the results aren’t always linear. the impact depends on altitude level, duration, how well you recover, and how your training is managed.

What’s the Point?

The main objective is to improve your aerobic engine. Endurance athletes are most commonly associated with altitude training because their success depends on sustaining work rates with minimal oxygen cost. But it’s not exclusive to marathon runners and cyclists. Sprinters, rowers, team sport athletes — they all need aerobic underpinning for recovery and repeated efforts. And recovery itself, from heavy training blocks or injury, is a physiological process. That makes it a physiologist’s job.

Altitude training is still one of the most effective legal ways to stimulate red blood cell production, if you do it properly.

What Doesn’t Work

Let’s be honest. Spending four days in the mountains doesn’t change your physiology. Short altitude camps are useful for acclimatisation (especially for competitions at altitude), but not for building performance capacity at sea level.

Equally, hammering high-intensity sessions during your first few days at 2,000m is a quick route to overreaching. You’re not superhuman; you’re hypoxic.

There’s also the problem of overestimating the gear. Sleeping in a hypoxic tent for five hours a night while smashing triple training sessions at sea level won’t make you Mo Farah. Adaptations take time. The “dose” matters.

Different Models of Altitude Exposure

1. Live High, Train High – Traditional altitude camps (e.g. Flagstaff, Font-Romeu, St Moritz). Typically 2–4 weeks at 1800–2500m. Training intensity often reduced; benefits seen on return to sea level.
2. Live High, Train Low – The gold standard. Athletes live at altitude but descend to train harder at lower altitudes. Maximises red cell stimulation without compromising training quality.
3. Intermittent Hypoxic Exposure/Training – Short bursts of hypoxic exposure during training or sleep using simulated environments (e.g. altitude tents or hypoxicators). Evidence is mixed but promising if protocols are right.
4. Repeated-Sprint Training in Hypoxia – Emerging area. Can enhance anaerobic capacity, particularly relevant for team sports. Still under research.

The Critical Factors

• Time – You need 2–3 weeks minimum for haematological changes; ideally longer for sustained benefit.
• Altitude – Around 2000–2500m is the sweet spot. Too low = weak stimulus. Too high = risk of illness, sleep disruption, and poor training quality.
• Individual Response – Not everyone adapts the same way. Some athletes are ‘responders’, others less so. You only find out by tracking.
• Recovery – Sleep quality often declines at altitude. That’s an adaptation in itself, but it makes proper rest even more important. Monitor HR, HRV, mood, and fatigue.

Getting Started: A Practical Plan

• Set a clear goal – Are you preparing for an altitude race, aiming to build aerobic capacity, or boosting red blood cell count before a sea-level peak?
• Book a block – Plan for at least three weeks. Anything less is fine for acclimatisation, but won’t move the needle on performance.
• Ease in – The first 3–5 days are about adaptation. Reduce volume, lower intensity, and avoid back-to-back hard sessions.
• Track your data – Use resting HR, HRV, SpO2, perceived fatigue, sleep quality, and session RPE. Keep it simple but consistent.
• Plan the return – Performance often dips in the first few days post-altitude. The sweet spot for racing is often 7–14 days after descent, but it varies.

Not Just for Endurance Athletes

Sprint events, strength sports, power-based disciplines; they all benefit from recovery and metabolic efficiency.

That’s where good physiologists can still have big impact. Altitude can influence buffering, lactate clearance, oxygen kinetics; not just aerobic endurance.

What matters is understanding what the body needs to do to meet the performance demand, and how you use physiology to get there. That’s what separates good support from guesswork.

What to Look for in a Physiologist for Altitude Training

• CASES Accredited (UK)
• ACSM Certified (US)
• ESSA Accredited (Australia)
• Solid experience working with training plans, physiological monitoring, and recovery strategies
• Familiar with lab and field testing, blood markers, wearable data, and training load analysis

Ask them what they specialise in. Ask for examples. If they’ve published – even better, you’ll get a sense of their scope and application. But don’t confuse academia with impact. The best ones work seamlessly with coaches, adapting plans based on what the data says, not just delivering a test and vanishing.

If you want support building a physiology led plan for performance, take a look at the physiologists on the Athlete Now platform.

Further Reading

• Millet, G. P., et al. (2010). “Combining Hypoxic Methods for Peak Performance.” Sports Medicine, 40(1), 1–25.
• Gore, C. J., et al. (2007). “Altitude training and haemoglobin mass from the optimised carbon monoxide rebreathing method.” Medicine & Science in Sports & Exercise, 39(5), 955–962.
• Chapman, R. F., et al. (2013). “Timing of return from altitude training for optimal sea level performance.” Journal of Applied Physiology, 114(6), 793–802.
• Wilber, R. L. (2007). “Application of altitude/hypoxic training by elite athletes.” Medicine & Science in Sports & Exercise, 39(9), 1610–1624.
• Faiss, R., et al. (2013). “Living high-training low: effect on aerobic performance.” Pneumon, 26(2), 63–70.