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Returning from Injury with Altitude Training

Returning from Injury with Altitude Training

Altitude training helps athletes returning from injury achieve fitness targets with reduced mechanical load.

Returning From Injury

Returning from injury requires a careful balance between cardiovascular rehabilitation and minimizing mechanical stress on the musculoskeletal system. Achieving cardiovascular intensity is crucial for overall fitness and the restoration of physiological function, but it must be done judiciously to prevent re-injury or exacerbation of existing conditions. Overly aggressive approach may impose excessive mechanical loads on injured tissues, jeopardizing the recovery progress and increasing the risk of setbacks. By emphasizing cardiovascular intensity without a corresponding elevation in  mechanical load, individuals can foster a safe and effective rehabilitation process. This often involves incorporating low-impact activities such as swimming, cycling, or elliptical training, which minimize stress on weight-bearing joints while still challenging the cardiovascular system.


Reduced Mechanical Load

Altitude training provides a unique avenue for load-compromised individuals to attain exercise benefits with reduced mechanical stress. Individuals can achieve similar fitness outcomes through the additive stress of hypoxia on internal load while reducing mechanical work, mitigating strain on compromised joints or muscles.

This is supported by evidence from research from The University of Western Australia who found that when heart rate is clamped, increasing simulated altitude led to a stepwise decrease in Power Output and Oxygen Saturation SpO2 while maintaining tissue saturation index,  Blood Lactate (BLa) and cardio-respiratory responses, and neuromuscular fatigue (MVC, CAR, peak twitch). In the study, sixteen trained males participated in endurance sessions at various simulated altitudes, including sea-level and hypoxic conditions (~3000 m). Participants cycled for 60 minutes at a heart rate corresponding to 80% of their ventilatory threshold. Altitudes ranged from 0 m to 4000 m. 


Scientific Research

Maintenance of internal load despite a stepwise reduction in external load during moderate intensity heart rate clamped cycling with acute graded normobaric hypoxia in males (Li et al 2022)

  • “Increasing hypoxia severity reduces cycling power output and arterial oxygen saturation in a stepwise fashion without affecting exercise responses between sea-level and simulated altitudes up to 3500 m”

Hypoxic conditioning: a novel therapeutic solution for load-compromised individuals to achieve similar exercise benefits by doing less mechanical work! (Girard et al 2021)

  • In load-compromised individuals, hypoxic conditioning can be particularly beneficial to increase relative exercise intensity without an accompanying heightened mechanical load response.
  • During rehabilitation programmes, hypoxic conditioning likely represents a promising exercise modality to increase the cardiovascular intensity of the session, without a corresponding elevation in the mechanical load imposed on the musculoskeletal system 
  • This novel approach, therefore, has the potential to improve exercise prescription for injured or load-compromised athletes unable to tolerate the mechanical stress associated with their normal physical conditioning routines. In many professional clubs, apart from injured athletes, ‘healthy’ athletes can also take advantage of hypoxic conditioning. 
  • Reducing the mechanical demand of exercise likely offers new solutions to improve therapeutic outcomes by maintaining or regaining fitness.

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