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		<?xml version="1.0"?><rss version="2.0"><channel><title>Altitude - Tri247</title><link>http://www.tri247.com/index.html</link><description>Latest altitude articles from Tri247</description><item><title><![CDATA[Sleeping your way to the top]]></title><link><![CDATA[http://www.tri247.com/article_2559.html]]></link><description><![CDATA[Alastair Brownlee has had a great year. Coming back from injury, Alastair secured some impressive results; Silver medals at both the World Junior Duathlon and Triathlon Championships; an impressive European Championship Gold; and an awesome Silver medal at the World Cup in Rhodes amongst a stacked senior field. Not at all bad for an athlete who is still just 19 years old. 

Like all good athletes, Alistair is sleeping his way to the top. Each night, when other athletes hit the sack, Alistair is committed to getting in that one extra training session. Each night he climbs into a hypoxic tent provided by The Altitude Centre and sleeps in rarefied air.

Top athletes know the commitment needed to be one step ahead of the rest. Remembering the words of Daley Thompson, who always said that he exercised twice on Christmas Day, just in case his main rival was training only once, Alastair is able to train whilst his rivals simply sleep. That&rsquo;s why six of the last seven Ironman World Champions use simulated altitude training, it&rsquo;s not possible to sleep if you know your rivals are training.

Interestingly, Chrissie Wellington, who recently won the Ford Ironman World Championship in Hawaii, spent five years living in Nepal at an altitude around 5,000 meters and now uses two training camps; one in Phuket where she is able to train in heat and humidity, and the other in Leysin, Switzerland at an altitude of 1,250 to 2,200 meters.

The &#039;Sleep High&#039; technique is used by all top distance athletes and is the most common form of altitude training, often preferred by the American athletes. Sleeping at simulated altitude can actually be better than sleeping in the mountains themselves. To sleep at simulated altitude you will need:


A hypoxic air generator
A space to contain the rarefied air
A carefully controlled altitude training programme


Portable hypoxic generators are available to rent or buy and they can produce simulated altitude environments up to 12,500ft/3,810m. The rarefied air then needs to be contained around the athlete for a duration of approximately eight hours a night for three weeks or more. A range of tents and cubicles are available for this purpose, from portable solutions to more permanent structures. Some athletes even choose to have their whole bedrooms converted for seamless comfort. The Altitude Centre has recently installed a room system in a multi-million pound penthouse apartment in London, making it arguably the highest simulated altitude apartment in London and possibly the world. The installation came with a state of the art climate and altitude control, where the user can simply dials in their desired sleeping altitude, &ldquo;Hmm, I think I&rsquo;ll sleep at Le Plaz tonight, darling&rdquo;.

As well as having the right kit, it is important to set the right training programme to ensure your get a positive effect from this training stimulus. The Altitude Centre work with athletes to pinpoint their main goals for the season, then design altitudes training strategies around their goals, ensuring they peak for the key event.

Sleep is the key
Sleeping is hugely important for recovery, it is the time when a lot of the body&#039;s repair work is done. Top athletes are aware of the fine balance between training and recovery, if you over do it you risk falling ill and all the good work done in training goes out the window. Training in your sleep will improve your physiology and your performance, but it is important to maintain the balance between training and recovery, even in your sleep, so the key with altitude training is to start off gradually and build into it. Too many athletes go too high, too quickly.

After a couple of nights of sleeping in the hypoxic tent at a moderate altitude your body starts to adjust to the low oxygen through its own natural adaptive process, it&rsquo;s at this stage when you can then increase the altitude slightly until you adapt again to the increased stimulus. Just like climbing a mountain, you should go a little higher each day and allow your body time to adjust. After a period of sleeping in the tent people often remark that their sleep quality has improved. The equipment used by The Altitude Centre pumps in over 100 litres of air per minute, this ensures the environment is fresh and clean and totally safe. The tent is not sealed as it is important to flush the hypoxic air through, rather than trapping it inside, so there&rsquo;s no worry Alastair would get shrink wrapped if the machine accidentally got switched off!

Athletes normally stop using their tents a week before key competition, but the more they are used the more the body adapts to be able to cope with the stimulus so it is possible to use the tent all the way up to competition. Athletes also use hypoxic tents whilst injured to maintain fitness and to speed up the body&rsquo;s own genetic potential to recover, and this has been covered in an earlier article.

The benefits are well documented for the &#039;sleep high&#039; modality. This mild form of gradual acclimatisation seems to work mainly on a blood level to boost the oxygen carrying red blood cells. The benefits include:

An increase in red blood cell mass which means more red blood cells to transport oxygen to the muscle cells.
An increase in total blood volume, which moves oxygen more efficiently through the blood stream. Greater blood volume increases the stroke volume of the heart improving the oxygen carrying capacity of the blood.
An increase in heamatocrit, the ratio of red blood cells to total blood serum resulting in a greater percentage of blood cells carrying oxygen.


Levine &amp; Stray-Gundersen are the classic reporters of the &ldquo;Living High-training Low&rdquo; technique and their research published in 1997 showed the following improvements in elite athletes:

5% VO2 improvement
9% red cell mass volume improvement
13.4 second time trial improvement over 5,000m


The benefits of sleeping at altitude can be found from as little as 1,200 meters. The altitude &lsquo;dose&rsquo; required to stimulate the bodies own genetic potential to adapt to cope with the altered environment varies from athlete to athlete. It is not how high to sleep for maximum effect it&rsquo;s more about finding the right height for you. That&rsquo;s why simulated altitude training can be better than heading to the mountain. The user can control the precise altitude that gives them maximum effect without the risk of over doing it. For example if you have had a particularly hard training day you might decide to sleep at a lower simulated altitude as the extra work your body is having to do in the repair process of the days training will effect the amount of oxygen your body needs to process during your sleep. At real altitude the air is thinner, because the air pressure is lower, that&rsquo;s why sprint times are faster at altitude - the body moves through the thin air more easily. The same happens in the lungs, even though there is less oxygen in the air, the air passes through the lungs easier, this can lead to a de-training effect upon the lung, even with increased ventilation due to the reduced oxygen the lung membrane doesn&rsquo;t have to work as hard. Simulated altitude air is the same density as ambient air  so there is no de training effect upon the lungs.

Simulated altitude training can be done from the comfort of your own home, it enables athletes who are not able to live permanently at altitude the ability to compete side by side. like all forms of altitude training it can only enhance your own genetic potential and as WADA (World Anti Doping Agency) concluded it is a legal means of improving sports performance and will remain off the List of Prohibited Substances and Methods in Sport. Sleep well!

Levine, B.D., &amp; 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.



The Altitude Centre offer consultations on all elements of hypoxic training. They also have simulated altitude systems to rent or buy. For further information contact Richard Pullan on 0870 950 4479 or email richard@altitudecentre.com or visit www.altitudecentre.com
]]></description></item><item><title><![CDATA[Exercise at altitude for injury rehabilitation]]></title><link><![CDATA[http://www.tri247.com/article_2033.html]]></link><description><![CDATA[In the Junior men&#039;s World Championships last weekend Alistair Brownlee won an impressive Silver medal. What makes it even more impressive is that it comes off the back of just four weeks of quality training, following Alistair&rsquo;s stress fracture which put him on crutches a couple of months ago. Alistair used IHT (Intermittent Hypoxic Training) at the initial stages of his injury when he wasn&rsquo;t able to exercise. We used IHT for three weeks to treat his stress fracture before he returned to exercise. During the past four weeks Alistair has been doing hypoxic workouts and sleeping in our hypoxic tent.

In this article we will describe the basic principles behind hypoxic workouts and their role in injury rehabilitation. The next article will describe the role of sleeping in hypoxia, but first we will concentrate on the principles of exercising in hypoxia for injury rehabilitation.

Exercising in hypoxia can be done in three ways. 

Rent or buy a portable hypoxic generator from The Altitude Centre and attach an exercise mask so that you can then train on a running machine or bike or any other piece of equipment wherever you like. This is the cheapest way to exercise in hypoxia and the recommended altitude we suggest depends upon the individual but is generally around 9,000ft/2,700m. 
A better way to train in hypoxia is to create a room that is flushed with reduced oxygen air to simulate the same altitude equivalent environment. Facilities such as these have been installed at the English Institute of Sport and several Premiership Football and Rugby clubs allowing athletes to exercise without the restriction of wearing an oxygen mask.  Such a room environment enables athletes to do dynamic exercises that are specific to their chosen sport. 
The third option is to go to the mountains, the problem with this is that it is not often practical to head for the hills whenever you sustain an injury.

We recommend hypoxic workouts when the athlete has been given permission by their doctor to start doing moderate exercise again. Alistair used IHT whilst he rested with his stress fracture, then started hypoxic workouts three weeks later.

Hypoxic workout is used to:

Maintain/improve fitness
Speed recovery 
Boost morale

Hypoxic workouts put more emphasis on the cardiovascular system. Your heart rate and breathing increase in order to get the available oxygen to the working muscles. One of the benefits of a hypoxic workout for an injured athlete is to exercise at a reduced muscle load whilst achieving the same cardiovascular benefits of a much harder workout. You can run slower to achieve the same cardiovascular results in hypoxia. This means less stress on the injury site but great cardiovascular stimulus enabling the athlete to maintain the right training zones and build on fitness whilst injured. &ldquo;I found the training a perfect way to ease back into my full fitness regime it allows me to achieve a harder workout than I could without the system&rdquo; says Alistair. 

This type of workout is also fantastic for fatigued athletes who want to challenge their cardiovascular system without overloading their fatigued muscles. A hypoxic workout of moderate intensity reduces delayed onset muscle soreness (DOMS) due to its lower intensity. DOMS  is why your legs ache the day after your big race or hard training session, it&rsquo;s not the build up of lactate acid that people mistake it to be. DOMS it is the result of microscopic tearing of the muscle fibres caused by repeated muscle contractions. 

Exercising in hypoxia whilst injured focuses rehabilitation training. The athletes know they are maximising their own genetic potential to recover quicker. Each individual recovers at a different rate, this is due to genetics, we can not change this, but what we can do is enhance the individuals ability to get better quicker. Athletes are also able to feel that they have achieved a great workout which boosts morale during the period when they are not able to compete. At Spurs FC all injured players who are due to be out of action for more than three weeks, once cleared by the medical doctor, are rehabilitated in the hypoxic chamber we installed at the beginning of the season. The result this season is that players have returned fit to the match squad quicker than they have before.

There are many other benefits of exercising in hypoxia but for this article I will concentrate on just two, Human Growth Hormone and stem cell migration.

10 minutes hypoxic exposure increased Human Growth Hormone (HGH) by up to 215% (Davydov et al 2001). Growth hormone is vital for injury repair as it stimulates tissue and skeletal growth. Growth hormone also promotes muscle growth and the breakdown of body fat for energy, unfortunately it is greatly reduced after the age of about 20. If you have an injury such as a broken arm, exercising in hypoxia raises Growth hormone levels spread all over the body, so it will in fact help mend the arm injury by exercising the legs!

Stem cells have a beneficial role in inducing tissue regeneration. Stem cells live in the bone marrow which is an hypoxic environment.  Harrison et al 2002 measured bone marrow oxygen saturation and came up with a mean figure of 87.5%. Peripheral blood taken at the same time had a mean oxygen saturation of 99%; quick note here, blood is 99% saturated with oxygen, you can&rsquo;t get any more in by breathing pure oxygen at normal pressure. Most athletes do not see changes in their oxygen saturation when they exercise, elite athletes may see a reduction in their oxygen saturation when they are reaching their VO2 max, but for most it stays static, the only way to influence this figure is to reduce the oxygen concentration of the consumed air, ie by exercising in hypoxia.
Stem cell migration is a very new area of science but it could be hypothesised that peripheral hypoxia could create the right conditions to aid stem cell migration to the injury site by replicating the same hypoxic conditions in the blood as that found in the bone marrow.

In a bone marrow study by Quinlan et al 1998, Hypoxia increased the number of CFU-GMs that form white blood cells to boost the immune system and fight infection by 110%. BFU-E colonies that are involved in the production of red blood cells were also increased by 78%.

For injury rehabilitation we recommend that all exercise sessions are done in hypoxia, once the athlete is returning to match fitness we reduce these to approx two or three sessions per week to enable them to get the benefits of normal sea level training. Hypoxic training is used in combination with sea level training for fit athletes to boost VO2 max by 5% and exercise until exhaustion by 35% (Dufour, et al 2006)

The Altitude Centre offer consultations on all elements of hypoxic training. They also have simulated altitude systems to rent or buy.
For further information contact Richard Pullan on 0870 950 4479 or email richard@altitudecentre.com or visit www.altitudecentre.com
References
Davydov A.L* Starkova N.T., Koroleva A. V., *Ehrenburg I. V., Tkarohouk E.N. Effect of interval hypoxia growth hormone secretion. Moscow State Medical Stomatological University, Moscow, Russia. Hypoxia Medical Journal  1-2/02 2001

Dennis P. Quinlan, Jr, MD; Pranela Rameshwar, PhD; Jing Qian; Paul B. Maloof; Alicia M. Mohr, MD; Carl J. Hauser, MD; David H. Livingston, MD Effect of Hypoxia on the Hematopoietic and Immune Modulator Preprotachykinin-I. Arch Surg. 1998;133:1328-1334.

Harrison J. S., Rameshwar P., Chang V., Bandari P. Oxygen saturation in the bone marrow of healthy volunteers. New Jersey Medical School, The University of Medicine and Dentistry of New Jersey, Newark, NJ. Journal of the American journal of Hematology. Blood, 1 January 2002, Vol. 99, No. 1, pp. 394-394 

Dufour S.P., Ponsot E., Zoll J., Doutreleau Sss., Lonsdorfer-Wolf E., Geny B., Lampert E., Fl&uuml;ck M., Hoppeler H., Billat V., Mettauer B., Richard R., Lonsdorfer J,. Exercise training in normobaric hypoxia in endurance runners. I. Improvement in aerobic performance capacity. D&eacute;partement de Physiologie et des Explorations Fonctionnelles, H&ocirc;pital Civil, and Facult&eacute; de M&eacute;dicine, Institut de Physiologie, Unit&eacute; Propre de Recherche de l&#039;Enseignement Sup&eacute;rieur &Eacute;quipe d&#039;Accueil 3072, Strasbourg, France; Institute of Anatomy, University of Bern, Bern, Switzerland; Laboratoire d&#039;Etudes Physiologiques &agrave; l&#039;Exercice, D&eacute;partement des Sciences du Sport et de l&#039;Exercice, &Eacute;quipe d&#039;Accueil 3872, Universit&eacute; d&#039;Evry Val d&#039;Essonne, Evry, France; and Service de Cardiologie, H&ocirc;pitaux Civils de Colmar, Colmar, France. J Appl Physiol 100: 1238-1248, 2006; doi:10.1152/japplphysiol.00742.2005 8750-7587/06]]></description></item><item><title><![CDATA[Altitude training for injury recovery]]></title><link><![CDATA[http://www.tri247.com/article_1742.html]]></link><description><![CDATA[When people talk about Altitude training the image of Kenyan and Ethiopian athletes dominating distance events springs to mind. Some athletes and coaches know a little about altitude training and its effect on increasing red blood cell count subsequently delivering more oxygen to the working muscles, but pressed further, athletic eyes glaze over. There&amp;rsquo;s a bigger picture out there and Richard Pullan from The Altitude Centre in his first report explains how and why altitude training should be used with injured athletes.
Sustaining an injury is devastating for any athlete, it can be costly too. In football the FA estimate the true cost of injury to Premiership Clubs is in the region of &amp;pound;200 million per season, for a triathlete the cost is more personal, and recurring injuries often end careers.
The Altitude Centre works with a variety of top athletes from Premiership footballers to triathletes, helping with recovery and fitness.&amp;nbsp; When World Junior Triathlon Champion Alistair Brownlee suffered a recent stress fracture he turned to The Altitude Centre for advice, here we explain why.
When an athlete sustains an injured the rehabilitation process, started as soon as possible, involves:

Early diagnosis
Proper treatment
Time for repair
Limit de-training effect
Keep morale high
Preventing re-injury

Altitude training is being used throughout this rehabilitation process. This first report focuses on the initial stages of Alistair&amp;rsquo;s injury and how we can create a firm building block for recovery and limit any drop in his fitness.
Bone repair
At the initial stage of an injury, such as a broken bone or stress fracture in Alistair&amp;rsquo;s case, vascular disruption secondary to the fracture creates a hypoxic environment. Nature is quite clever, at the point where blood supply is cut off, the area becomes hypoxic. Not only do germs not breed, but the body responds to this hypoxia by rebuilding the connective tissue. This hypoxic microenvironment stimulates the expression of a variety of repair proteins, fibroblasts, endothelial cells, and osteoblasts. The tissue inhibitor of metalloproteinase-1, is also decreased in response to the local hypoxia.
Hypoxia can improve bone healing by altering the expression of cytokines, bone-specific extracellular matrix scaffolding molecules (collagens I and III), and their regulators according to Warren et al. 2001.
At the initial stage of a bone injury, hypoxia actually helps build the blocks for future recovery, in my later report we will see the role of hypoxia in increasing oxygen to the cell, which seems a paradox when you are actually breathing less oxygen at the time. Just like training, providing a stress stimulus, in this case reduced oxygen, actually makes you stronger and more efficient with it. Breathing supplementary oxygen under normal pressure does not increase oxygen delivery to the cell and in the long run will inhibit this process as your body starts to rely upon it. Less is more.
Sprains
With inflamed injuries such as an ankle sprain some swelling can be a good thing. Swelling can immobilise a joint to protect it from further damage and increase blood flow.
Too much swelling cuts blood supply to the injury site and traps toxins from broken blood capillaries. Most people put ice on an injury or use ultrasound to reduce swelling. Ice works by constricting the vascular system and stemming the flow of blood.&amp;nbsp; If no swelling is apparent heat is used to help speed up the repair process and mobilise the joints. Sometimes the use of cold and hot compresses are combined to flush through toxins.
Intermittent hypoxic training
A technique called Intermittent Hypoxic Training (IHT) is now being used by Physiotherapists to help injury recovery. Team GB Physiotherapist Ian Andrews has seen fantastic results on Grade 2 ankle injuries; the technique is now endorsed by the Australian Physiotherapy Association.
IHT utilises short bursts of very low oxygen air, followed by equal bursts of room air breathed via an oxygen mask. No exercise is required, which is great if you are not able to bear weight on the injury, such as in Alistair&#039;s condition. The five minute intervals are repeated for 60-90 minutes a day over a three week period. During the hypoxic intervals blood shifts from the arms and legs to the body core in a protective response, increasing blood flow to vital organs. This blood shift is similar to applying ice on an injury which produces the same peripheral vaso-restrictions. During the hypoxic phase the peripheral cells become more receptive to oxygen as they scavenge what&amp;rsquo;s available. When the period of breathing normal air commences vaso-dilation occurs and blood supply is restored. At this point greater oxygen is delivered to these cells whilst they are in their receptive state and for a brief moment more oxygen is delivered than at ambient room conditions. The intermittent nature of this technique acts like a hot cold compress, swelling is visibly reduced.
Maintaining fitness and morale
Whilst Alistair Brownlee is out of action with his stress fracture and forced to put his feet up, he is able to receive the recuperation benefits of IHT as well as maintaining a fitness boost, all via the little oxygen mask he wears watching TV.
IHT is used by many top athletes to improve power and endurance, several studies have shown performance improvements via this passive hypoxic technique. The most recent published study by Hamlin &amp;amp; Hellemans 2007 showed an average performance increase of 2.3% for a 3km run, with some of the tested athletes improving by as much as 6.1%, it is no wonder top athletes are utilising hypoxic training to improve performance. Anything that can help Alistair hold on to his World-beating fitness during this period has to be good for morale - having an injury is never part of the plan. 
As Alistair breathes the five minute intervals of hypoxic air he is probably receiving the hardest cardiovascular workout he has ever had, but he simply does not notice it as most of the adaptations are happening at a cellular and sub cellular level. All Alistair can feel is a slight increase in his breathing rate and an associated rise in heart rate with a general sensation of relaxation and calm bough on by the stimulation of the pleasure hormones Dopamine and Serotonin. Alistair is training at 22,000ft from the comfort of his armchair.
In our next report we will show how hypoxic exercise sessions are helping to bring Alistair back to full fitness without overstressing his stress injury.

The Altitude Centre offer consultations on all elements of hypoxic training. They also have simulated altitude systems to rent or buy. For further information contact Richard Pullan on 0870 950 4479 or email richard@altitudecentre.com or visit www.altitudecentre.com]]></description></item></channel></rss>