Training at height. New insights.

Height training is a well-known training method. In the past, athletes had to rely on internships in the mountains, nowadays it is also possible to train and / or live at simulated heights. There are new, promising developments in this area concerning intensive and short-term training protocols. These developments are listed in this article.

Altitude training and internships are often associated with endurance sports such as running, cycling and skating to improve 1) the performance at altitude and 2) the performance at sea level. However, more and more forms of altitude or hypoxic (low oxygen) training are appearing that (also) focus on team sports and / or sports with a large anaerobic component.


The traditional training internship, where a period is spent at height to both stay and train there, is also called Live High Train High (LHTH). A disadvantage of this form of altitude training is that due to the reduced oxygen content in the air the athlete cannot deliver the same power compared to training at sea level. As a result, the absolute intensity during these forms of training decreases by approximately 7% per 1000m increase. To counteract this decrease in absolute intensity, a new way of altitude training was developed in the early 1990s. Hereby training takes place at a lower height than the height at which the athletes stay the rest of the day. In this way the intensity of the training can be guaranteed, while the body still receives a hypoxic stimulus. This new type of altitude training is called Live High Train Low (LHTL) and the positive effects were confirmed several times in follow-up studies. In practice, LHTH and LHTL are often combined where possible into Live High Train High & Low (LHTHL), whereby only the more intensive training sessions are carried out at a lower height and the quiet training sessions at the height of stay. In a recent altitude training study, the best results on swimmers' performance were found at four weeks of LHTHL compared to three and four weeks of LHTH and four weeks at sea level living and training. Whether LHTHL is also more effective than LHTL is not clear in this study, but it is a lot more practical. Modern variants of LHTL are:

  • staying at simulated heights (normobarable hypoxia) in heights and
  • apartments (and training in normal outdoor air);
  • staying at height and training with extra oxygen, which is administered via a mask;
  • Live Low Train High (LLTH), where you expose yourself for a short time to oxygen-poor air that simulates a high altitude. With this last form of altitude training (LLTH) a distinction can be made between:
  • Intermittent Hypoxic Exposure (IHE): exposure to hypoxia, often by inhaling hypoxic air 6 through a mask, without training / exerting; - Intermittent Hypoxic Training (IHT): the athlete trains for a few hours a day at simulated heights for one to four weeks, for example in a hypoxic room.


IHT comes in many variants, from all-out efforts of less than 30 seconds to two hours of training at 60-70% of the heart rate reserve. The interest in IHT lies in the fact that it is a special way of training and you don't have to go to the mountains for it, which saves both money and time. Below we will first discuss the physiological adjustments for (traditional) altitude training. Subsequently, new literature regarding different LLTH training courses will be discussed. The question of why some athletes respond less to altitude training than others will also be discussed.

Read the full article by Sam Ballak, Susan Bol & Albert Smit here