Written by Hugo van den Broek
As a longtime resident and guesthouse owner in Iten (Kenya), which is situated at an elevation of 2400m, I meet and talk with runners every day. People come from all over the world to train in Iten, since it’s one of the most famous training locations in the world.
I’ve seen many runners do amazingly well after a period of training at high altitude, but I’ve met others that didn’t do so well, after coming from Kenya. Sometimes they would say: ‘I think I’m not a responder’, referring to the idea that some runners tend to respond well to altitude, and others don’t. Although we can argue about the idea that altitude training does not necessarily work for everyone, I actually think that most of them could have done better, if they had a good understanding of altitude training.
So here are my tips for training at high altitude. Some of them come from personal experience, others are based on scientific research. They will help you get the most out of your running (or cycling) camp.
1. If done correctly, altitude training works.
Scientific research shows that altitude training has a positive effect on our performance, if done correctly. The best effects are found at an elevation of 2000 – 2500m. This is the elevation at which almost all Kenyans train. Eldoret is situated at 2000m and Iten at 2400m. Although many runners believe that there is less oxygen in the air (at high altitude), that is not the case. The amount of oxygen is similar to sea level, but the air pressure is lower, making it harder for our lungs to absorb the oxygen. As a result, there is an erythropoietin (EPO) response in our blood, that leads to an increased rate of red blood cell production and haemoglobin mass.
In other words; our body starts to make more red blood cells, and more Hb. This way the ‘oxygen carrying capacity’ of our body improves, and that leads to an improved performance.
Apart from that, science has found that athletes who train at high altitude for just a few weeks, increase the number of capillaries in their muscles (the tiny blood vessels). They also have an increased amount of enzymes in their blood, that help with energy production.
To explain this very simple: when we are at high altitude, our body is in stress because it’s so much harder to absorb the oxygen from the air. And since we need oxygen for everything we do, our body quickly finds ways to deal with this, by making our whole cardiovascular system stronger and more efficient. Note that when I use the word ‘stress’, this has a positive meaning for me. Stress is a stimulus, that makes us stronger. But of course, only if we allow the body time to respond to it, and give it enough rest as well.
Something that is not really documented, but that I find beneficial as well (and that other elite runners have mentioned to me as well) is the mental aspect. At high altitude, not a single session feels easy. Easy runs feel a bit harder than at home and hard workouts feel a LOT harder than at home. It’s as if the RPE of every session is just a bit higher than what you are used to. This toughens you. When coming back to sea level, sessions at race pace just feel more comfortable than before.
To summarize all of this: (training at) altitude is a good form of stress, that makes us stronger.
2. Check your iron levels
In order for your body to have a good ‘EPO response’, it’s important that your iron levels are high enough when coming to high altitude. This is why it’s good to get a blood test done a few weeks before you travel. You especially want to check the level of ferritin, and make sure this is at least 50. If this level is too low, you may not improve at all from altitude training, and think you are a ‘non-responder’, while all you needed was a bit of iron to respond well.
Think of it in this way: the altitude is a form of stress, that can make your body stronger, but only if you give it the tools to adapt! The most important physiological tool is iron.
Some scientists even recommend aiming for a ferritin level of 150, and supplementing with 100 – 200 grams of iron per day if ferritin is below this. This includes taking iron while at the place of altitude.
3. Take it easy in the first days
From my own experience, it’s important to take it easy in the first 3-4 days at altitude. You can run, but you just have to reduce the pace and intensity. On day 4 or 5 you can do a workout, but not a very hard one. You still have to keep it controlled. The reason is that – as mentioned before – simply being at high altitude is a form of stress for the body. Training is also a form of stress. Those two combined can lead to an overdose, that takes a long time to recover from.
We have a guesthouse in Iten (which is where the physio running camp takes place) and have met so many amateur and elite runners there. Some of them did not want to listen to this advice, and started training as if they were at home – from day one. Without exception, they reached a point, either in their second or third week, where they felt totally exhausted and were forced to take several days off. In some cases, athletes screwed up their whole training camp, by starting out too fast in the first days.
4. Monitor your recovery
There are a few ways of monitoring your recovery, and your adjustment to altitude. One way is by measuring your morning heart rate, also known as resting pulse. At low altitude your resting pulse might be 60 per minute (it differs per person). When you come to high altitude, you will probably see it’s 70 or 75 per minute. As long as your resting pulse is still significantly higher than at home, you don’t want to train very hard.
Another way is by checking your HRV, or heart rate variability. This is a pretty accurate measurement of how well recovered you are. When your HRV is low, it means there is less variation in the time between two heart beats, and this is generally not a good thing. You want more variation, so a higher HRV, especially on the days that you do a hard session.
A third way of monitoring yourself at altitude, is to come with an oxygen saturation meter (you can also buy this in Kenya). This device measures the percentage of Hb that is bound to oxygen in your blood – preferably around 95-100% at sea level. At altitude, especially after hard training, you can see lower levels, such as 92% of even lower. When you get those lower percentages, you know you’re giving a stimulus to your body, but you also know that you should wait some time before you do another hard run.
5. Adjust your zones
When we train at altitude, our zone 1 – 5, are probably not the same as at home. The main reason for this, is that our maximum heart rate is suppressed at altitude.
There’s something funny about this. Scientists call is the altitude paradox:
When we run easy at altitude, our heart rate tends to be higher, and also our lactate levels are higher than at home. In fact, on most of our runs at altitude, we will produce more lactate than we normally do. At the same time, when we try to go all-out, our lactate levels don’t reach as high as they do at sea level, and the same counts for our heart rate.
The most likely explanation, is that our body tends to protect itself. Since it’s harder to absorb oxygen from the air, our body ‘chooses’ not to recruit as many muscle fibers when we run or cycle hard. This is a way of reducing the stress on our system and to make sure there’s enough oxygen available for our brain – in other words, our body doesn’t want us to get into the danger zone.
More concrete, this means that if you run your zone 3 (marathon intensity) at a heart rate of 155 – 165 at home, you may have to adjust that to 150 – 160 at high altitude, to have a similar training impact.
6. Don’t worry about the pace
I’ve met quite a number of runners who feels stressed or sad, that they run so much slower at altitude. Don’t be! Altitude is altitude. You can’t compare your pace at an elevation of 2400m (where you often run up and downhill as well) with your pace on a track at sea level.
And every runner is different. There are some who, after one week of training, come relatively close to their sea level speed. Others spend 3-4 weeks at high altitude and still run a lot slower than what they are used to, even on the track. But both of them can have a big effect from the training at altitude.
As far as we know, there is no correlation between how much slower you run at altitude, and how big the altitude effect is.
I used to come to Kenya and do my tempo runs at 3.30 per km (after 1-2 weeks of adaptation), versus 3.10 per km at home. But I would just tell myself: All I know is that I came here in a decent shape, and that I’m training well now. So when I get home, I will be in an even better shape. No matter how much slower my runs are here.
And PS: you also should not worry about some of the things your watch tells you. For example, the moment you arrive at altitude, your watch will tell you that your VO2max has gone down, and that you’re in a very bad shape. Obviously, this is a direct effect of being at altitude and has nothing to do with your actual shape.
7. Adjust your training
There is not much documented about this in scientific literature, but from my own experience and that of many elite runners and coaches, I can tell with certainty that if runners stay at altitude for 3-4 weeks or longer, they should make their training program a bit lighter than what they would do at home, to have the same internal load. Basically this means that you need to include more easy days between harder workouts than you would do at home.
I remember, it must have been back in 2009 or so when I showed my training program to the famous Italian coach Renato Canova. After giving one look at it he told me: “Hugo, this program will put you in top shape in 2 weeks, but in 4 weeks you are in hospital’. This led to a discussion where Renato told me that, according to him, my training program was too heavy. He told me that I could do this at home, but not in Kenya.
And I agreed with him. The altitude means the hard workouts have more impact. Three weeks of training here in Kenya can have the same effect as 6-8 weeks of training at sea level. But when a workout has more impact, it also means it needs more recovery.
While many runners are used to doing a workout every Tuesday and every Thursday (and Kenyans do the same), I feel that this is almost impossible for sea-level runners who come to altitude. It’s only possible if one of those workouts is very light. If you plan to do two hard workouts, it’s best to have at least two easy days in between them, instead of one.
And sometimes you should not be scared to take a day off from training. This is always the case of course, but even more so at high altitude. During my own professional running career, I made a few times the decision to cancel the training that was planned for that day and take a day off. It was always a hard decision to make, but every single time it was the best thing to do, and a few days later I would have a very good workout.
If you come to Kenya for a short period, for example, to attend the physio running camp or the Kenya Camp, you can still get away with doing a few workouts in a row (Thursday, Saturday, Tuesday), as long as you take a few days of recovery or easy running after that. It gets harder when you stay at altitude for a long time.
8. Eat and drink well
During my first training camp in Kenya, I made the mistake of trying to lose weight, by controlling my food intake. I’ll never do that again. I still ran a pretty good race when I got back home, but the rest of the year wasn’t good.
First of all, when at altitude, you need to make sure you drink enough. Many elites drink 4 to 5 liters of water (and tea) per day. The altitude, in combination with the heat, makes you sweat a lot without noticing.
Secondly, our body uses a bit more carbohydrates at altitude. So it’s also important to fuel well. At our physio running camp, we make sure there is enough food for everyone, all of the time.
9. Use the hills and roads
This is more a personal advice, rather than something backed by science. As a runner, I used to love training in the hills and on the dirt roads (trails). I feel like hills and trails challenge you in a different way, and make you a better, and more robust runner. When paths are uneven, we have to correct ourselves while running. This strengthens the structures around the feet, ankles, and knees. When we run up and down the hills, there is a strength component as well. Apart from that, we produce more lactate when going uphill and use that lactate again when on a downhill. Training this lactate shuffle is very useful.
So as a coach, when I meet foreign runners in Iten who tell me that they prefer to run on a flat road so that they can come close to their sea-level paces, I feel disappointed. That is not why you come to Kenya. This partly goes back to point number 6: don’t worry too much about the fact that your runs go slower at altitude. That is just how it is. Use the environment to your advantage. It’s also a way of enjoying your stay. I think it makes for a better experience when you run in different places, go to a forest with hills, run on different dirt roads, and so on. We do the same with our physio running camp. We run in all the places where the Kenyan elites also train. And if you want to run fast, you can go to the track once in a while and do some 400m intervals (we do that with our physio running camp too)
10. Taper well
If you’re having a race immediately after coming back from altitude, you have to make sure you taper well. This means reducing the training load early enough, to get fresh for your race. What you don’t want, is to step in the plane while still being tired. It’s a mistake to think that you will recover on the plane, and in the day after.
Most Kenyans do a lighter long run, one week before their race. And their Tuesday track session has just 50-60% of its normal volume. The rest of the week consists of easy running only.
It’s also important to know when to fly back home. If you’re using your high-altitude training to get ready for a race, there are basically two options:
1. Fly back just before your race, arriving home just 2 days before (this often means that you arrive at home, or at the town where the race is held, on Friday when the race is on Sunday)
2. Fly back 2.5 weeks or more before your race
Science tells us that many athletes experience a dip in their performance between 5-14 days after high altitude. Although we don’t fully understand the reasons behind this, it’s something that many runners have experienced. By the way, I’m not one of them. I personally could perform very well a week after coming from altitude, and some of the athletes that I coach as well. But if you don’t have much experience with training at altitude, it’s best not to take a risk here and leave altitude either a few days before your race, or more than two weeks.
Did you find this blog interesting? Coach Hugo has written more blogs, which you can find HERE. Or sign up for our Physio Running Camp to be coached by coach Hugo, talk with him about your training, and attend his seminars.
You can find more information about the Physio Running Camp Kenya by clicking HERE.
References:
Brooks G.A. The science and translation of lactate shuttle theory.
Cell Metabolism 27, April 3, 2018, pages 757 – 785
Chapman R.F. et al. Defining the ‘dose’ of altitude training: how high to live for optimal sea level performance. Journal of Applied Physiology 116:595-603, 2014. First published 24 October 2013
Constantini K, Wilhite D.P., and Chapman R.F. A clinician guide to altitude training for optimal endurance exercise performance at sea level. High altitude medicine and biology. Volume 00, Number 00, 2017
Mujika I, Sharma A.P., Stellingwerf T. Contemporary periodization of altitude training for elite endurance athletes: a narrative review. Sports Medicine 2019, published online: https://doi.org/10.1007/s40279-019-01165-y
Stellingwerff T. et al. Nutrition and altitude: strategies to enhance adaptation, improve performance and maintain health: a narrative review
Sports Medicine (2019) 49 (Suppl 2): S169–S184
Presentation by Trent Stellingwerff and racewalker Evan Dunfee.