Acclimatization Strategies, Part 1: Foundations and Moderate Altitude

00:00.00

Alyssa

Welcome to the uphill athlete podcast. We are here to educate and inspire all mountain athletes. I’m joined today by Martin Zohr who is one of our resident altitude experts and you’ve heard him before on our first episode of acclimatization and also well I guess altitude acclimatization and. Also, on a few other podcasts talking about altitude. So, Martin, thanks for being here today.

00:43.32

Martin

Thanks Alyssa, I’m glad to be here again talking about altitudes. 1 of my passions. So yeah, let’s talk today about this specific topic about the strategies and we decided to break it down into 2 chapters.

00:59.83

Alyssa

Yeah, so we are going to be diving into specific acclimatization strategies and we are going to focus on what would we say like low altitude to kind of like.

01:18.75

Martin

So, nothing more. Yeah, moderate high altitude then then the next time we want to talk about the extreme altitude so anything about five thousand meters yeah

01:18.96

Alyssa

High or how moderate yeah.

01:26.12

Alyssa

Yeah, I said low and then when I don’t think low is the correct term that we want to use for that, we did talk about these different moderate high and extreme.

01:44.70

Alyssa

In our first episode we’re going to revisit them to help with specific strategies because they are different, and they require different ah skills and strategies for lack of a better word. Ah for these specific areas. So, let’s get into our first piece which is why do we need to acclimatize and how do we choose a correct strategy for what we’re trying to do.

02:14.71

Martin

All right? So, these questions I try to answer through studying or doing my research with my school of course but the ah people I guess approach us also in up athletes to relay. Ah understand do they at all need to acclimatize and they have their objective. So, ah I think it’s important first to start with the category. So low altitude or coming from sea level ah to low altitude then moderate altitude last time in one of those podcasts we did. So, we set those levels ah to let’s say low altitude I would say anything below eighteen hundred meters so thousand eight hundred meters ah which is basically just a low altitude that doesn’t really create any significant effect in the body and so. For the majority of people. You don’t really need to worry about it. You don’t need to worry about ah getting sick. You don’t need to worry about your performance changing or being affected to a large extent so that’s low altitude. So, then the next category is moderate altitude., and maybe high-altitude slash because we can maybe talk about this category today altogether so anything about this level of 8008HundredMeters ah somewhere to five thousand meters so ah whatever is it in feet. You can maybe translate it to feet for 4 hours

03:47.58

Martin

Ah, audience.

03:49.73

Alyssa

Yeah, that would be 3000 would be around ah like Eleven thousand feet and then five Thousand meters would be about like 17 to 18 does that sound about right? Yeah, okay.

04:03.54

Martin

I yeah think sixteen seventeen I think ah because I know it’s like thirty something I multiplied 30

04:07.54

Alyssa

I always use 3 as the base point. But then I know it’s more than three feet per meter. So, it’s like 3 point three Ish. So, I always add in a little bit extra for that.

04:24.60

Martin

So just to specify why do we use these ah benchmarks or these thresholds. Maybe even so as I was mentioning the Eight Thousand Eight hundred meters

04:40.60

Martin

Ah, it is really not significant enough to cause an effect, so we don’t need to really worry about it and then maybe the next level the five Thousand meters more or less. Let’s say and is really a level where most people can acclimatize to because it’s ah quite a significant level then of course. Ah. Ah, by the way on the big mountains. This is a level where you find your base camps. So, for example, Everest base camp is 5300 years, so you already need to consider this altitude., and ah prepare for it to acclimatize. So, the process of acclimatization is. What we will talk about ah we already covered it a bit in the last in the last podcast but what is important to know that most people can get there with the process with time and then ah, ah then what? why then? Why do we need to acclimatize so we need to answer those questions. So, first of all, you with altitude with increasing levels of altitude. Ah, it’s really challenging to the body to the physiology to how our bodies function and so if we go too fast too high to altitude. We can develop.

05:55.98

Martin

Illnesses. So, the first. Ah first ah you can feel some symptoms like headache nausea dizziness and others a loss of appetite. But then if you really are not really respecting that increasing increase increasing level. Ah progressively. And you go too fast. You can actually get sick and seriously sick. So, the first sickness is called acute mountain sickness, and then if you actually are not respecting or you just kind of in trouble or for different reasons. Ah you can develop the more severe versions of this, and they are. High altitude cerebral edema or pulmonary edema those are very serious of course actually can lead to death. So, this is actually the primary way to answer your question. Why do we need to acclimatize? So as mountaineers or trail runners’ climbers. Ah, we try to acclimatize to actually avoid getting sick. So of course, to stay healthy and avoid this, then the second important factor is that the higher we go in altitude our performance ah suffers. It definitely affects. Ah. The way our body functions the physiology and specifically to the performance. So, by acclimatizing, we are actually trying to at least maintain to some extent our performance ah or to some level even increase it.

07:18.42

Alyssa

Are.

07:24.13

Martin

Then it of course depends which category we are talking about if it’s the moderate high or extreme altitude. But let’s this time talk about the lower levels. But when you think about the high mountains, you really want to actually get there, get to the top because it’s it. The altitude has that effect it actually really slows you down. Ah your body is under such a huge stress that it’s really becoming very challenging to just walk or just to climb ah step by step and higher you go. Everything’s just slowing down so that’s the second baker.

08:01.34

Martin

Big objective or purpose of acclimatization. But then, the adaptations that happen through the acclimatization process. Actually, what we noticed, or athletes have noticed, is that it can be actually. Helpful when you get when come back down to sea level or low altitude. Some of those adaptations are actually ah, optimizing performance or actually enhancing performance to some level so we can talk about those and ah other purpose. Maybe just to mention. It is rehabilitation. Ah there are nowadays ways to go to hypoxic chambers or hypoxic gyms where you can actually do your training with some level of altitude which is simulated through some generators and. By doing that you’re actually basically either. You can do your training at a lower intensity but because you’re breathing hypoxic air. Your kind of ah equalizing that so you’re actually increasing the effect of that training by doing it at altitude. Or you can just do our shorter training course instead of doing 60 minutes you can do maybe thirty forty minutes for example. Ah, which means that in a rehab process. This is important right? You try to return to your activity. You try to get stronger and so, this can definitely be a part of your rehab process.

09:31.46

Martin

So, it’s already been used. There are commercial gyms that have this kind of equipment. But.

09:40.50

Alyssa

, oh, that’s ah, super helpful and I think yeah, we throw around the term acclimatized so often we understand it’s really important, but it’s really helpful to hear the exact specifics of why it needs to happen., so then.

09:56.50

Alyssa

Now that we’ve established why I think this is where you come in in such a helpful manner for so many athletes it is like we have athletes that come in and they’re like okay I know I have to acclimatize. But I don’t know how to choose what that strategy should be so how do you help an athlete walk Through. Choosing the correct strategy for their objective.

10:19.77

Martin

Excellent. So that’s a great question and so well then, the way I start is actually asking more questions and that really is so the intake process with the new client. So ah, whether it’s. The acclimatization strategy or if it’s at the actual training, right? So, you need to really find try to find out a lot about your client about the athlete so where you where you are right now. So, try to, try to find out about the fitness levels etc. and then. Okay, what is your objective? The race is it mountain is it some kind of challenge endurance challenge. That’s usually the case with our clients in our polite lead and ah, how long do you have to actually prepare right? So, then we have some kind of information we have a point a and point b how do we get there. And then if it’s the objective include some kind of altitude then right then I get into the research and see what’s involved so what are the factors that we can actually do something about with the training and if the altitude is the is the part of it right? So then of course with. What is the level is it the 5000 all the way to Everest the Everest Stuver right? So, then it gives me some kind of ideas, and do we have enough time to prepare for this objective and ah, where does the client where does the at least live.

11:47.21

Martin

So close to the mountains far from the mountain’s sea level even below sea level. You know New Orleans places like that they are actually good below sea level., and so it’s challenging of course, but it’s possible and there are people over there that actually are preparing for big mountains and so there are ways.

11:52.78

Alyssa

This is.

12:06.00

Martin

For them to be prepared and so we can discuss these, but this is really what the way I work I’m trying to really get into the ah to get as much information as possible and then ah set the strategy. Do we have enough time? What needs to be done already to prepare. The athlete with the fitness to be fit enough to then ah get to the mountain and be strong enough and have enough in runs etc. But also, where does the acclimatization fit in and of course then the different levels of altitude ah require different. Different strategies, different time to acclimatize and then okay when I have that information. How do I get there? What will the time of the expedition be? For example, if it’s a mountain climb. But then there are situations like ah Mountain Races trail races, right? so.

13:02.20

Martin

Ah, some of them happen at altitude significant altitude. Let’s say thousand three thousand meters some of them higher races that are sometimes, now we’re talking today. So, this week. There is a big race happening in the alps. It’s a very famous race and so the athletes go from Zermatt which is thousand six hundred meters over the past three thousand six hundred years so and then go more or less about two thousand five hundred meters all the way but still. This is a high altitude so it will definitely affect the performance affect the fatigue recovery and there’s ah, quite ah, quite a tough cut time cut. So that’s what the athletes are mostly concerned about, whether they make it through the hard point and to the end within that. Then within the timeframe. So of course, some of them live in the mountains for them. It will be easier to acclimatize and prepare specifically for the altitude. Ah, but some of them actually maybe most of them. They don’t have that luxury so then of course. It comes to creating a strategy for what to do about it, and then it comes with really how much time do you have, what resources do you have and the possibilities to travel and but nowadays and we will talk about this later. Ah.

14:32.55

Martin

There are actually ways to acclimatize or pre-acclimatize also at home.

14:36.58

Alyssa

Oh, that’s fantastic and I think that’s probably the best coach answer to say is the way that I start coming up with strategies to ask even more questions because I think that is a lot of our job is. Asking more questions to get more information to also help realize truly what’s realistic because you know I will get into this more There’s obviously very ideal ways that you can acclimatize and then there’s I can’t get to the mountains, or I live at sea level or. These are my limitations whether that’s monetary time family commitments et cetera and so part of the individualization is the fact that we are working for you like working with you not just. Saying hey you have to go move to Colorado for the next four months so yeah

15:32.48

Martin

, yeah, definitely Ah so sometimes it’s actually the case some clients at least they actually if they have these options consider that they go and I’m super happy as a coach of course but usually it’s a goods. Great point. You’re saying here and to why I look at.

15:38.47

Alyssa

, yeah, which is amazing. Yeah.

15:51.70

Martin

These things are actually the usual cost but cost and benefit perspective, right? So, we definitely want these benefits but how much will it cost you so the cost obviously financial cost the time spent away from your job, from the family and logistics and actually.

15:59.44

Alyssa

Yeah.

16:09.96

Martin

To some point where you can maybe it will actually reduce your capacity to train. So, then you actually have to consider how much it is actually important and maybe it’s just important to be at home. Be comfortable, have a capacity to train ah prepare as best as you get fitness, physical fitness will always be. If. Not the biggest factor within mountain sports that we that we deal with an athlete, right? So, mountaineering or trail running or Utra endurance Events. So ah, physical fitness is always your biggest asset but the. Yeah, we talk really about yeah acclimatization and try and to see how much of a vector that is and what we can do about it. But I think to look at it with ah with that perspective of course cost benefit can help you out and maybe. Sometimes you should even bring that anxiety down. Just try to calm down. Okay I can do this, or I don’t so I will just focus on getting fit be healthy and get to the start line as healthy as and fit as possible sometimes is the case that.

17:15.34

Alyssa

Yeah, yeah, yeah, I think that that anxiety is such a great point because I do think like I say this all the time to my clients just in normal training where I say I don’t want to.

17:22.41

Martin

So.

17:30.42

Alyssa

To be getting up at four zero am every day in order to get your training in because that’s a sustainable way for you to live and if yes, obviously there’s times that we make compromises that we stretch ourselves within our training. We’re doing uncomfortable things, but it also has to be. Somewhat realistic and not push you to the point where you’re sick or injured. You know, not actually being productive with those changes because you’ve extended yourself too far. So, I think that’s why it’s so important to work with Martin to work with you know, a coach who has. This knowledge and is able to make a plan that you don’t have like yes you have to make adjustments. But you’re not shoving your life into a one size fits all.

18:19.13

Martin

And I think so I mean, it’s a great point and something I would like to talk about is really what the cost of acclimatization is actually real. Ah, the physiological stress coming from the process of acclimatization.

18:30.83

Alyssa

Are.

18:33.29

Martin

It is real and it definitely is. You need to you need to be aware of it and consider it So again, the strategies come from do I need to acclimatize for my project if I do then? Okay I need to know how long I need for this acclimatization and then the next point I need to really make sure that the ld. That leads understand is that it costs you physiologically It’s ah it’s a tough process for the body and so, then it really is I need to acclimatize I need to go through this process, but I need to also know that my recovery will go Down. I will go through a lot of process Stress. So, my training will suffer to some extent I will have to really adjust my training vole training Well ever whether it’s intensity vole or both doesn’t matter. But I really need to be aware that I’m actually overreaching but I really need to know that. I Do this for a good Reason. So, I think actually in this chapter or in this podcast now we will talk about the lower levels of Altitude. The moderate and high altitude. There are definitely coaches out there that actually tend to not, suggest or recommend The. Acclimatize If. You really don’t have that option because it’s just costly. It’s logistically difficult and the time you need to actually spend at that altitude is quite significant to really get those important adaptations. So sometimes it’s actually just better to skip it and not acclimatize.

20:04.18

Alyssa

Are.

20:04.32

Martin

Don’t climb acclimatize at all just that that just actually arrive in the day or two before the race and just show up and basically go and hope for the best knowing that there will be some limitations knowing that you will go through some tough times if you pass through different like. Ah, portions of the race or whatever it is in your objective. But I guess that it’s really important to know ah to ask us coaches or specialists ah for altitude to really consider those options and give you a clear idea. Okay, you’re going for this objective. So, we can. We can make this plan. with the possibilities you have. But I guess it’s very important to also know that the higher you go about three thousand four thousand meters, especially the risk of actually running into the trouble of getting sick. Ah, really suffering because the altitudes are getting higher and higher. Another important point is it’s very individual so some people will suffer. Some people will suffer less or suffer not at all actually at some level so ah, very hard to predict. Ah we still don’t have or but have very limited ways to assess this at this point today. But hopefully in the future in the near future. We can change this. We can actually do some testing and give you a good idea about your rate of acclimatization or the way your body can deal ah with altitude I think it will be super helpful and people can really appreciate it because then you can really consider. Okay.

21:38.98

Martin

Is actually like ah actually the altitude of factor for me or I don’t need to care right? Now. It’s quite difficult I think then it’s really coming also to trial and error so getting more experience you will be able to say okay I don’t need to acclimatize for UTMB I’ll be fine at two thousand seven hundred meters in the in the mountain buses. So. I can just do my training back at home for other people is like I really suffered last time so actually will come to Chamonix 1 or 2 wo weeks before and spend some time up there at altitude and so that the altitude doesn’t become a limiting factor for my performance.

22:14.50

Alyssa

Yeah, and I think that’s so key I know this has been talked about many times of the importance of training and the importance of putting yourself in positions where you can gain that knowledge because if you don’t then it might be at the moment of. For trail running the moment of performance where you need to be at your best or it could be in the instance of mountaineering or alpinism where it’s a safety issue and so the more that you can expose yourself in situations that. Have some safety nets rather than the moment where you must perform, I think the better off you are, but Martin or go ahead.

23:01.97

Martin

Is now I think it’s yeah, I agree there is definitely I mean we now talk also about those distinct categories. So, met maybe? That’s what is important to mention the moderate altitude. Let’s call it like. Thousand eight hundred meters all the way to maybe 3500 and where probably it’s not the exact my number the actual numbers we can mention that actually later we just spoke about it between the 2 of us it really depends where you are on earth because the altitude is actually. , or the way our body functions is actually a function of barometric pressure. So, the higher you go at altitude. Ah, the barometric pressure goes down and it actually is affecting our body the way we can get enough oxygen into our body so that’s actually a function of the pressure. Not. Actually, the altitude., and so what is important to know as well is that the pressure atmospheric pressure is affected or works so as a function of temperature of air. So, the colder it is the lower the pressure even lower I mean so. On the equator on earth, it’s warmer so ah the altitude will actually feel slightly less demanding or challenging than when you go to the south or to the north. So, Denali is a mountain very far north or wins in Antarctician is obviously very so far. South. So.

24:35.68

Martin

Even those mountains are well they are quite high but let’s say Denali is about six thousand two hundred meters it actually feels or the alpinists that have climbed up there. They know that it actually feels much harder than that. So, this is the reason why. Ah, but now I lost this. But.

24:55.89

Alyssa

No, ah just to know just to build off of that we actually had that discussion in ah the podcast before this one with ah Bill Allen where he’s done a lot of guiding on Denali as has Steve. Where they were talking about how the altitude is more challenging in Denali and so you gave them, they had ideas I think very similarly to what you said, but it’s nice to hear the actual, concrete facts behind that. So, thank you for yeah, adding on too. A piece from a previous podcast. You didn’t even know about we’ve cleared that up.

25:30.12

Martin

It’s actually quite fascinating and I you know it’s the research that that actually glorified that for me too and there are actually some nice fun facts about it. But I think I actually mentioned this before in the podcast. But. 1 fact is that if Everest, which is at thirty-degree latitude, was further to the north. Let’s say in Europe where I live in Chamonix which is about fifty-degree latitude. So ah, we would not be able to climb Everest without oxygen, the parametric pressure would be so low that it would just be impossible just even just sit there. Ah so let alone be active. So ah, quite fascinating., but, yeah, it’s ah. And so, but 1 was at the topic we talked about before this this will need to be cut out but okay, right? So, the barometric pressure again is the ah the important factor actually that is changing with the increasing altitude. But I would like to actually talk about it.

26:22.00

Alyssa

Are.

26:41.12

Martin

Ah, the lower mountains. Ah so many mountains like rainier Kilimanjaro or Mont Blanc here in Chamonix so those mountains are let’s say kind of on the borderline ah to high altitude or the top of that high altitude category. Let’s say so I would say there is in this mountain on these mountains. There’s. There is already some risk of getting those the altitude sickness if you really push it too fast or you’re just kind of individually susceptible to getting sick. , so but the way these mountains are usually climbed is actually quite interesting for me as ah, you know, just a. Being a climber list and living in Chamonix but also a recent researcher because also the acclimatization process takes certain time the adaptations that happen from the first minutes in hypoxia to then we days and weeks and months obviously some of them really take a long time. So let’s say within the low moderate and high altitude category of mountains some of them you actually climb within maybe 3 4 or five days sometimes people come here to Chamonix and they climb Mont Blanc within three days and they are not acclimatized at all and some of them are actually getting sick already about they hit the gutter hat and the slightly a above like let’s say four thousand to hundred met and actually they have to be helicoptered and rescued and they have to go down well logically because they just can’t spend enough time to acclimatize. But what is interesting is that they.

28:05.29

Alyssa

Are.

28:15.54

Martin

What they call acclimatization or the companies that offer these climbs is maybe four or five days so now that I can talk more about the adaptations. How and how long they take what I tell my clients often is that. You will be leaving the mountain you will be going back home and you’re actually still not the climatized even, so the process is still kind of somewhere in the middle. But what happened was that you adapted enough to actually get up there that you were actually able to get there without getting seriously sick.

28:48.58

Martin

And you are able to maintain to some extent to some extent the Aerobic performance but let’s say we want to talk maybe ah more ah about the moderate altitudes the lower portions where , you’re already getting some effects of altitude on your body. , and you dread definitely want to know about the strategy How long you want to spend there and then you really want to go down to sea level and you want to perform you want to have the high grade or low being and all these factors that ah that athletes are after.

29:25.30

Alyssa

Yeah, so I think that that goes back to what is what is the goal coming out of your acclimatization strategies. Ah that you’re targeting. Ah Martin, do you want to touch on. Just briefly because we have talked about adaptations before, but do you want to review just a few pieces of what these adaptations are in the body and then we can dive into the specificity within moderate altitude.

29:57.48

Martin

Yes, definitely I think it’s worth talking about this again, but ah, very briefly. So, whenever we get to hypoxia so the reduced amount of oxygen in the air that we breathe so our body we breathe the air and. So, our body has a way to sense it real fast within minutes our brain actually finds out that there’s a certain lack of oxygen ah in in the air. So ah, the adaptations that happen are really fast within minutes. So, the first the first are hyperventilation and increased heart rate. So, both are actually ah functionally a way to provide just more air and so more oxygen into the body into our tissues because we really need oxygen continuously our brain needs oxygen our muscles need oxygen to be to be active or to just kind of be or even resting right? Ah, this adaptation is ah is acute it really happens within minutes and hour minutes and hours, so our heart rate goes up and our breathing gets deeper. But also, you’re going to breathe at a higher rate, but then at the same time there is a huge cascade of changes and adaptations that are very complex. There are molecules in our bloodstream in our body that get ah that get produced or, that just kind of appear in the large quantities they are called hypoxia and usable factors. It was very important that it was discovered actually several years ago only and this actually these molecules just kind of spread around the body.

31:31.32

Martin

And they are like signal signals to different parts or functions or organs in our bodies that actually do something so basically the acclimatization is really about that sometimes we only focus on the hemoglobin which is actually enhancing or. Improving our oxygen carrying capacities as athletes so we are familiar with that right? So, but actually but it’s a very complex response which is affecting really like different parts. But what is happening and what I like to actually talk about is ah how long these things take. So, if we stay at altitude if we keep acclimatizing., so first really the first minute’s hours and let’s say a couple of days the heart rate goes up and the heart of heart ventilation. Also, what is happening is race, so we actually are losing the liquid part of the blood. So, the fluids. So, the body is trying kind of artificially to increase the density of the blood by reducing the liquid part basically so it gets denser, but it can come at the cost because then the heart sort of needs to work harder to push that blood around but well.

32:43.28

Alyssa

Are.

32:48.26

Martin

The body works that way, but I would say you can already sense it or maybe you can already imagine a higher heart rate. Ah you’re breathing more so it’s sort of resembling a stress reaction when you’re stressed your actually your heart rate goes up your chest is burning., you’re breathing more and mean but maybe without realizing but it actually is a stress. That’s the important part that is really important about acclimatization. It is quite ah, quite a stressful process. Especially that first let’s say week.

33:22.96

Martin

Two weeks and of course if you stay at altitude then actually go up altitude., then to let’s say higher mountains I’m not saying that it’s less stressful but actually what is happening in the first days these first adaptations start to go down so the heart rate to some extent, not exactly to the sea to this. Sea level like level. But ah it comes down. It comes down to hyperventilation as well because the other adaptations then take place and help you to utilize it better. So, you don’t need those first the acute ones and that’s a good thing because you really don’t want to be. Having a heart rate of 20 when you’re when you’re going up at altitude or you’re in your training camp. But it does five hundred meters or training for your train rates or something, so you definitely don’t want those, but they are super important in that first part. So, what is actually happening then? Mainly the big part of the acclimatization is of course actually trying to increase the hematoma, right? So, increase the number of red blood cells that are actually improving or increasing. your capacity to carry oxygen around your body. Ah so. That 1 is actually taking from days to weeks and actually keeps going up. Ah I think it’s about 1 % on average 1 % increase in hundred hours every hundred hours it’s increasing but it also depends on many factors already individual. Some people have a larger capacity to preapprove.

34:46.84

Alyssa

Are.

34:56.60

Martin

To increase their ah hemoglobin count. Ah, but , if you’re actually staying at altitude for many months that this process is still increasing and I think it’s it kind of stops around eight months that’s what been observed but that’s usually not the case for most of us we don’t stay so long. , if you actually are then staying for a couple of weeks or even months at altitudes sometimes that happens in expeditions or other cases. Ah, your body is also trying to help this process of getting that oxygen which is which is in the less little quantities around you. So actually, you’re creating more capillaries, so capillaries are really the smallest blood vessels that are kind of Circ navigating or whatever you call it? that are around your tissues and circulating our tissues and specifically when it comes to activity and training our muscles.

35:47.40

Alyssa

Cir circulating.

35:54.26

Martin

So actually, you are improving up your capacity to bring to bring nutrients but Oxygen mainly to the muscles quickly and more efficiently and so it’s actually one of the byproducts or one of the factors that gets improved by the acclimatization process.

36:06.42

Alyssa

And then remember.

36:11.86

Martin

But you see what is important to know is that from the first adaptations those take minutes and hour minute minutes and hour minute minutes then to the adaptations that really need some time you need really to spend some time at altitude to create those and once they appear the others kind of disappear or don’t need to stay there. And so, it’s like huge complex process what I’m what I’m trying to stress this the timeline is that it’s really important for me to and to know when I’m trying to create a strategy for an athlete right? So, let’s talk about examples. Let’s say. UTMB race, right? So, it’s a race where you start at thousand meters in Chamonix then you have to climb some mountain buses which are but somewhere like two thousand meters two thousand seven hundred, I think is the highest point if you do that big loop. Ah, but actually the time spent on it. Regular athlete. It’s actually probably one short portion of the rates that you will actually spend above. Let’s say that thousand eight hundred meters that that treasure we talked about before, right? So, then it’s really about determining if that actually is such a big factor that I need to stress that about this. So. What is actually happening often that people are oh I need to acclimatize they come four or five days before the race and they just so let they take the lift they go up to three thousand even four thousand meters here with the a killed them at the lift and they just go crazy and they run it through two thousand meters and what are they actually doing.

37:43.30

Martin

Just talked I just talked about those adaptations. They are actually creating a lot of stress in the body. So. That’s the first 4 or 5 of the six days. They are actually the not saying most stressful but very stressful in this process in this long process of acclimatization so are they actually doing something that will benefit them to some extent? Yes, but actually maybe they are just doing too much. It’s just too much additional stress. They probably should be better, much better off just resting. Maybe just to arrive a day or two before the race. And just to be ready and just hope for that. You know the portions of the race there where they will run above two thousand meters will actually be okay, maybe they will lose 30 minutes total of time or maybe one hour but maybe it’s actually better than just. Going through this like four or five days going crazy running at 2 3000 e thousand and actually going through this very f stressful process of the first days of an acclimatization so it’s actually a huge deal and it’s been studied. It’s been definitely studied in research and ah so actually the recommendations for this specific case of ah of races like utmb. If you really arriving enough time before so you actually have time to acclimatize? But this again actually within the timeline of those adaptations that is probably minim one a week six seven days or you actually arrive the day before and you are just.

39:12.92

Martin

Have a relaxed day, deal with jetlag, have a good sleep and then go for the race. But then there are maybe races that are I think it’s hard work or western state I’m not an expert here, but it’s actually

39:30.40

Martin

Big part of the race.

39:30.80

Alyssa

Yeah, so Leadville and hard rock. You are above., ah you’re at least above like twenty-seven hundred meters I think the entire time topping out. Well above 30

39:48.48

Alyssa

2 3 three hundred meters so it’s the entire race. You’re above yeah, pretty so you’re definitely in that moderate altitude zone. Yeah.

39:58.85

Martin

Yeah, yeah, so you see having said all of this I would say that if I have someone approaching me and that wants to do this right? I would definitely try to talk about the strategy How to acclimatize right? So. Another thing is also you want to acclimatize basically to be at altitude. But then Also here we talk about performing at Altitude. So that’s another level. It’s also very important adaptations that happen in your muscles in our cells. Ah energetically algorithm I mean. Ah, that are affected by hypo Hypoxia, and you definitely want to give some time for the body to adapt to working out exercising at Hypoxia or being a high-performance athlete, you know you definitely want to go after these like ah. Marginal gains, right? So, I think Altitude is one of them. So again, trial error you already should know how your body is reacting. But yes, in this case, you see there is a bit of a difference with Between unity Nb and these races most of the race you will actually be at that altitude and so. It’s a factor that you should consider addressing. Yeah.

41:08.50

Alyssa

Yeah, I think that’s very interesting because I would say a lot of people tend to think of utmb as a quote unquote altitude race and I always say not particularly because you’re spending such as a small portion of your time really at that. Critical altitude zone as you were talking about versus yeah, the ones in Colorado where you are the whole time up there. So, I think that’s an excellent point.

41:37.89

Martin

Yeah, yeah, I think it’s like we discussed before. So. It’s a perfect example of ah, there’s always a tradeoff for everything. So of course, I pre refer you if you become and acclimatize but that will also cost you. It will cost you money, it will cost you time. And so that’s time is actually something I really wanted to stress about how long it actually takes how long do you need at least for this basic acclimatization. Then if we talk about the you know races that are skimo races or climbing Mont Blac I think that’s also very different. But. But’s say if it’s utmb run. Of course it’s such a long event we try. There are the factors that you need to cover are like primary is the fitness, right? you really need to be ready you’re training all those months before needs to be needs to be top and the nutrition and sleep and. Strategy for basing etc. But let’s say if the altitude is like for sure a factor in Performance. So, it’s good to have that conversation and just based on your possibilities for traveling either. Is it possible or not so then knowing just to have that answer if the client asks.

42:53.52

Martin

If you have this information, you can already be at work a bit better. Another thing actually what I would like to so mention here is that stress that you go through in that first at least that first part of acclimatization is that you definitely need to.

42:58.96

Alyssa

Definitely yeah.

43:12.99

Martin

Address your taper, right? So taper is maybe something we already covered in the previous podcast. So, it’s the period before your objective or your race where you basically try to reduce the vole so to bring this sort of let’s say super compensation in your performance, so you really try to reduce the fatigue and you’re trying to improve your form. So, the factories you can sort of monitor in training Peaks Ah, the platform the software use ah for coaching for training. But yeah, physiologically it’s the real thing. It’s been proven that it’s important why I mention it or talk about it here with altitude is that. You see that the altitude the adaptations happen within certain time quite fast. But then if you go away from the altitude back to sea level or low Altitude. You start to lose them. The body will not keep what it doesn’t need.

44:08.68

Martin

And in the case of altitude adaptations that happens too., and so you need to consider that too. So, if you have a client that asks. Okay I’ll be in altitude month before is that? Okay so I say. But it will do something but probably most of those adaptations will actually disappear then homological adaptations probably will be gone usually the estimate is weak but probably two weeks after two weeks you probably lose most of them or are you starting very quickly to lose most of it. So, two weeks is a sort of a borderline. So. That’s also something very important to consider and coming back to the Taper. So, if you choose to acclimatize just before the race you need to also be aware of that stress. So, either. You have to make the tape longer. So that you make sure that you actually have enough fitness to so you can actually ah force to cut the training vole even before two weeks like two weeks earlier or ah like longer than that I mean, or you know there are different scenarios, but it’s quite challenged to make all these things happen. And again, it comes to like great the two to the good analysis of the objective. How important is it to acclimatize for your race or your mountain for your climb?

45:30.95

Alyssa

Yeah, no, there’s just so many factors that are do you have to take into account and it’s not just oh yeah, let’s show up a few days beforehand because it doesn’t work very well that way.

45:49.93

Alyssa

And think yeah, yeah, so let’s get into specificity of what are you trading for is how you want to do we want to touch on that next Martin with the live high train high strategies. Yeah.

46:02.25

Martin

Yeah, again, it’s kind of what we’ve already talked about anyway. I’m trying to really ah stress the importance of ah okay, what is what is altitude What is acclimatization How long does it take How is it important for your objective. So here in this chapter. Or in this podcast today. We talk about that moderate high altitude.

00:03.57

Martin

Right? So, within the ah this chapter today about moderate and high altitude so something between two thousand meters let’s say ah to put it simply to five thousand meters ah so there are actually different strategies. Those are those that are actually called funny names. Let’s say that it’s basically live high train high live high train low live load train high and ah actually one more which ah which I would like to actually cover here because it’s important. So, let’s start with that moderate altitude. So. Ah, the way it all started maybe with the altitude training because people actually started to go to altitude and do some trading camp there. It started with Olympic games in Mexico in 1968 why because Mexico City is ah in ah, quite a considerably high. It’s about two Thousand five hundred meters if I’m not mistaken. So anyway, most of the events, specifically the endurance events, were held at that altitude which definitely affects and definitely for these Olympic athletes at the top form at the highest level. Of course, you really want to get the most to be there the most effect, right? And be the most competitive. So actually, then athletes chose either to live there to so to be there a month before or they were trying to actually bring some strategies and there was not much research done.

01:33.82

Martin

On this topic before that and so it was a lot of trial and error or some somewhere some went right? Some went wrong, but definitely since then people started to realize that something’s going on. So of course, you were trying to acclimatize for that performance at ah that moderate altitude, right? So specific altitude. But then what they also noticed was that that the adaptations after spending some time at altitude training and let’s say acclimatizing but actually performing at altitude they went back down to sea level and their performance for wait in enhanced at least for several weeks the hemoglobin was increased which actually directly affects your vo2max. So maximum aerobic capacity Vo2 Max definitely improves. So. That’s why also unfortunately that ones that into doping so erythropoietin when it’s actually, injected artificially or how do how you call it. It’s actually a hormone that is produced in the body naturally and specifically at altitude, right? That’s the that’s actually the one of those first responses ah that then offsets the production of red blood cells, but that production actually takes quite longer so we need to wait for it for a week or 2 until it starts to really make ah make an effect on our body. But so, the athletes can actually of course use it then in their sea level performance. So, then we really talk about the strategies like live high train high so you really are at altitude camp, or you will live in the mountains so you or you just go.

03:09.68

Martin

To acclimatize ah for your mountain in in the country. So, let’s say like Everest basecamp. Ah, it’s a track you you’re trekking from two thousand meters so Lula all the way to ah to Everest Basecamp which is at five thousand three hundred meters so sort of that borderline we talk about today and you actually are taking your time. You’re actually going gradually slowly to the to that altitude and it probably will take you ten days at least if not two weeks to actually get safely to that out in you so you just spend the time live high trainer. What is actually another ah then and next, way next strategy is to live high train low. So, these are different scenarios so athletes that that are really high performance. They are going to. Places like I don’t know Albuquerque New Mexico flagstaff Arizona here in Europe we have San Moritz place where you can stay easily in a hotel at two-thousand-meter altitude and do a really good quality training. But what is the problem? Also, if as you already know your aerobic performance suffers. So, your quality the quality of your training will decline more or less and of course for these high-performance athletes when they are really at the at the cutting edge of performance and they are really.

04:39.48

Martin

Really try to be competitive. This can be quite an issue. So, what they actually started to do was their sleep and they spent the day up there in the training camp in altitude and then they drive down to I don’t know five hundred thousand meters down lower down and they do their training workout actually and lower altitude. We’re in the full amount of oxygen making sure that they are really fast, and they really can get that quality into training then they go back up and keep acclimatizing do that for 2 3 weeks and then they go to compete. So, it’s ah it’s a one way to do if. Exit. strategy is low limbo train high. So, I would say the case where I look in Chamonix which is thousand was a meter, I don’t think its ah considered even high altitude or moderate altitude doesn’t really have so much effect I would say but you actually have a really easy way to taking the lefts who basically go. Ah. To almost four thousand meters taking the gilded middle lift here which is famous and you are at almost 4000 meters 20 minutes 30 minutes maximum and you can climb ski a train run if you choose to climb on block climb different routes and just be out there actively right? and then you take the lift down and come back home for lunch. So that’s a great way to train of course at altitude. But you actually live low. So, it’s one way one way to do it or you really have clients that or we have athletes that live in in the cities and, but they really have a.

06:12.92

Martin

Mountains within driving distance. So, if they had that option, I definitely encourage them to do that if they can go spend time at altitude and do some specific training. Of course it’s a great way., is that enough how you know how much do they need? That’s of course those. I already talked about it today. How much time you actually need to bring enough adaptations. So many questions first you know what the objective is again. What is your objective? So based on that I will be able to tell you yes, it’s enough if you go to the mountains once per week. Or not you have to just try to spend more time in hypoxia or in altitude., maybe 1 one last category is live high trade low and high. So. It’s kind of a combination. Ah so, basically that’s were. You want both? you actually are maybe trying to acclimatize for a climb for a mountain or even for some race so ski mountain and race fkt attempt on a mountain and so you have a way to be actually at altitude. Ah, and.

07:28.19

Martin

But also, you just basically do some training at sea level or lower. Ah lower a case with normal baring Hypoxia. So, it’s maybe a chapter. We can quickly cover here, basically. For people at least that have no access to the mountains nowadays. We also have ways to ah for them to acclimatize at home. So, there are companies that are offering generators. Ah that actually simulates altitude. So maybe Illa That’s a. Next chapter we can talk about.

08:04.47

Alyssa

Yeah, yeah, let’s get into it so thinking about I think that this is probably 1 of the most Probably what are the questions you get the most. It’s a question I get. Also, from athletes is like hey I’ve heard about this sleeping in a tent norm a baric Altitude. What is that and how do I know how to use it so would love to hear your perspectives on it and. We’ll stick with I mean of course expand into high or extreme altitude as needed. But how useful would it be for moderate altitude?

08:50.49

Martin

So, I think it’s just worth mentioning what it what it actually basically means ah this these hypoxic Tens we are actually talking about Hypoxia, but which is norm baric so comparing to hyperbaric. Which is lower pressure right? So, we discussed that the lower atmospheric pressure the higher you go at altitude Real altitude. Ah So what is actually happening with these generators is that they are creating hypoxia by changing the ratio of ah Oxygen molecules in the air. Usually, it’s a tent. You actually have a tent you sleep in or spend some time in. Sometimes they are actually commercial gyms that use these generators, so you have a limited space with some machines exercise machines., but. What is actually happening is that ah instead of 21% of Oxygen Molecules. You’re trying to reduce this percentage of Oxygen Molecules. So, the pressure is staying the same as the atmospheric pressure. Ah, but you are. Basically, reducing the Oxygen levels artificially by increasing the Nitrogen Levels. So, Nitrogen is the one the one that is most prevalent so it’s about 80% of Oxygen ah of molecules in the air around us is ah is Nitrogen The next is really close to 21%

10:22.62

Martin

Is oxygen and then very small fraction being the rest of the different gases molecules and this is actually the same on top of Everest actually still eighty to 20 % nitrogen oxygen so it’s really That’s the density. That is reduced when you when you are on top of Everest. It’s about 30% of the value of sea level. So, it’s quite remarkable, very much lower than of course it affects your aerobic capacity everything. That’s why it’s so difficult to get to Everest without supplemental oxygen. Ah, but back to the normal brake so these generators actually we can use nowadays back now in our homes. Ah with the with tents. So, as I was talking about the timeline. How long does it take to acclimatize? It’s very important to know that so you.

11:21.63

Martin

In order to acclimatize with the help of the generator you can imagine that it’s quite annoying. Actually, it’s ah it’s quite ah, it’s quite a challenge to get enough time in that Hypoxico and it’s actually that one thought that that 1 thing that is maybe the most important is the dosage. So.

11:37.99

Martin

What is the dosage of hypoxia I need to get acclimatized enough. So, its really time spent so by using the tat you are actually trying to sleep at this simulated altitude and or there is also a use with masks. So, you have you put the mask on and you breathing this reduced oxygen ah air either statically, you’re just sitting around reading your book watching Netflix or and trying to accumulate a time but also you can use it on a static. Static exercise machine either a stat bike or treadmill and you can actually do active training at Hypoxia, the obvious question it comes with is it actually real. Is it valid does it do what it says it does, so it’s been. I have researched many times over in the last twenty thirty years and ah there have been studies that are very skeptical, and they didn’t find any findings or just that it’s just not worth your time., and so. But it works to the large extent it works. That’s kind of what I can say we have we have it confirmed we have worked with ah with athletes and using this strategy.

13:01.22

Martin

But of course, it requires quite specific knowledge. So. It’s not ah, it’s not super easy. Definitely very complex as you already understand probably from this ah from what I bring all the information I gave today. But what is actually happening is really you try to simulate that altitudes you start at lower levels. Ah, you observe the metrics which you can so in this case, we try to observe the hydrate saturation. Specifically, the saturation is really something you can see saturation as of oxygen is actually going down so in sea level or when we are acclimatized even in mode editor. High altitude. Our situation is about Ninety-Nine 90 8% ah when you have some kind of well hypoxia which can be due to altitude but there are also some ah medical issues or sicknesses that are actually affecting your saturation. Think so some pulmonary diseases. So definitely when you are in intensive care and a hospital you, they are putting the clepe on your finger and continuously. Measuring your heart rate. But also, saturation is a very important metric. So, for us, it’s very important due to acclimatization. So, when you are going into the mountains or just try to see how your body reacts. It’s a great metric to go for you will see how much it drops if you spend some days at an altitude does it stay still low or does it.

14:35.62

Martin

Does it get better it. It should actually get better. So, it just really gets you gives you some information besides the feeling because you probably feel to some extent the altitude already., so yeah, this is this is the way. Yeah.

14:49.71

Alyssa

Yeah, we actually yeah, just as ah, we were able to get a pretty nice Oxygen saturation finger monitor from there are some really cheap ones out there that don’t work very well and then there’s some much nicer ones that are a bit more expensive and.

14:53.19

Martin

So.

15:07.50

Alyssa

It’s been extremely useful when we do go up. We can pretty easily get to 20 over 2500 in places in California and it’s really useful to have that information because you can.

15:20.19

Martin

But.

15:26.34

Alyssa

Think you’re okay and actually be quite surprised by the information and also feel quite bad and you know it’s better than you expect. So, it is very useful to have I think Oxygen saturation is such a key. Ah.

15:42.10

Martin

So yeah, so.

15:44.19

Alyssa

Key piece of data to be too honest to stay safe I think at altitude for sure I think it’s worth investing in if you’re looking just to learn more and to be able to understand yourself.

15:57.82

Martin

So, for sure I mean I think it’s very important. Maybe not so much that moderate altitude level like training camps below three thousand meters but still even if you as you say you might go sleep up on some mountain buss at 40500 meters and.

16:06.91

Alyssa

, yeah, definitely.

16:16.91

Martin

You might not sleep that great and you might wonder why what’s going on but actually realize wow, there’s already some effect so. It’s actually also something I wanted to, wanted to say how important it is to know it’s very individualistic. We really are. Genetically predisposed to either acclimatized well or not so well some people well that there’s different responses and ah and so and it’s really hard to predict and ah so it really comes. It’s important to get that experience. Ah, but yes, then I think in higher levels of when you try to climb some mountains and you will spend some time up there when you will sleep in some high mountain huts and or then you really are going to so the mountain rangers or ranges in Nepal and you’re really going to sleep up there for consecutive nights you know to have that metric is actually really good to know the saturation because then you sort of you can react you can maybe say okay, my saturation is dropping below 85% so something is definitely not right and I really definitely feel it. So, and it’s not It’s just not safe and so just spending 1 extra day at that level before going higher can actually tell you from getting into trouble or well actually in higher levels. It can. It can actually save your life. So, yeah, but this is actually important the one metric.

17:45.66

Martin

There are also of course others ah when it comes to testing athletes or if we get questions about what we do to monitor athletes to Mark Progress so important thing to do some blood tests., of course. You can discuss that with your doctors but that that know better about this. But what is important to increase your hemoglobin numbers is actually connected really strongly to iron levels very so it’s a very simple test to you can actually see if you are within healthy limits. And you actually have the capacity to acclimatize because if you’re in low level switch which you can definitely happen specifically female athletes., then you know you are actually your body will have a real trouble to acclimatize if you are on low level so you can supplement them. And so, it’s very important to do it in time maybe 2 3 weeks before you start acclimatizing for whatever goal race you have because the supplementation of course takes time to kick in the iron levels to be in a correct level and then maybe monitoring throughout the adaptation process as well. Ah, to make sure that everything’s fine and yeah there are different decisions, so we do, but these are the ones that are probably the most important and the hard rate as you know, ah you know the first stage of acclimatization stressful. You can expect that the heart rate will actually be quite higher.

19:18.16

Martin

Definitely will affect when you actually are training at altitude you can expect that the heart rate will start. It will not make sense when it comes to your normal intensity zones right? So usually, I prescribe then the intensity by Rb the effort. How do you rate your effort and then have the scale and. Actually, know how hard I am pushing so you actually have that subjective feeling so that’s really it best because you actually are experiencing the stress from the physical activity and the stress from altitude. So combined you have a pretty good feeling about it. Your breathing is harder etc. So. Just very important to be aware of that when you’re at that institute.

19:59.82

Alyssa

Absolutely and that’s one of the pieces I tried to do encourage my athletes to understand Rp you know using a combination when they aren’t at altitude because so often, we get athletes who come in and. They’re really so reliant upon heart rate to tell how they feel that when and heart rate does have an ah fair amount of variability within it and so they’re so reliant upon like that heart rate Neber this is the edge of my zone too and if I go over one beat or under 1 beat.

20:34.98

Martin

Yeah, so.

20:36.22

Alyssa

You know there’s that ah that precision that’s actually really not that precise and so I try to say hey, but how do you feel and you know just yes, you want as much information as you can get that is useful to you but you need to be able to rely on your own feeling and.

20:55.77

Alyssa

Sense of how well I am doing and what is my rate of perceived exertion. So yeah, I’m always glad when that comes up of like Rp is really useful for us at altitude and for when we’re in our training because also what if you’re watch. Stops working. You know there’s a bajillion with things that can happen like we didn’t used to always have smart watches and heart rate monitors that told us exactly how we’re supposed to feel so it’s always good to tune back into your own sense of.

21:13.93

Martin

Yeah.

21:31.35

Martin

Yeah, now it’s a great point but also knowing that altitude is I mean the heart rate. Let’s go back to the heart rate is also affected by hydration, right? So ah, that happens a lot of.

21:31.43

Alyssa

Exertion and how you’re feeling.

21:48.22

Martin

Specifically, I talked about it diet that I is that’s actually one of the symptoms or the first so-called adaptations at altitudes the rate that those that happen real fast within the first hours and days so that will for sure affect your heart rate already otherwise. Also, when you become ready to. I would say above three thousand meters we need to confirm this but say that the high altitude. Ah, also our body suppresses the heart rate for different reasons. But I think it’s mainly to protect it for us not to really go to the max. So, imagine your pling mountain in and you know. You’re talking to your guide to say hey we need to slow down because I’m not in myself. Its ah makes no sense. You know it’s ah you really definitely want to know yourself enough. So, it’s really good to practice that already and I’m definitely working with my athletes in that way, you know I need I need to know your heart rate.

22:43.42

Martin

But if it’s allowed to you. It’s still good to know the trends the way your body is responding to the exercise but also ah get that gunner connected to your Rb so you know okay, is it easy moderate is it a hard effort because then you will be actually automatically, I think it’s actually happening then.

23:01.45

Martin

And you just kind of know where you are you can sustain this for hours or you are pushing hard, and you say okay well, I can keep going like this. But I think there’s a good chance that I will just burn in in 30 minutes or something if I go like this so and to slow down and. And keep it moderate so ah, super important I don’t use them.

23:25.55

Alyssa

Yeah, absolutely Martin, is there anything else you’d like to touch on before we wrap up or should we save the rest for our second episode on high and extreme altitude.

23:41.83

Martin

It gets good to wrap it up Era then we covered a lot and I’m happy that we were able to talk about the different aspects and there’s always so much more to talk about this discuss. But I hope that this was helpful I would say that the listener stay might. Now understand that it’s quite complex but we can definitely also keep it simple I don’t overthink it is either. It’s really just that simple question at the beginning you know So What is my goal How long do I have time to prepare ah and specifically now to altitude. Is it really a decisive factor to I need to invest into it and if I do then just reach out and we’re able to either give some consultations or provide help so and next time I’m excited to talk then about ah now the big ones and. Yeah, what? what is different. What is the same but still, it’s definitely becoming a bigger factor in your performance, so we’ll cover this in the next podcast.

24:50.50

Alyssa

Absolutely well. Thank you, Martin that was really hopeful, and thank you all for listening to the uphill athlete podcast. You can reach out to us on uphillathlete.com to schedule consultation with Martin or write to us more about altitude training and helping you answer those questions if you could rate review subscribe on your favorite podcast platform that helps us help more athletes. It’s not just one but a community we are up to athletes.