Now lets us talk now about how to prepare for a stage race (or other ultra) that is being conducted at altitude. As stated in the first installment of this series, there is a high probability that you do not live at altitude. So, what can be done to prepare? Well there is in fact a fair amount that you can do. Of course it all depends on what you are willing to invest in.
You could pull up roots and move to a high altitude location to live and train. Some are blessed to be able to pursue a meaningful career in a locations that are at altitude. For me it is in the mountains of northern New Mexico above 7,200 feet (2,200 meters). But just because you live at altitude does not preclude you from training appropriately for an event at altitude! Let’s see what we can do.
Minor modifications to your training regime will help significantly to prepare you for altitude. The strategies here are all directed at minimizing performance loss, particularly at your bottom end (slowest pace). The top end pace is going to suffer for most people at altitude even when running downhill and there is nothing to be done about it. Basically you are trying to up your average pace by maximizing your slowest pace.
First and foremost is to develop a strong base and prepare yourself for some more high intensity work when you are six to three months out. Paying these dues early will benefit you in the long run (pun intended) with good aerobic endurance.
Once your base is in place it is time to start the real preparation. The overall focus here should be on improving your ability to consume/convert oxygen to useful energy. Perhaps this sounds somewhat familiar to you? This is more commonly known as your aerobic threshold and it is measured by VO2 max.
There are numerous ways to increase your aerobic threshold (VO2 max training) but all involve some sort of interval training in an anaerobic state. The most common involve intervals and/or hills. It is left to the reader to research and come up with a VO2 max training regime that best fits you. For me, I prefer steep hill intervals with nice recovery jogs back down to the base. Starting out it is usually hills that are about 400 yards long. When peaking, it is repeats on the 3/4 mile ski hill with 1000 ft of elevation gain. I occasionally throw in a “speed day” every now and then with sprints on the flats.
Typically one should be doing these workouts in combination with long days, easy days, pack runs, etc. You will have to listen to what your body is telling you to come up with an appropriate mix. Obviously building your VO2 max base will take time so be sure to plan for it (typically multiple months) and do not overdo it early. It is hard work but in the end it will be worth it. An added benefit of all this it that these workouts will also improve you performance at lower altitudes.
One final note on VO2 max is not to take much stock in the GPS watch measurement of VO2 max/acclimatization. Your watch is basically measuring oxygen saturation of your blood, not the conversion of oxygen to energy. This is a highly indirect measurement. Accurate measurement of VO2 max needs to be accomplished in the laboratory. Sorry.
All along the way do not forget your mental preparation. You need to instill in yourself a positive mental attitude that you are preparing and that you can succeed even though it may not be your finest performance. But then again who knows? Perhaps it will be one of your best races to date!
Finally, a couple of months out it would be a good idea to cut back and/or eliminate your caffeine and alcohol consumption. While most everyone enjoys a good cup (or two) of Joe in the morning, managing your desires will help with the acclimatization process later. Remember, there are a lot of decaffeinated brands on the market today that are just as tasty as the real thing. This also goes for the beer or wine with dinner. Sorry, it all depends on how dedicated you are to this.
For most athletes it has been shown that it takes 21-28 days for the body to adapt in a meaningful, but not permanent way to altitude. How long it actually takes is dependent upon the individual. For most of us we can not commit to a four week vacation prior to a race so we do the best we can. Fortunately most of us can do some type of acclimatization before and usually up to about a week before a race.
As part of your training for a high altitude event you may wish to “practice” acclimatization a couple of times. This can be as simple as heading up to the mountains for a long weekend for some serious back-to-back-to-back runs with your kit or perhaps some other ultra. Understanding what you can expect and how you can manage at altitude is good to know. Most people (here in the US anyway) are not too far away from what is considered high altitude and even if you are not within driving distance, budget airlines can get you there fairly cheaply. From the map below it is obvious that heading into the inter-mountain west is preferable.
If you do some of these practice trips, pay attention to how you feel especially in the first couple of days. Practicing acclimatization can give you an idea of how rough it is going to be up high and enable you to identify strategies to deal with physiological changes.
Prior to Race
Acclimatization prior to the big race is critical. Smart racers will arrive three days or more prior to gear check to begin the acclimatization process. Arriving early also has the added benefit of relieving stress associated with traveling. You can get over your jet lag, make sure your luggage/race gear arrive, re-pack for the 27th time and do some sight seeing. Coming in early will give you three to five days at altitude before you toe the line on the first stage and put you well on the way to being as acclimatized as best you can.
But you also need to keep in mind what you are doing during the acclimatization period. There are multiple things to keep in mind to speed along acclimatization.
- TAKE IT EASY: Spend your time at high altitudes relaxing. Sleep in and lounge around. Mentally relax and enjoy the views. Avoid the urge to go stroke out a quick 20 miles to relieve your taper stress. Save it for latter, you will need it.
- Hydrate: Drink enough to remain properly hydrated. Your plane ride, the dryer environment and changes in breathing will all tend to dehydrate you. If you are tired of plain water then try flavored sparkling/mineral water.
- Do not smoke and avoid (minimize) drinking alcohol: Both of these increase dehydration and decrease respiration rate during sleep. Coffee is also unfortunately a diuretic and can negatively impact hydration.
- Eat carbohydrates: At altitude the preferred energy source are carbohydrates. They are converted the easiest (requiring the least amount of oxygen) and provide the glycogen necessary for muscular activity. When arriving at altitude your body taps blood sugar as the primary fuel source during rest and during exercise. Since it takes more oxygen to metabolize fats/protein, low blood sugar levels will occur more quickly at the same intensity of activity at altitude compared to sea level if increased carbohydrate intake does not occur.
- Eat lots of food: It is important not to go into caloric debt prior to the race. You body and metabolism will be working harder even at rest to compensate for the altitude so your calorie needs are going to rise. It is also not a bad thing to indulge a little prior to the start. Even though carbs are preferred at altitude it’s better to eat the wrong food than not enough food.
- Manage the headache: If your head is throbbing Acetaminophen or an NSAID (such as ibuprofen) can be taken for headache. Avoid the NSAID if possible.
- Iron: Be sure your diet includes sufficient iron since you will be in overdrive producing red blood cells with their hemoglobin oxygen transferring proteins. This is especially true for women.
At this point it is worth mentioning some additional things that you may be aware of that are billed as being able to improve your altitude performance. For the average stage racer they are most likely not worth the cost/effort.
Quite honestly these do nothing for you. These products function by restricting the air flow into your lungs, not by changing the partial pressure of oxygen in the air you breathe. You may get a stronger diaphragm but no improved acclimatization.
Hypoxic Tents and Chambers
If you have some serious coin to spend then you could consider a hypoxic tent/chamber. These are basically confined spaces where the oxygen content of the air is lowered via various means. Some research has shown that hypoixc tents/chambers are less efficient than sleeping at real altitude and that per-acclimatization at altitude is more effective. There are also some possible side effects including the potential for bad sleep. In addition to tents and chambers there are also mask type contraptions. You may want to save your money for weekend trips and/or time before the race.
Acetazolamide, which is sold under the trade name Diamox among others, is a common drug used to treat altitude related symptoms. How it actually works is not totally known but it is generally accepted that thru diuretic effects, bicarbonate is excreted thru the kidneys/urine. This forces a blood chemistry change that causes deeper and faster breathing, which in turn increases the amount of oxygen in the blood helping with acclimatization. There a numerous potential side effects (dehydration, tingling toes and fingers, electrolyte imbalances, abdominal cramps, etc.) with this drug that can impact the stage racer and honestly if a reasonable regime of acclimatization is followed it is most likely unnecessary.
Other steroid based drugs are available to treat various altitude related symptoms but carry additional risks that are unacceptable to most.
In closing, good luck with your training. You need to be sure that you train sufficiently but not to over do it. Your first goal should be to get to the starting line healthy and this is even more important if you are racing at altitude.
Next is Racing Strategies!