Few informed observers doubt that that EPO is part of the performance tool kit of many athletes headed for Rio. But for most, including the Australian swimming team, it will only be the EPO their own kidneys have secreted in response to oxygen starved altitude training camps.
This phenomenon carries none of the stigma of the synthetic variety of the erythopoietin hormone which revolutionised blood doping in the latter part of last century.
But should the practice be totally stigma free? While not banning it, the IOC has labelled altitude training “against the Olympic spirit.”
After all, much of the broader doping debate turns on concerns of fairness and health risks.
Altitude training is known to place certain athletes at risk of stroke and heart attack. It could therefore be said to discriminate against the risk averse, and seems unfair to athletes denied the resources and assurances of institutional backing.
That national programs can be nervous about their involvement was shown when Swimming New Zealand was caught out concealing the 2014 hospitalisation of top distance swimmer Lauren Boyle during altitude training in Spain.
Team coach David Lyles issued a press release claiming there had been “no major illnesses or disasters”, only to be corrected by chief executive Christian Renford, who could only tell the press “we are trying to discover the actual nature of her illness”.
Altitude training camps have been on offer, if not compulsory, for Australia’s “high performance pathway” swimmers for some years.
I know, because I refused to allow a 17-year-old swimmer I coach to attend one. If she’s still with me when she’s 21 she can make up her own mind, but I’ll probably counsel against it.
Apparently the ideal duration of such camps is between two and four weeks, and at an elevation of around 2,000 metres. The optimal performance benefit from the adaptations occurs three weeks afterwards.
Advocates say there is still no ‘one size fits all’ approach to the practice, although a ‘live high, train low’ approach has recently become popular.
This requires the locating of low altitude training facilities near high altitude dorms. The major such facilities are in Spain’s Sierra Nevada region and various US venues.
There are also sea level proxies such as altitude simulating tents and ‘high altitude houses’ where the oxygen is artificially regulated to 75 per cent of their low altitude neighbours.
Physiological adaptations beyond simply ramping up the red blood cell and haemoglobin values can include improved glucose transport, glycolosys, and PH regulation.
Another, more worrying benefit, is angiogenesis, whereby new blood vessels grow rapidly from existing ones, raising concerns about accelerated tumour growth.
Let’s not also forget that blood viscosity associated with high red blood cell counts can raise blood pressure and precipitate vascular trauma.
One of the reasons a total ban has never looked like “getting off the ground” is that some athletes actually live at high altitudes through no fault of their own.
It’s either where they were born or where they work. You can hardly go around telling sportsmen they have to come down to sea level to live and train. Or can you?
delbeato
Roar Guru
"Few informed observers doubt that that EPO is part of the performance tool kit of many athletes headed for Rio. But for most, including the Australian swimming team, it will only be the EPO their own kidneys have secreted in response to oxygen starved altitude training camps." Brad, on what basis can you rule out Australian swimmers using synthetic EPO? As an Aussie fan, I'd love to know they were clean. But do you have any evidence that you could share? I mean that genuinely, I'd love to hear that there is.
Rob
Guest
Altitude exposure whether natural or simulated does not produce the same effects (in magnitude) as even a low dose regimen of synthetic EPO. Normally after the first night or two natural EPO levels have risen and basically have returned to baseline levels thereafter no matter how long the exposure. This rapid increase and then normalisation of natural EPO level does not translate in increased red blood cell production and therefore haemoglobin levels. The increase in red blood cells following at or following altitude exposure is only transitory and is due to the increased diuresis (fluid loss through increased urine production) falsely elevating the red blood cell counts. People (inc. athletes) who reside naturally at altitude (for example the Andes) may have higher red blood cell counts (and haemoglobin levels but does not necessarily mean that they use oxygen more efficiently than low-landers, otherwise only high altitude dwellers would dominate racing. With regards to Kenyans and the like their performance edge is probably genetic (they don't have significantly higher red blood cell or haemoglobin levels compared to others) but do have large distribution of 'endurance' muscle fibres. A general response to altitude exposure is a delayed lactate response hence supporting an increased endurance performance generally. In other words altitude exposure is not the same as EPO doping - the performance benefit is gained through an entirely different physiological mechanism. Therefore no need for a moral or ethical debate about altitude exposure although there are some medical concerns. People (inc. athletes) who possess certain abnormal haemoglobin types (sickle cell carriers) are at risk of serious damage to their health if exposed to high altitude environments so that's where the attention should probably be devoted to with this issue,
jameswm
Roar Guru
A lot of Aussie distance runners spend January in Falls creek. The accommodation is there from ski season, but lots of hilly, grass trails.
jameswm
Roar Guru
My understanding (though I am far from an expert) is that the main thing is sleeping high. If you train high, you can't work as hard, for obvious reasons. So if you train low and sleep high, you get the best of both worlds.
nickoldschool
Guest
Thanks Brad, really interesting topic rarely discussed in Oz. Training in altitude has been very popular in many sports in continental Europe for a long time now and as far as I know many pro football, rugby, cycling etc teams still spend a fair bit of pre season or pre comp prep in altitude. Have never felt there was any stigma attached to it as it's also seen as a good way to be isolated as a team (less media attention, fans etc) and breath some fresh, clean air, with lower levels of allergens. I hink the EPO related bonuses are only one aspect of the benefits. I actually had never heard or read about risks attached to it as mountains are just part of the natural environment there.
Brad Cooper
Guest
Thank you. Ethically, it's an interesting area. But the same proliferation of red blood cells that killed 8 or so cyclists in their sleep in the 1980's are the same ones that could harm anyone. Except that those cyclists were injecting synthetic EPO, so they may have been several times the dose you can get from a mountain vista.
Brad Cooper
Guest
Yes, and that's obviously why they haven't been confident enough to ban it. A barrister could have a lot of fun. I'm not an expert on it, but apparently living high and training high isn't as beneficial as living high and training low. It sounds like training high can limit your training output. Cheers.
Swampy
Guest
Thanks brad - an enlightening piece. I've previously never seen the risks of altitude training/living put into a media piece.
jameswm
Roar Guru
The IOC has labelled altitude training “against the Olympic spirit.” How does this deal ith the Kenyans who have lived and trained at altitude since they were born? Legislate against high altitude training and you are giving the Kenyans a bigger advantage.