Into Thin Air

By Staff

Coaching Management, 15.1, January 2007,

Almost everyone agrees that athletes who take a banned substance to improve their performance violate the spirit of competitive athletics. But when it comes to performance enhancing practices, the line between fair and unfair can be harder to define. This fall, the World Anti-Doping Agency (WADA) examined the issue as it applies to athletes using high-altitude tents, deciding—for now—that the practice resides on the fair side of the line.

WADA ruled against adding hypoxic chambers, or high-altitude tents, to its list of prohibited substances and training aids in September. The decision means Olympic-level athletes are still allowed to use artificially induced hypoxic conditions in their training. If WADA had banned the hypoxic chambers, the NCAA likely would have followed suit.

In recent years, many athletes, especially those competing in endurance events, have used altitude tents to follow a “live high, train low” training philosophy. Their school of thought says that if athletes live at high altitudes and train at lower elevations, their performance improves. Acclimatizing the body to higher altitudes—7,000 to 8,500 feet—increases the number of circulating red blood cells as the body compensates for the lower-oxygen environment. More red blood cells mean more oxygen is delivered to tissue during exercise. Altitude simulation allows athletes to create more red blood cells, which helps them to work out longer and harder under normal conditions and results in greater physiological gains.

The hypoxic chambers, usually set up around an athlete’s bed, pump in nitrogen to lower the space’s oxygen level, simulating the air at higher altitudes. Starting at around $5,000, altitude tents are cost-prohibitive for many high school and college athletes. However, a number of professional and world-class athletes are utilizing the technology, including Suzy Favor-Hamilton, a three-time Olympian and former U.S. record holder in the 1,000 meters.

WADA’s decision is immersed in debate regarding what constitutes “performance enhancing.” Dr. Benjamin D. Levine, Director of the Institute for Exercise and Environmental Medicine at Presbyterian Hospital in Dallas and a professor at the University of Texas Southwestern Medical School, believes altitude tents are no different than an athlete traveling to a mountain location to sleep—they’re simply cheaper and more practical. As a result, Levine believes that banning the tents should not be on WADA’s priority list.

Levine expressed his views in a letter to WADA, which was also signed by 76 other scientists and bioethicists. Levine feels it’s problematic to target altitude tents when other, similar legal practices athletes use to enhance performance are legal—for example, sitting in a sauna to acclimate to heat and humidity, or wearing a cooling vest or sitting in cold water to cool the body before a race in hot weather. “If you’re going to ban altitude tents, why not ban those practices, too?” Levine asks.

Those in WADA who favor a ban argued that because the training method is performance enhancing, it could be considered in violation of the organization’s “spirit of sport” doctrine and may not be completely safe. WADA President Dick Pound said that despite the decision to allow altitude tents, discussions and studies remain ongoing, and athletes who use hypoxic chambers should do so with caution.

“We are pleased with the progress of the discussion surrounding artificially induced hypoxic conditions,” Pound told Reuters. “While we do not deem this method appropriate for inclusion on the [banned] List at this time, we still wish to express the concern that, in addition to the results varying individually from case to case, use of this method may pose health risks if not properly implemented and under medical supervision.”