Playing at Great Heights!

By Damon Leedale-Brown, Sports Scientist & Conditioning Specialist

Having recently returned from 3½ weeks of squash training camps with US Junior players in Colorado, and this week working with 4 players who are due to fly out to Quito in Ecuador to compete in the World Junior Men’s Championships, it seemed timely to write about the challenges of adjusting to and competing at high altitude.

During our time in Colorado we stayed at 8,000 feet, and trained at elevations ranging from 5,500-9,500 feet. Quito is the capital city of Ecuador, and the central square in Quito is registered at an altitude of 9,186 feet which by definition is considered as High Altitude (8,000-12,000 feet). With rapid ascent to elevations above 8,000 feet many of us will experience Acute Mountain Sickness (AMS), and interestingly there are no specific factors such as age, sex or physical fitness that correlate with your susceptibility to altitude sickness.

Maintaining hydration at high altitudes is perhaps the most important component of managing AMS, both long before a match and while playing.
Maintaining hydration at high altitudes is perhaps the most important component of managing AMS, both long before a match and while playing.

Physiology of Altitude:
As you go from sea level to higher altitudes the atmospheric pressure decreases. At sea level atmospheric pressure averages around 760 mmHg, but at 12,000 feet the pressure is only 483 mmHg. Essentially the air is less dense (thinner) at higher altitudes even though the actual % of oxygen in the air does not change. Another way of looking at it is that you take in fewer oxygen molecules per breath.

The thinner air at altitude presents less oxygen to the lungs, resulting in lower oxygen in the bloodstream and subsequently less oxygen available to the working cells that are producing energy for the body’s activities. This also explains why in the early days at altitude most physical activity will feel much harder than at sea level! Because it is harder to get oxygen into your lungs the body initially responds at altitude by increasing your breathing rate, depth and heart rate at rest.

Acute Mountain Sickness (AMS):
The signs and symptoms of AMS usually appear 6-48 hours after arrival at High Altitude and can include a throbbing headache, sleep disruption, loss of coordination, dizziness, muscular weakness, sudden breathlessness, loss of appetite, nausea and vomiting. These symptoms are typically accentuated by exercise. Around 40% of individuals suffering from AMS become symptom free after 3 days, and 60% after around 4-7 days.

While the reduced availability of oxygen is the main reason that exercise at altitude is more difficult, one of the major factors linked to AMS is dehydration. The lower humidity (drier air) and increased breathing rate at altitude means you lose more fluid through respiration than at sea level. Remember that even a slight loss of body fluids of around 2-3 lbs (through sweating and respiration losses) can lead to a significant decrease in performance.

Practical Implications for Players:
For squash players traveling to and competing at altitude these are the main steps that should be taken to try and reduce or prevent AMS:

  1. If practical, ascend gradually to higher altitudes. This could involve spending a few days at lower altitudes (i.e. 5,000 feet) before moving up to altitudes above 8,000 feet.
  2. Maintain hydration—probably the most important aspect of managing symptoms of AMS. Make sure you are well hydrated on arrival at altitude, especially after a long travel day when it is easy to become dehydrated. Drink small amounts of fluids at regular intervals to help maintain hydration, and definitely before you feel thirsty by which time you are already dehydrated. Always carry fluids with you so they are readily available—this in itself should encourage you to drink more.
  3. There is some evidence that a high carbohydrate diet allows for better adaptation and lessens the risk of AMS. Remember that carbohydrate is a primary fuel source in high intensity sports such as squash, so maintaining adequate carbohydrate stores in the body is critical to performing well physically and mentally. At altitude there will be a heavier reliance on the anaerobic energy systems during high intensity activity. As the primary fuel source for the anaerobic systems is carbohydrate (Glycogen) you can become glycogen depleted very quickly if adequate supplies of carbohydrate are not being taken into the body.

A Players Perspective:

I spoke with Chris Gordon (US Men’s No. 3 and PSA No. 82) who has played many events at altitude mainly in South America, and he had some great advice and tips for players competing at altitude:

  • Mentally go in with a positive mindset, expect it to be challenging but be fully ready to face these challenges.
  • Don’t be surprised to feel okay on the day you arrive but then feel worse on days 2-3.
  • As you can get depleted & fatigued easily at altitude, make sure you take more time than usual each day to rest and relax in between matches and training sessions.
  • With the thinner air the ball moves quicker and tends to have a higher bounce at altitude. You have to work even harder to control the ball, and also be strategic with your play into the front of the court as the balls tend to “sit up” creating more opportunities for your opponent to apply pressure on you from the front of the court.
  • It’s harder to volley as consistently as at sea level as the ball is coming onto your racket quicker, so you have to choose the right balls to volley and not over commit.
  • Play smart tactically and adopt a fairly simple game plan—try and contain your opponent in the back of the court with good use of height and controlled pace. This helps create time and reduces the level of physical work you have to do.
  • Look to attack in short bursts of play and use explosive/high intensity movements to attack, not defend, whenever possible.
  • Be more patient and disciplined in teasing-out openings from your opponent, and be very positive with your attacks when these opportunities arise.

Hopefully the US Junior Men’s Team traveling to Quito will be able to successfully apply some of the guidelines presented in this article to help them cope well with the High Altitude environment, and allow them to perform strongly in both the individual and team event.