Doping vs. "Himalaya Hotels"
Editor: Just after the Salt Lake 2002 Olympics, I got a thought-provoking letter from a loyal reader that questioned (as many folks around the world are doing) the difference between use of altitude simulation (i.e. tents or houses) and actual blood doping. In the transition to a new website design during Summer 2002, my response to this letter was delayed over and over...growing with each month. Eventually it looked like a Editor's Column even though it covered a bunch of topics in no particular order. If you pardon the rambling style, it might (or might not) make for interesting reading.
Re: Doping vs. Himalaya Hotels
This is a topic that I've struggled with personally for the past couple years. But largely not for the reasons most people might think.
I have had personal discomfort with the concept of altitude tents (no one in North American skiing has the funds to match what the Norwegians, Swedes, Finns, etc. have done in fully equipping entire houses with altitude equipment). However, my personal misgivings have little to do with the moral basis for their use and far more with the financial end of things. This financial concern is largely not for those "poor, unfortunate souls" (many eating better than some U.S. post-grad skiers I know) in other ski nations. My concern is primarily for the majority of the athletes in our program...and around North America...that enjoy zero support from the U.S. national program and next-to-zero from any other source. Since most U.S./Canadian athletes can't afford tents (and they do work quite well) the simple fact is that the devices create even more of a divide between the haves and have-nots in XC. With already paper-thin depth in elite XC skiing, anything that makes the chase even more futile pushes even more promising athletes out the door.
So...you can see, even though I've helped at least a couple prominent NorAm athletes get a tent over the years, I'm not a big fan of the fact they are out there. But then again, I'm not a big fan of the fact that it costs six figures (US dollars) per year in wax and waxing equipment to take care of international teams. Or the fact that a pro sports team can spend more in one night's laundry than our entire grass-roots XC club's annual budget (my 1000 volunteer hours a year not factored into that budget amount). Wealth is relative. Life isn't fair. You either deal with, change it, or leave.
I can also see where folks can draw the conclusion that the tents are no better than doping. To the most popular points I say this...
1.) How to get "high"
The "live high/train low" benefits can be obtained one of two ways. You can either physically live in a location with 6000-14,000ft...and then drop down to lower elevations for workouts. Or you can use a tent and train out the door wherever you are.
There is zero...none...zilch...proven physiological difference between an athlete that is physically transporting themselves up to altitude for the effect and an athlete using a tent. The air they are using is the same. Nothing is going into the blood artificially. The body is left to do the work when it comes to creating the increased red blood cell count that comes with altitude...and/or doping. At the end of the day, an athlete manipulating real altitude and an athlete "faking it" with an altitude tent are doing precisely the same thing. Both athletes are on totally even ground in terms of the physio side of things. Conversely, athletes that train/race doped are on a completely different playing field as athletes that train/race clean. There is a very real difference!
Now, you can rightfully argue that the logistical advantage goes up for the athlete using the tent. They indeed don't have as many logistical hassles as using "natural" altitude for training benefits at precise times of the year. There's no need for added travel, you don't have to be based in great locations with ideal altitude variations, you can even really crank up the overnight altitude for extended periods in such a way that would be nearly impossible naturally.
But then again, athletes physically able to change altitudes can enjoy some logistical advantages with that system also. I know first hand about this. A decade and a half ago I was one of those athletes that used "natural" altitude changes throughout my career down in California's Sierra Nevada. I also routinely have non-tent XC Oregon athletes change altitudes here in Bend, Oregon. By using natural terrain features that offer multi-thousand foot locations within an easy drive, athletes can elicit many if not most of the benefits of any altitude tent.
The bigger point here is that if we are to cry "doping" at athletes using tents, we have to also be equally harsh about those athletes that manipulate altitude by living in locations like the North American mountain west or Central Europe where one can experience 4000-6000ft worth of altitude changes just by driving 30-90 minutes down the road. The pump of the altitude tent is simply replaced by the engine in a car. To not recognize this simple fact would be utterly hypocritical.
2.) The body: altitude simulation vs. doping
Now let us turn to the actual physiological changes that take place with doping vs. altitude simulation.
With altitude simulation in a clean athlete, the red blood cell count will increase over time, but it will be naturally limited by the body's ability to manufacture, store, retain, etc. that higher count. The body in question is also getting nothing in terms of "aids" to ward off natural fatigue, soreness, and sheer physical limits. You can live in a tent all you want and train at sea level all you want, and if your body breaks down with more than 1-2 intensity workouts per week...or if your body can't go over 700 hours per year...you will end up injured, sick, overdone, goodnight sweet prince. Simple as that.
HOWEVER...if you dope with someone helping you that really knows how to dope, you can fight all those negatives. You can train like a madman/madwoman. You can push the envelope harder and harder with intensity and hours. You can increase muscle size, power, and endurance. You can take your RBC thru the roof...literally to the dead zone. If you combine doping WITH altitude simulation (as all the "best" doped athletes do), then you are basically unbeatable by a clean athlete except when the stars align.
Of course, doping does have a huge problem (besides ethics) in that you can die doing it. You dope too much or the wrong way and you eventually can turn your blood into "sludge". The blood becomes so thick a perfectly healthy world-class athlete suddenly becomes a heart attack waiting to happen. By comparison, a clean athlete using altitude simulation simply cannot turn their blood into sludge. Cannot be done. Want proof? Look at native runners in various nations around the Americas and also in Africa over centuries if not the recent past. Many of these folks live most of their entire lives above 8000ft. I know several athletes (various sports) from Colorado that think they are going low when they drop to 8000ft. No sludge. Ever. They may have their speed compromised, but their body is never in danger...that's the point here.
Same rules apply to clean athletes using tents. You simply can't find a single one of these athletes that is dangerously pushing the envelope with RBC count the way dopers have pushed the envelope. Athletes that train/live clean using altitude manipulation...physical or via tents...show few to no negative physical side effects. Indeed, one could claim that if any evidence was there to support the notion that moderately high altitude hurts athletic people then we'd have to evacuate much of the western U.S. and Canada. It wouldn't just hurt or kill athletes, it would have the same impact on the general populations living at 6000-8000-10,000ft-etc.
On the other hand...let's look at doped athletes. I was told a story a couple seasons ago about a certain Central European team that was woken up every night at 3am or so to run around the hotel. Why? The coaches were worried that the EPO-derived "sludge" would kill the athletes as they slept. Several pro cyclists have already died from EPO use creating sludge. I've also heard rumors of several cases in the 70s and 80s of simple blood doping transfusions causing major health problems or deaths. Further, any physician can tick off dozens of possible complications that might kill or seriously hurt people that use steroids, HGH, etc.. We have no idea what the long term impacts will be of the impacts of masking agents and deliberate dilution of blood RBC to meet "max limits"...but I'm betting it ain't going to be good.
The bottomline is that altitude manipulation is a natural process. The tents make the process weird, even mechanical...that's for sure. But it is ultimately just thinner air. The athletes still have to do all the work. The body ultimately decides how much it will work...thus making it as safe as life generally is. If we get too uptight about the machine itself we have to start questioning if athletes in hot areas should have access to air conditioners or heaters in cold areas. It can get nutty pretty quick.
The bottomline with doping, by comparison, is that it is an invasive process of direct manipulation (and violation) of the body's natural systems. We know that it kills. We know that it hurts people that do it. And we barely know what the long term impacts will be.
Final thought...tents are actually saving money.
This point actually deflates some of my original argument that tents widen the gap between haves and have-nots. That still holds up on a large scale developmental index, but between nations, tents could actually save money in some cases.
The ironic reality is that tents and other equipment for entire "houses" actually can lower the cost for an entire group using good protocols. This isn't something that applies to grass-roots programs like XC Oregon (the tents, afterall, cost $4000-5000 a pop) but it does apply to international teams. When I was an elite level skier in the early 90s I could do training camps for $1500-2500 a shot...but that was living on rice and beans, plus sleeping on a lot of couches. Certainly I never had a coach go with me. National teams, on the other hand, will routinely spend $2500-5000 per athlete for altitude camps. Multiply that cost times 3-4 camps per year and you get a sum that is far higher than the cost of buying tents for a whole team.
I totally agree that tents aren't fair for a B, C, or D level skier trying to climb up the ladder. But that is a development issue rather than a moral issue. Leave the tents alone and focus on the real problems facing sport today.