The truth about altitude and late season swoons

When I first moved to Colorado, I was coming from about 250 ft of altitude in Chicago (where I was born) to 9,200 feet up in Summit County. For those not in Colorado, it’s an hour up the interstate 70 and through either Loveland Pass or the Eisenhower Tunnel to get to the main area of the county, which includes Breckenridge, Frisco, Keystone, Silverthorne and other towns and areas. I loved it from the first time I saw it, years before I moved up there.

And, for years after, I’d find myself breathing differently just to go up six steps. It wasn’t hard - but I’ve been told that there’s only a third of the oxygen that there would be in Denver, the Mile High City, so you simply pant more. Denver has a third less oxygen than the air at sea level. Later I trained heavily at the altitude at the Continental Divide and I found that by going down to Denver, still a mile up, to work out it was like drinking oxygen soup. When you train at altitude, you adapt and you get in that kind of condition. I shared a clinic with an expert on high altitude nutrition for the first year I was there and there was no shortage of such cases, so I got a fast indoctrination into the concepts of training at altitude and nutritional approaches to preventing altitude sickness. I then spent another 15 years or so living down lower at the connection of SW Denver metro and the foothills, and I learned about adjusting to that altitude. It’s not complicated. Friends from sea level would visit and quickly adapt. Many did so in a few days which is medically about normal. Rehydrating consistently and taking simple over the counter nutrients is all that’s required in the vast majority of cases. And a professional athlete is at a vastly lower risk than an average person.

Because of my background, I read with interest the article from Mike Klis the other day in the Denver Post. He talked about the fact - and fact it is - that Denver has for about a decade or more often started out faster and ended the season with poor records. Klis used this as ‘evidence’ that ‘maybe’ altitude is playing a role here and said twice in a row that ‘maybe’ that the first job facing new Denver strength coach Luke Richesson will be figuring out how to keep Denver from fading due to altitude late in the season. It’s an interesting theory, with but a single problem.

It’s ridiculous. It’s on the thin line between a cheap refusal to check your premises and an outright lie, employing a cheap form of rhetoric. When folks ask why we get irritated with some of the Post writers at times, this kind of thing is why. You imply a question in big, broad strokes and you say that ‘maybe’ the new guy should be doing something about it, and there’s not a bit of truth to what you’re implying. What he’s claiming is a blatant lie. And, Klis is a smart enough guy to know exactly what he’s doing when he pulls one like that.

Here's the direct quote:

Maybe the Broncos have by and large not been a very good team the past decade and training in altitude deserves credit for the team's traditional fast starts. Or maybe altitude fatigues the Broncos through an arduous NFL season like no other.

The truth is that it takes between three days for most, to a maximum of three weeks for the average person to adjust to Denver’s altitude. Athletes generally do so more quickly. There are rare exceptions, and I’ve had to send patients to lower altitudes, first from the mountains, and later, and far more rarely, from Denver, if they suffered certain rare conditions. Anyone with a health problem - such as Steelers safety Ryan Clark - should talk to their doctors before suddenly changing 1-2 miles in altitude - it’s good sense. All of the patients I had to send back lower had been born at low altitude. Far more importantly, all of them suffered from substantial underlying systemic health problems. I also had patients with life-threatening severity of asthma who did better in Denver than at lower altitude. The dryness of the climate seems beneficial for some cases.

For a healthy athlete who trains here, it’s of no particular concern. Pittsburgh’s Clark suffers from an inherited condition, sickle cell anemia, which is more prevalent among people of African American ancestry, and those who suffer from it cannot safely work out at this altitude. Beyond that, if you move from sea level you might gasp a bit at first, you might run out of gas a bit sooner (although not even to the point where most athletes can’t keep up for a single game of football), but if you live there, one thing that doesn’t happen is that you wear out sooner in the season as a result of living at altitude.

I’ve trained for years up there, both outside of Denver and along the Continental Divide. You always need to rotate your training, get enough rest and proper nutrition, watch alcohol and make sure that you’re rehydrating enough to make up for the thin air. Your body uses more B, A, D and E vitamins, as well as certain trace minerals. UV rays are stronger, and you need to compensate if you’re outdoors a lot. You may need more protein - many do.

I think that it’s fine that Klis raises the subject. I object to his deliberate pretense of conjecture on something that’s counter to what’s common knowledge in the community. It was a sleazy way of implying a falsehood, and he ought to take responsibility for that.

I seem to recall when some professional writers were taught to actually research the things they wrote. And, they teach how to manipulate people in lots of classes - they used to teach it as ‘Rhetoric’. Two sentences, both essentially starting with ‘maybe’ (and describing something that’s medically erroneous) could have easily been avoided by just picking up the phone and asking a doctor, or by tapping a couple of queries into any search engine, if he didn’t know himself. Denver is blessed with extremely good hospitals for patient care, wide-ranging research and the teaching of medicine. Maybe a doctor with some experience with higher altitude adjustment would be best, but any doctor could either tell him the facts or at the least point him to someone who could.

There’s also lots of information on the internet on this. Of course, that would have killed the maybes that aren’t maybes at all. The article was based on an entirely and deliberately erroneous concept. It also spent enough time talking about the pattern that its conclusion will probably get around, as they often do. That hasn’t been rare from this source either. Rumors are fun, facts are boring. If it thinks, it stinks.

Just so you do know - a lot of things go into losing later in the season. Other teams getting film on you matters. Insufficient talent matters. Insufficient coaching expertise in order to come up with new adjustments and approaches on both offense and defense matters a lot. Team cohesion counts. Lack of cohesion in the locker room over the wins and losses is a killer. The Broncos found that having your defense believe that the players on it will be treated as second class citizens matters a lot.  None of these have anything to do with living in Denver and training as a professional athlete there. Actually, Denver and the entire Front Range are huge draws to athletically minded individuals, including those of us who do as I once did and who wear technical gear in order to go out and shoe it through backcounty snowstorms in zero conditions - by choice, with two golden retrievers leading the way.

Do we need ask how rumors start? They often start with that magic word ‘Maybe’. It’s a word that suggests without telling, and used correctly, most people who read your article will believe something that’s an utter lie. If you use words for a living, you know that. And you do it anyway.

Why does it matter, outside of simply not being true? I knew a lot of folks to whom it mattered. I ran a clinic up in Frisco, in Summit County, and taught semi-private students there. For those of you who haven’t had the pleasure of coming out there yourselves, until you do, it’s next to where Breckenridge is in the mountains. Nearly every one of my patients and students directly depended on tourist income to make their living and things as minor as snow flurries during a Monday Night Football game would cause phones to ring off the hook with new reservations. Spreading rumors that suggest that exercise out here is less than beneficial is flatly stupid in an area that relies that heavily upon tourism, and equally important, it’s medical nonsense.

‘Maybe’ a newspaper should start with facts. One of our readers thought so. Doctor Dennis Clifford has served as head of the Exempla Hospital Quality Control Board. He runs one of their ICUs, and has been a consultant to the US Olympic Committee. This was the comment he sent me:

Klis's article is appallingly misinformed and incorrect.

Dear Denver Post: Please educate your columnists in the basics of logical arguments and have them read Thomas Paine for an example of convincing logic. There is absolutely no evidence that residence at high altitude impairs normal healing of injuries or causes chronic fatigue in athletes. Quite the opposite, I have been a consultant to the US Olympic committee concerning athletes with respiratory conditions such as asthma and have been to the facilities at Colorado Springs many times. There is a reason the training center is at 6300 feet and it's all positive. To suggest that performing at altitude causes the Broncos to lose games late in the season due to inadequate conditioning is exactly the kind of pseudoscience that corrupts average people into believing in alien abduction. Heaven help us! What is correct for all football teams is there is a cumulative affect of repetitive trauma over a season that causes some teams to have diminished performance as the season goes on due to injury.

Dr. Dennis Clifford, MD

Ethics, accuracy, knowledge. What interesting thoughts.

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