Introduction: Many swimmers continue to use altitude training as part of their preparation despite questions of its efficacy. This belief seems to be strongly tied to the notion that an increase in hemoglobin mass will transfer over to increased sea-level performance. The purpose of the presents study was to examine whether altitude training lead to greater increases in competitive performance compared to sea-level training, and whether changes in hemoglobin mass was associated with changes in time-trial performance following altitude training. Methods: Race records of 44 elite swimmers were sourced from several online databases. Swimmers were allocated to either altitude or sea-level groups based on whether they sojourned to altitude or not. Competitive performance over two long course seasons were investigated, and changes in performance where calculated before and after each altitude training period. In addition, hemoglobin mass and time-trial performance were measured in 8 Norwegian swimmers before and after an altitude camp during the early short course season. Results: The inclusion of altitude training during the early season both increased (0.8%) and decreased (-0.3%) competitive performance compared to sea-level. However, these changes were unclear. Large individual responses were observed (0.6%-1.0%), and results from altitude training were not reproducible across seasons. In addition, altitude training increased hemoglobin mass substantially by 5.8%, but time-trial performance only by 0.4%. Overall, there was a lack of association between these two variables. Conclusion: Altitude training was associated with similar increases in competitive performance compared to regular sea-level training. Although, hemoglobin mass increased as a result of training at altitude, this adaption did not seem to carry over into improved performance. It is thus questionable if an early season altitude training camp is conducive in improving performance in elite swimmers.
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