In 1973, Sir Roger Bannister said that no clear proof of benefit of altitude training had emerged during a panel discussion on this topic, published in BJSM.1 What have we learnt in the intervening 40 years?

Altitude training—what use in team sports?

To date, most altitude training research is oriented towards individual endurance athletes, while the potential benefits for team sports remain largely unexplored. Hence, the safety and equality aspects of competitive football matches held above 2500 m have been passionately debated for over two decades.2 In 1993 this debate was invigorated when Brazil lost its first qualification game for a World championship in the stadium of La Paz (Bolivia), located at an altitude of ∼3600 m. Undoubtedly, the altered environment at altitude had a significant impact on players physical performances,3 and some athletes were better able to cope with the change in altitude than others, especially those who were better acclimated.4 Recently, the fact that Argentina suffered their worst loss in 60 years, a sound defeat of 6-1 against host Bolivia in a South Africa World Cup qualifier, clearly demonstrates that playing international games at altitude is a major challenge.

Despite the apparent lack of strong scientific evidence, it is striking to observe that altitude-training centres have been established around the globe, and are now offering team sport players the opportunity to train under sport-specific hypoxic conditions. Girard et al5 have shown how sprinting and small-sided games can be performed inside inflatable hypoxic marquees. …