Role of Hyperbaric Oxygen Therapy in Athletics and Sport Injuries

Role of Hyperbaric Oxygen Therapy in Athletics and Sport Injuries

Role of Hyperbaric Oxygen Therapy in Athletics and Sport Injuries

Athletics and Sport Injuries

Running, jumping, throwing, and walking competitions are all included in the sport of athletics. Athletics includes a variety of competitions in running, walking, leaping, and throwing activities. It is also known as track and field sports. 

The phrase “sports injury” describes the different injury types that are most frequently sustained while participating in sports or exercising, however, they are not just for athletes. However, “sports injuries” ultimately refer to those that affect those who are active. The most typical kinds of sports injuries—those to the musculoskeletal system—are the subject of this health issue. The network of muscles, tendons, ligaments, bones, and other tissues known as the musculoskeletal system gives the body its stability and permits movement. Acute and chronic injuries are the two main classifications of sports injuries. Acute injuries occur suddenly, such as when someone trips, gets struck or bends a joint, but chronic injuries typically arise from overusing a particular body part and manifest progressively over time. Sprains and dislocations are examples of acute injuries, whereas stress fractures and shin splints are examples of chronic injuries [1].

Types of Sports Injuries

Different sports injuries result in various symptoms. After suffering from several injuries, many athletes lose sight of what it feels like to feel “normal.” Consider the frequency with which baseball players develop chronic shoulder or elbow discomfort, swimmers experience a swimmer’s shoulder, soccer players sustain anterior cruciate ligament (ACL) tears, and football players sustain concussions. The most typical forms of sports injuries consist of:

1. Sprains: A sprain happens when the ligaments are overextended or torn. Ligaments are strands of connective tissue that hold two bones together in a joint.

2. Strains: A sprain happens when muscles or tendons are overextended or torn. Tendons, which connect bone to muscle, are substantial, fibrous strands of tissue.

3. Knee problems: Any injury that restricts the knee joint’s motion may qualify as a sports injury. It may be anything from an over-stretch to a tear in the knee’s tissues or muscles.

4. Swollen muscles: A natural response to an injury is swelling. Muscles that are swollen may also hurt and be feeble.

5. Achilles tendon rupture: At the rear of your ankle, there is a strong, thin tendon called the Achilles tendon. This tendon may rupture or break when playing sports. 

6. Fractures: Broken bones are another name for bone fractures.

7. Dislocations: A bone in your body could dislocate due to a sports injury. A bone is yanked out of its socket when that occurs.

8. Rotator cuff injury: The rotator-cuff is made up of four separate muscles. Your shoulder may move in any direction thanks to the rotator cuff [2].

How to Prevent Sports Injuries?

  • Warm-up 
  • Put on the proper footwear.
  • If required, tape or strap your joints that are at risk.
  • Use the proper safety gear
  • Make sure to stay hydrated 
  • Try to avoid working out between 11 am and 3 pm when it is the hottest time of the day.
  • Keep your general fitness at a high level
  • Cross-train with various sports.
  • Make sure your workouts involve the proper amount of impact and speed work so your muscles are prepared for the demands of a game.
  • Do not push yourself above your exercise capacity. Increase exercise time and intensity gradually.
  • Apply proper form and technique.
  • After exercise, stretch slowly and steadily to cool off.
  • Give yourself some time to rest between workouts.
  • Have routine medical exams.

Hyperbaric Oxygen as Effective Medicine for Athletics and Sport Injuries

How does it work?

By administering pure oxygen under high pressure, hyperbaric oxygen treatment (HBOT) increases the amount of oxygen in the blood & tissues (hyperoxia) (about 2-3 atmospheres). One method of treatment involves being exposed to pure oxygen (O2) concentrations at high atmospheric pressures, or hyperbaric oxygen therapy (HBOT). According to the Undersea & Hyperbaric Medical Society, this pressure may be greater than or equivalent to 1.4 atmospheres (atm) (UHMS). For all current UHMS-approved uses, patients may only inhale oxygen when restrained in a space with a minimum air pressure of 2 ATA [4].

Hyperbaric oxygen treatment has been effective for professional football, basketball, and baseball players’ sports performance, injury recovery, and other purposes. Lebron James, Michael Phelps, and Tiger Woods are just a few of the thousands of athletes who utilize HBOT and have each stated that they have benefited from using a hyperbaric chamber. The CDC estimates that almost 3 million traumatic brain injuries are recorded each year. Nearly 10% occur when participating in sports.

How are athletes benefited by HBOT?

Athletes can recover from sports-related injuries and maintain their health with the use of hyperbaric oxygen therapy (HBOT), a potent anti-inflammatory and wound-healing accelerator. HBOT is given to professional athletes to aid in their recovery from a variety of problems, including joint discomfort, muscle tears, broken bones, and even concussions. Athletes who reside at sea level can imitate “living high” in the altitude chamber. An air unit circulates up to 150 litres of air per minute through the chamber as the person sleeps while also ejecting carbon dioxide. The body puts forth greater effort to create more red blood cells, boosting the amount of oxygen delivered to the muscles [5].

Skeletal muscles are modified by intense activity. However, athletes are suffering from increased soft tissue damage due to overuse and hard training. Extra oxygen is needed for prolonged muscle use. Your blood and tissues receive an oxygen boost with HBOT therapy. Your muscles can get to the oxygen more quickly as a result. There is no more efficient or effective technique to get this much oxygen into your cells. Studies confirm that HBOT speeds up myogenesis (the process by which muscle tissue is formed) in cases of soft tissue muscle injury, such as bruising [6]. Some athletes and famous people claim to have slept through the night in a hyperbaric chamber. However, you only need a few 2 hours at an absolute atmosphere (ATA) of 1.5 to 3 to start experiencing the advantages of HBO therapy.

Numerous advantages of hyperbaric oxygen therapy for athletes include:

  • Improved by Increasing Physical Performance 
  • Mental Clarity
  • Enhanced Sleep
  • Decreasing Soreness
  • Healing Inflammation and post-injury swelling
  • Heightened energy
  • Heal faster and reduce recovery time

HBOT works by significantly reducing inflammation, enhancing stem cell release and activation, improving vascular flow, repairing bone and cartilage, and preventing the formation of scar tissue.

In a recent analysis, HBOT was also demonstrated to be effective when combined with platelet-rich plasma, stem cell injections, and other therapies for even faster recovery from concussions and other sports-related ailments [7].

A 2014 study also discovered that HBOT can enhance the healing potential of stem cell therapy, a procedure used by professional athletes to recover from injuries. Another 2015 study found that combining exercise rehabilitation with HBOT and blood platelet injection therapy sped up rugby players’ recovery times, allowing them to return to the field sooner [8].

The following two ways that hyperbaric oxygen therapy speeds up the healing of wounds:

1. Angiogenesis

Angiogenesis is often known as the development of new blood vessels. While tissue angiogenesis occurs in reaction to hypoxic, or low oxygen conditions, and this is what happens soon after HBOT, collagen deposits rise under hyperoxygenation. The largest angiogenic stimulation occurs in metabolic tissues like the muscles, liver, and fat, and changes between hyperoxia and hypoxia are crucial for boosting the vasculature in our bodies.

2. Collagen Buildup

As was previously mentioned, increased collagen deposition in tissues promotes capillary formation, creating the foundation for the angiogenic circumstances that develop after the hyper oxygenated conditions of HBOT.

It is believed that increased angiogenesis and tissue collagen levels after injury are what cause hyperbaric oxygen therapy to have positive effects on an athlete. Since they can increase blood flow and nutrient transfer to places that require it most, these factors are thought to play a crucial role in the recovery process following soft tissue (or muscle) injury [9]. 



According to a 2007 study from a Japanese research team, muscle stiffness, oedema, and pain scores were dramatically decreased when athletes with muscle injuries incurred during physical exercise were subjected to HBOT for an hour within 7 days of injury [10].

One of the most vocal HBOT practitioners is Joe Namath. After retiring from NFL sports, Namath started using HBOT to treat the effects of many concussions on his cognitive function. Namath examined the damage to his brain before, during, and after HBOT sessions using SPECT scans. Namath exhibited improvements in the flow of blood to his brain following 40 HBOT sessions. His SPECT scans after 120 treatments revealed normal brain blood flow.

In a rabbit model, Wang and colleagues were able to show that distraction segments of animals treated with HBOT had higher bone mineral density and superior mechanical properties compared to the controls and produced better results when used during the initial stages of the healing process of the tibia. Researchers looked examined how HBO affected the tendon-bone junction’s neovascularization, the collagen in the tendon graft, and the tendon graft’s interface with the bone, which is incorporated into the osseous tunnel. 40 rabbits were employed in the study, and they were split into two groups: the control group, which was kept in cages with regular air, and the HBO group, which was exposed to 100% oxygen at 2.5 ATA for two hours every day for five days. The amount of trabecular bone surrounding the tendon graft was much higher in the HBO group, boosting its integration into the bone and, consequently, the tensile loading strength of the tendon transplant. They postulated that HBO aids in blood vessel angiogenesis, boosting blood flow, which results in the outcomes they saw [11].

Human Trials of HBOT for sports injuries 

Soolsma investigated the impact of HBO on the healing of the grade II medial ligament of the knee that was present in patients within 72 hours of damage in a randomized, controlled, and double-blind research. The data suggested that, at 6 weeks, HBO had positive effects on pain and functional outcomes, such as decreased volume of oedema, a better range of motion, and an improvement in maximum flexion, compared with the other group, after one group was exposed to HBO at 2 ATA for 1 hour and the control group at 1.2 ATA, room air, for 1 hour [12].

In a fascinating study, 32 patients with acute ankle sprains were studied by Borromeo and colleagues to see if HBO affected their recovery. In the first session, the HBO group was exposed to 100% oxygen at 2 ATA for 90 minutes, and in the following two sessions, it was for 60 minutes. The placebo group underwent three 90-minute bouts of ambient air at 1.1 ATA during seven days. Joint performance improved in the HBO group [13].


[1]. R. D. Hawkins, M. A. Hulse, C. Wilkinson, A. Hodson, and M. Gibson, “The association football medical research programme: an audit of injuries in professional football,” British Journal of Sports Medicine, vol. 35, no. 1, pp. 43–47, 2001.

[2]. Hadanny A, Efrati S. The hyperoxic-hypoxic paradox. Biomolecules. 2020;10(6).


[3]. Holloszy JO. Biochemical adaptations in muscle. Effects of exercise on mitochondrial oxygen uptake and respiratory enzyme activity in skeletal muscle. J Biol Chem. 1967;242(9):2278–82.



[4]. J. Huard, Y. Li, and F. H. Fu, “Muscle injuries and repair: current trends in research,” The Journal of Bone & Joint Surgery, vol. 84, no. 5, pp. 822–832, 2002.

[5]. J. Fulton, K. Wright, M. Kelly et al., “Injury risk is altered by previous injury: a systematic review of the literature and presentation of causative neuromuscular factors,” International Journal of Sports Physical Therapy, vol. 9, no. 5, pp. 583–595, 2014.


[6]. Chiu CH, Chang SS, Chang GJ, Chen AC, Cheng CY, Chen SC, Chan YS. The Effect of Hyperbaric Oxygen Treatment on Myoblasts and Muscles After Contusion Injury. J Orthop Res. 2020 Feb;38(2):329-335. doi: 10.1002/jor.24478. Epub 2019 Oct 6. PMID: 31531986.


[7]. Cabric M, Medved R, Denoble P, Zivkovic M, Kovacevic H. Effect of hyperbaric oxygenation on maximal aerobic performance in a normobaric environment. J Sports Med Phys Fitness. 1991;31(3):362–6.


[8]. T. Jarvinen, M. Jarvinen, and H. Kalimo, “Regeneration of injured skeletal muscle after the injury,” Muscle Ligaments and Tendons Journal, vol. 03, no. 04, p. 337, 2019


[9]. Y. Ishii, M. Deie, N. Adachi et al., “Hyperbaric oxygen as an adjuvant for athletes,” Sports Medicine, vol. 35, no. 9, pp. 739–746, 2005.


[10. M. Horie, M. Enomoto, M. Shimoda, A. Okawa, S. Miyakawa, and K. Yagishita, “Enhancement of satellite cell differentiation and functional recovery in injured skeletal muscle by hyperbaric oxygen treatment,” Journal of Applied Physiology, vol. 116, no. 2, pp. 149–155.

[11]. Wang I.-C., Ueng S.W.-N., Yuan L.-J., Tu Y.-K., Lin S.-S., Wang C.-R., et al. (2005) Early administration of hyperbaric oxygen therapy in distraction osteogenesis: A quantitative study in New Zealand rabbits. J Trauma Injury Infect Crit Care 58: 1230–1235


[12]. Soolsma S.J. (1996) The effect of intermittent hyperbaric oxygen on short term recovery from grade II medial collateral ligament injuries. Thesis, University of British Columbia, Vancouver 


[13]. Borromeo C.N., Ryan J.L., Marchetto P.A., Peterson R., Bove A.A. (1997) Hyperbaric oxygen therapy for acute ankle sprains. Am J Sports Med 25: 619–625 


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