Hyperbaric oxygen therapy for high performance athletes: a narrative review

Elite athletes who sustain severe injuries may experience physiological, psychological, and financial repercussions. Many therapies, including hyperbaric oxygenation (HBO₂), have been investigated as potential methods of preventing and treating injuries in elite athlete populations. This narrative review explores several applications of HBO₂ therapy relevant to athletes, based on the available human and animal literature. In animal studies, the administration of HBO₂ is associated with improved muscle healing after soft tissue injury. Although human studies are inconclusive, some data suggest that short courses of HBO₂ may result in reduced pain and faster return to play after soft tissue musculoskeletal injury. For individuals with sequelae of traumatic brain injury, limited data suggest that HBO₂ may improve neurobehavioral symptoms. However, studies involving the use of hyperbaric oxygen therapy to treat concussions in athletes are limited. Mild HBO₂ has been used to facilitate post-exercise recovery and reduce fatigue and performance decrements. The treatment vessels used to deliver mild HBO₂ are typically intended for treating altitude sickness only. They are associated with safety and regulatory concerns when used for other purposes, including athletic recovery. Overall, there is limited evidence to support the use of HBO₂ to enhance recovery in athletes with musculoskeletal and mild traumatic brain injury. Further investigations should explore the optimal use of this therapy in the elite athlete population.