Why Athletes Should Consider Hyperbaric Oxygen Therapy (HBOT)

Injured or heavily loaded tissues often experience relative hypoxia, where oxygen supply does not fully meet demand. This can slow healing processes and prolong recovery time. But by increasing the amount of dissolved oxygen in the blood plasma, HBOT enhances oxygen diffusion into tissues that may otherwise be poorly perfused [12].

Looking at How Hyperbaric Oxygen Therapy Works

During HBOT, individuals breathe near-100% oxygen inside a chamber pressurised above normal atmospheric levels. This combination dramatically increases the amount of oxygen dissolved directly into the bloodstream, independent of haemoglobin [3][4].

As a result, oxygen can penetrate deeper into tissues, including muscles, tendons, ligaments, and cartilage. Elevated tissue oxygen levels are associated with enhanced cellular metabolism, improved mitochondrial efficiency, and activation of repair pathways involved in tissue regeneration [3][4]. Research indicates that hyperbaric oxygen exposure can stimulate the release of growth factors, support fibroblast activity, and enhance collagen production – all of which are relevant to musculoskeletal recovery [3][4][13][14]. It may also support angiogenesis, improving microcirculation and long-term tissue oxygenation [15].

For athletes, these effects are particularly relevant during periods of intensive training, competition congestion, or rehabilitation, where recovery capacity can be a limiting factor.

Examining the Evidence in Athletic and Sports Medicine Contexts

HBOT has been studied across a range of clinical and performance-related settings, including sports medicine, orthopaedics, and rehabilitation science. Evidence suggests that HBOT may support recovery from muscle damage, reduce perceived fatigue, and enhance tissue repair when integrated appropriately into training programmes [16]. Studies exploring muscle recovery following intense exercise have reported improvements in markers of muscle soreness and functional recovery when HBOT is used during the post-exercise period [4]. These findings suggest that enhanced oxygen delivery may accelerate the resolution of exercise-induced muscle stress.

For example, in elite youth footballers, just a single one-hour HBOT session post-match was shown to lower the Hooper Index (wellbeing/fatigue score) to 8.6 ± 2.41 versus 11.0 ± 3.23 in controls.

In injury-focused research, HBOT has been shown to support healing in soft tissue injuries, bone stress injuries, and tendon-related conditions by promoting oxygen-dependent repair processes [4][18]. While HBOT is not a substitute for structured rehabilitation, it may act as a supportive adjunct that enhances the body’s natural recovery response. While outcomes may vary depending on timing, frequency, and individual physiology, the importance of personalised application rather than routine or indiscriminate use is clear.

For example, a study of just mild HBOT in male university athletes found that after six daily 90-minute high-intensity cycling sessions, the treatment group showed significantly faster drops in perceived exertion (by post-6 intervention) and muscle damage markers like creatine kinase compared to controls, enabling a quicker return to baseline fitness [19].

Recognising Performance, Recovery, and Resilience Benefits

For athletes, recovery is not simply about returning to baseline but about adapting positively to training stimuli. Efficient recovery allows higher-quality training sessions, reduced cumulative fatigue, and more consistent performance over time.

By supporting cellular energy production and tissue repair, HBOT may help athletes tolerate higher training volumes or intensities with less residual fatigue [4]. This can be particularly valuable during competition phases or periods of condensed scheduling, where recovery time is limited. HBOT may also support neurological recovery. Oxygen availability is critical for brain metabolism, and some athletes report improvements in mental clarity, focus, and perceived readiness following treatment. It has even been trialled in supporting cognitive improvement following brain injuries [20].

Considering Which Athletes May Benefit Most

Over the long term, strategies that enhance recovery efficiency may reduce injury risk by limiting the accumulation of unresolved tissue stress and fatigue. Those returning from injury may also find HBOT helpful as part of a comprehensive rehabilitation plan, supporting tissue repair alongside physiotherapy and progressive loading. Endurance athletes, team sport players, and strength-based athletes all place distinct demands on the body, and HBOT protocols can be tailored accordingly [3][4].

However, response to HBOT is influenced by several factors, including training load, recovery capacity, injury status, and overall metabolic health [3][4]. Athletes undergoing high training volumes, intensive competition schedules, or repeated mechanical loading may derive particular benefit from enhanced recovery support. Lifestyle and nutritional status also influence responsiveness. Adequate protein intake, micronutrient sufficiency, hydration, and sleep are all essential for tissue repair [21]. When these foundations are in place, adjunctive therapies such as HBOT are more likely to deliver meaningful benefits.

Supporting Results Through an Integrated Performance Strategy

HBOT is most effective when integrated into a broader performance and recovery framework. Training load management, sleep quality, nutrition, and structured rehabilitation remain central pillars of athletic health. Athletes who view recovery as an active, multi-faceted process – rather than a passive absence of training – are often better positioned to sustain performance and reduce injury risk over time.

When used strategically, HBOT may help create a more favourable internal environment for recovery, allowing athletes to better engage in physiotherapy, strength training, and conditioning work [3][4]. Rather than replacing established recovery practices, it complements them by addressing cellular oxygen availability. This integrated approach aligns with contemporary sports science principles, which recognise that long-term performance is built through consistency, adaptability, and resilience rather than short-term gains alone.