"Hyperbaric Oxygen Therapy for Athletes: What the Science Actually Says About Recovery"

Every athlete knows the feeling: a hard session is done, but the body needs days to recover. Muscle soreness, fatigue, stiffness — these are signs that the body is repairing itself. The question is whether and how we can support that process.

Hyperbaric oxygen therapy (HBOT), also known as barotherapy, is a method used by both professional and recreational athletes worldwide — and one whose results are scientifically proven.

What happens in the body after training?

Intense training causes micro-tears in muscle fibres. This is normal — it is precisely the repair of these micro-tears that makes muscles grow and strengthen. The problem is that the healing process triggers an inflammatory reaction that requires oxygen. However, blood — and with it, oxygen — reaches damaged tissue less efficiently, which slows down recovery.

How does hyperbaric oxygen therapy help?

Barokambris hingab sportlane kõrgendatud rõhu all (kuni 1,5 ATA) puhast hapnikku. See lahustab hapnikku verre kuni 10-15 korda rohkem kui tavatingimustes organism õhust hingates hapnikku saab. Tulemus on mitmetasandiline.

Normally, oxygen in the blood is carried mainly by haemoglobin — a protein inside red blood cells that works like a small oxygen taxi. But haemoglobin fills up quite quickly and no more oxygen can fit into the red blood cells.

The increased pressure inside the hyperbaric chamber is precisely what makes the difference: oxygen dissolves directly into the blood plasma — the liquid part of the blood that flows around the blood cells. Now it is no longer just a single taxi, but the entire street is full of cars transporting oxygen. Oxygen reaches even those cells and tissues that normally receive less of it under standard conditions.

But what exactly happens inside the cell?

Mitochondria: the body's power plants

Every cell contains mitochondria — tiny cellular organelles whose sole purpose is to produce energy. The more mitochondria your cells contain and the more efficiently they work, the more energy you can produce. Without sufficient oxygen, the energy production process slows down, the cell switches to a less efficient process and the body fatigues more quickly.

Hyperbaric oxygen therapy (HBOT) gives the mitochondria a rich dose of oxygen. And research shows that the effect is not merely temporary.

In 2022, a study was published in the journal Sports Medicine Open an interesting study involving 37 middle-aged elite athletes. Participants were divided into two groups: half completed 40 hyperbaric oxygen therapy (HBOT) sessions, while the other half received placebo therapy.

It may seem that a placebo in hyperbaric therapy is difficult to achieve — and it is. The study solved this as follows: the actual therapy group was in an environment with a pressure of 2.0 ATA and breathed 100% pure oxygen. The placebo group, however, used half the pressure and regular air (which contains approximately 21% oxygen). This means that some effect was also present in the placebo group.

The results were remarkable. The HBOT group showed significant improvement in VO₂max — the maximum oxygen uptake capacity, considered one of the most important indicators of endurance. In addition, oxygen consumption at the anaerobic threshold increased.

The most important findings, however, came from muscle biopsies. The mitochondrial mass indicator increased and oxidative phosphorylation capacity improved. This suggests that new mitochondria were formed in the body and existing mitochondria began to work more efficiently. In practical terms, this means more energy from the same amount of oxygen, faster recovery and better endurance.

But even the most efficiently working cell cannot reach its full potential if the surrounding environment is inflamed. And that is precisely what often happens in an intensively training body.

Chronic inflammation and recovery

Every training session triggers a small inflammatory response in the body — this is a natural part of recovery and adaptation, through which muscles become stronger and more resilient.

Kui aga koormus on järjepidevalt kõrge ja organismi ei jõua taastuda, ei pruugi ka põletik enam täielikult taanduda. Organism püsib justkui pidevas stressiseisundis ning immuunsüsteem hakkab tootma üha rohkem tsütokiine — väikseid signaalvalke, mis juhivad põletikulist reaktsiooni. Lühiajaliselt on see vajalik ja toetab kohanemist, kuid krooniliselt kõrgenenud põletikutase võib hakata töötama organismi vastu: taastumine aeglustub, lihasfunktsioon halveneb ning vigastuste risk suureneb (Peake J.M. et al., 2017).

A person typically feels this as not feeling rested after a night's sleep, the body feeling heavy and tired, and athletic performance plateauing.

Several studies show that HBOT directly influences the levels of inflammatory markers. A 2023 study involving young athletes confirmed that following an HBOT course, various inflammatory markers decreased and oxidative stress was significantly reduced (Alessio H.M. et al., 2023). Bhutani S. & J. in their 2021 article found that HBOT reduces inflammation while simultaneously promoting angiogenesis — the formation of new blood vessels.

Recovery from muscle damage

A meta-analysis published in 2025 shows that hyperbaric oxygen therapy (HBOT) may play an important role in recovery from exercise-induced muscle micro-damage. The analysis covered 10 studies and 299 participants, and the results confirmed that hyperbaric therapy accelerates muscle tissue recovery compared to standard recovery. The studies used various approaches — mostly 60- and 100-minute hyperbaric therapy sessions — and found that longer sessions of approximately 100 minutes produced a stronger effect.

Interestingly, hyperbaric therapy was effective at both lower (≤2.0 ATA) and higher (>2.0 ATA) pressure levels, suggesting that the benefit does not depend solely on maximum pressure. At the Oxygen Therapy Center, we most commonly offer hyperbaric therapy at 1.5 ATA. An important nuance, however, is that while hyperbaric therapy supports muscle recovery and reduces tissue damage, it may not always reduce muscle soreness at the same pace. This means the body may recover faster even if the muscles still feel sore (Luo X. et al.). At the same time, Gušić M., Stantić T., Lazić A. et al. (2024) found that even after a single hyperbaric therapy session, an athlete may notice a significant improvement in how they feel.

Hyperbaric therapy for injuries

So far we have discussed how hyperbaric therapy enhances mitochondrial function, reduces inflammation in the body and helps recover from muscle micro-damage. Hyperbaric therapy can also be beneficial when an injury is already present.

The most common injuries for which people seek hyperbaric therapy are ligament injuries — the knee, ankle and shoulder. And here the science is quite clear.

In 2024, a study was published in European Journal of Translational Myologya systematic review analysing all HBOT studies on ligament and tendon injuries between 1999 and 2024 (Leite C.B.G. et al., 2025). The review included both animal and human studies. Result: HBOT in addition to standard treatment accelerated the healing of ligament and tendon injuries compared to standard treatment alone.

The mechanism is logical: ligaments and tendons already receive less blood — and with it, less oxygen — than muscles. Following an injury, oxygen deficiency in these tissues is even greater — and it is precisely this that slows down healing. Through hyperbaric therapy, oxygen reaches areas that would not normally receive as much of it, and stimulates fibroblast activity, which is essential for collagen production.

In a Japanese rugby study (Yagishita K. et al., 2019), the recovery of professional and semi-professional players from knee ligament injuries was examined. Result: the hyperbaric therapy group experienced faster pain reduction and players returned to the field significantly sooner.

Hyperbaric therapy should be completed as a course

Most studies on hyperbaric therapy have been conducted using a course format, where a course may consist of 10, 20 or even 60 sessions. However, it has been found that an effect can also occur after a single session. In 2024, a study was published in the journal Frontiers in Physiology a study conducted with young football players. The study involved 20 higher-level young athletes who played a full 90-minute football match. Immediately after the match, half of the athletes received a 60-minute hyperbaric therapy session at 2.2 ATA and 100% oxygen, while the control group underwent the same procedure under placebo conditions. Gušić M., Stantić T., Lazić A. et al. (2024) found that even a single 60-minute HBOT session after a match can significantly improve how an athlete feels.

As the above shows, a single session can have an effect, but the best results are achieved by completing hyperbaric therapy as a course. For athletes, we recommend:

• Acute recovery (before or after a major competition or injury): 10–30 sessions;
• (nagu Kreete teeb): 10-20 seanssi kevadel ja/või sügisel: 1–3 times per week during a training cycle;
• Seasonal course (as Kreete does): 10–20 sessions in spring and/or autumn

Mida ütlevad Eesti sportlased?

Regulaarne baroteraapia võib pikemas perspektiivis parandada kardiovaskulaarset efektiivsust. Mitmed sportlased on märganud puhkeolekupulsi alanemist pärast regulaarset HBOT-kuuri — see on märk paremast südame-veresoonkonna seisundist ja aeroobsest võimekusest.

Kreete's experience reflects what science confirms: hyperbaric therapy is not just a recovery tool — it supports the athlete's health as a whole.

You don't have to be a professional athlete to come

We also have many clients who do not compete — but train regularly and simply want to improve how they feel.We also have many clients who do not compete — but train regularly and simply want to improve how they feel. And it is often they who have pointed out that hyperbaric therapy has helped relieve muscle cramps.

Recreational athletes also report improvements in performance and faster recovery — particularly those who train regularly but whose bodies are simply tired and where ongoing training load does not allow for proper recovery.

Hyperbaric therapy is not just for professional athletes. Whether you go running three times a week, do strength training or swim during your lunch break — you are just as welcome at the Oxygen Therapy Center.

Who is hyperbaric therapy suitable for?

Hyperbaric therapy is beneficial for all athletes — professional and recreational alike — who:

• Train intensively and find that recovery between sessions is too slow
• Are recovering from an injury — muscle tear, ligament injury or fracture
• Suffer from seasonal allergies that affect training
• Want to improve endurance and aerobic capacity in the long term
• Keha lihtsalt ei taastu enam nii nagu võiks
• Simply want to feel better

Book a session

The Oxygen Therapy Center is located in Tallinn at Sügise 5. We have two hard-shell hyperbaric chambers where you can rest, read or use your phone during the session. Sessions last approximately 60 minutes.

References

Alessio H.M. et al. (2023). Hyperbaric Oxygen Therapy Counters Oxidative Stress/Inflammation-Driven Symptoms in Long COVID-19 Patients. PMC/PubMed. https://pmc.ncbi.nlm.nih.gov/articles/PMC10608857/

Bhutani S. & Bhutani J. (2021). The Effects of Hyperbaric Oxygenation on Oxidative Stress, Inflammation and Angiogenesis. PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394403/

Gušić M., Stantić T., Lazić A. jt (2024). Effects of hyperbaric oxygen therapy on recovery after a football match in young players. Frontiers in Physiology.

Hadanny A. et al. (2022). Effects of Hyperbaric Oxygen Therapy on Mitochondrial Respiration and Physical Performance in Middle-Aged Athletes. Sports Medicine Open. https://pmc.ncbi.nlm.nih.gov/articles/PMC8825926/

Leite C.B.G. et al. (2025). Efficacy and safety of hyperbaric oxygen therapy in ligament and tendon injuries: a systematic review. European Journal of Translational Myology. https://pubmed.ncbi.nlm.nih.gov/41036684/

Luo X. et al. (2025). Effects of Hyperbaric Oxygen Therapy on Exercise-Induced Muscle Injury and Soreness: A Systematic Review and Meta-analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/40784513/

Yagishita K. et al. (2019). Effects of hyperbaric oxygen therapy on recovery acceleration in Japanese professional or semi-professional rugby players with grade 2 medial collateral ligament injury. Undersea and Hyperbaric Medicine. https://pubmed.ncbi.nlm.nih.gov/31683363/