England football team prepares to play at altitude

Image from FOX Sports

England plays Mexico at the Azteca Stadium, 2,240 metres above sea level.

While I'll admit I know nothing much about football, I do have experience preparing cyclists for competing at altitude. This is my take on it.

Tuchel came out and said adapting to the altitude in four days is "physically impossible." He is right about the timescale. I wonder how much altitude preparation the team has been doing leading into the knockout stages? The Azteca is the only high-altitude venue in the tournament. Any team progressing from England's side of the draw had a very real chance of facing a game there in the knockouts.

At 2,240m elite athletes can expect somewhere between a 5-10% drop in VO2max compared to sea level and the fitter you are, the larger the relative hit, because elite athletes operate closer to their physiological ceiling. Distance covered per player also drops. In cycling we talk about altitude constantly. Grand Tour climbs regularly top 2,000m and the Azteca sits at the same height as a mountain stage finish in the Alps or Pyrenees. In cycling we plan for this months in advance.

What actually kills you in a football match at altitude is repeated sprint capacity, the ability to recover between high intensity efforts. That goes first. The pressing, the runs in behind, the tracking back. All of it becomes harder. A former West Ham player who played at the Azteca put it simply: "You cannot catch your breath. The first 45 to 55 minutes you're just trying to keep breathing."

Why this happens and why the timing is the worst possible for England.

When you arrive at altitude, plasma volume drops rapidly within the first 24-48 hours as the body loses fluid through increased urination and respiratory water loss. The result is thicker blood and a higher heart rate at the same workload, not a beneficial adaptation, but an acute stress response that makes everything harder before the body has had time to adapt.

On top of that, the dry thin air at altitude massively increases dehydration, you're breathing faster, losing more moisture with every breath. Even 2% dehydration measurably reduces performance.

Then there's alkalosis. The body's immediate response to low oxygen is to breathe faster, which blows off CO2 and shifts blood pH. Until the kidneys compensate, a process that takes several days, players can feel dizzy, nauseous and flat. The first few days at altitude is the worst window to compete in. England are flying in Friday for a Monday game. That's almost perfectly timed to land them right in the middle of it.

The ball.

At 2,240m the air is approximately 23% less dense than at sea level. The ball travels faster, flies further than the players are used to. Goal kicks and long passes will carry noticeably further than players are used to. Shots arrive at the goalkeeper quicker. Mexico's players will be used to this, they've played every game of this tournament there. England's aren't.

What could England have done differently?

England arrived in Florida on 1 June. The Mexico game is 6 July. That's 35 days in the US. The meaningful haematological adaptations from altitude exposure, increased red blood cell mass, haemoglobin mass, take a minimum of three to four weeks to build. Colorado Springs sits at 1,840m and is home to the US Olympic Training Center. Santa Fe, New Mexico is at 2,100m. Both have world class facilities. Both are in the US. Based there for the group stage, travelling down to sea level for matches, England would have arrived at the Azteca already largely adapted. Instead they chose Kansas City at 270m. The wrong call if you looked at the draw and saw Mexico City in the knockouts.

To be fair, England reportedly have been using hypoxic tents in camp. Two to three weeks of tent exposure produces a real if modest stimulus. We don't know the protocol they have been using. With athletes in the past I have aimed for 10-12 hours per day for at least 3 weeks.

Three legal, evidence-backed interventions worth mentioning.

Beetroot juice, dietary nitrate, is actually the best evidenced of the three at this specific altitude.

Sodium bicarbonate. At altitude the kidneys excrete bicarbonate as they try to correct alkalosis, which reduces the blood's buffering capacity exactly when you need it most for repeated sprint efforts. Bicarb supplementation partially restores that buffer.

Viagra. This always raises eyebrows but the science has a genuine basis. At altitude, pulmonary arteries constrict in response to low oxygen, this increases resistance, puts greater strain on the right side of the heart, and downstream reduces cardiac output. Sildenafil acts as a vasodilator, counteracting that constriction. The clearest evidence for performance benefit sits above 3,800m rather than 2,240m, so I wouldn't overstate it for Monday specifically, but the mechanism is real. (Not medical advice, before anyone starts.)

It is an interesting topic and it is worth saying - I am sure the FA considered basing the team at altitude and there are real drawbacks to that decision. Training quality drops, recovery slows, not every player responds well, and crucially the group stage games were all at sea level, so you'd potentially be compromising three guaranteed games to prepare for a knockout fixture that wasn't certain. The logistics of travelling from Colorado or Santa Fe to Dallas, Boston and New Jersey for group games adds another layer of complexity. It wasn't an irrational decision. It was a trade-off. You could just argue the probability of ending up at the Azteca was high enough to weight it differently.

I can't see England winning if I'm being honest. But I hope I'm wrong.