How do England prepare for playing at altitude against Mexico?

FIFA World

Cup 2026

The Azteca Stadium sits at the highest altitude of any World Cup venue in 2026 Hector Vivas/Getty Images

How do England prepare for playing at altitude against Mexico?

This article is part of The Athletic’s World Cup performance series, in which Alan McCall draws on more than 20 years of experience across elite football to explain the science behind the challenges teams are facing this summer and the strategies they will use to deal with them.

Here he examines Mexico’s altitude advantage, what it has produced in this tournament — and what their round-of-16 opponents England can learn from science and those who have faced altitude before.

Into thin air

Altitude is not new to the World Cup — but England are about to face one of its toughest tests. Mexico hosted matches above 5,000 feet in 1970 and 1986, as did South Africa in 2010. Yet one record spans all three tournaments and into 2026: Mexico have never lost a World Cup match at the Estadio Azteca.

Altitude means one thing above all else: thinner air. At higher elevations, the air still contains roughly the same proportion of oxygen, but it is less dense, meaning each breath delivers fewer oxygen molecules.

Less oxygen reaches the working muscles, recovery between intense efforts slows, and repeated high-intensity actions become harder to sustain. Sprint, press, change direction sharply, and the next sprint becomes harder to repeat with the same quality and intensity — not just in perception, but because the body simply cannot replenish oxygen to the muscles as quickly.

Within Mexico, the tournament’s three host venues are not equal. Monterrey, at around 500 metres (1,750 feet), sits low enough that altitude effects are likely negligible. Guadalajara’s Estadio Akron, at 1,566 metres (5,138 feet), is high enough for players to feel, but generally considered manageable. Mexico City’s Estadio Azteca, at 2,240 metres (7,350 feet), sits in FIFA’s moderate-altitude category — where physiological demands become more significant and preparation decisions genuinely matter.

For context, La Paz in Bolivia sits at 3,640 metres (11,960 feet), well into the high-altitude range. Lionel Messi once described playing there as “impossible”.

Dr Pablo Ortega Gallo, Boca Juniors’ long-time medical director, navigated it for decades. “If you play in La Paz, you try to arrive two hours before the match — straight from the airport to the stadium, finish the game and get out as soon as possible,” he says. “We put oxygen into the dressing room. You get out, play the game, then go.”

Mexico City is not La Paz. But its altitude matters.

What altitude does to a football match shows up in the data. At the 2010 World Cup in South Africa, teams covered around three per cent less ground above 1,200 metres (3,900 feet) — three kilometres less per match, which is small but significant. Match analysis from professional football also suggests around a quarter fewer explosive accelerations and decelerations at altitude than at sea level.

Perhaps the most telling outcome is goals. Analysis of 1,460 South American international matches spanning more than a century found altitude-adapted teams hold a real advantage of around half a goal per 1,000 metres (3,280 feet). In 2026, Mexico have made that advantage tangible: eight goals scored and none conceded across four matches at the tournament’s two altitude venues.

Recovery may be central to this. The repeated sprints, accelerations and changes of direction that define elite football all depend on recovering quickly between efforts. At altitude, that recovery takes longer — affecting both the ability to create attacks and to recover defensively.

Altitude does not necessarily reward fitness the way sea level does, as Dr Ortega Gallo attests: “I’ve seen teams pick their fittest players — the ones running hardest all season — thinking they’ll cope at altitude. Sometimes those players arrive and they can’t move. Nothing can predict physical performance at altitude.”

Science has yet to fully explain why some players adapt quickly while others struggle badly — making prior exposure and practitioner knowledge arguably as important as any preparation strategy. For England arriving at the Azteca in the round of 16, that prior exposure simply does not exist.

One more thing visiting players may not see coming is that the air at altitude is significantly drier, and the nights are harder. Professor Shona Halson, one of the world’s leading researchers in athlete sleep and recovery, notes that “night-time awakenings are relatively common at this altitude range, and that sleep apnoea is likely to be exacerbated in those who already experience it”.

Altitude has one further twist: thinner air means less resistance, so the ball travels faster, flies further and curves less. “Sometimes you’ll see a player try a little chip and the ball just flies,” says Paul Balsom, who spent 26 years with Sweden’s national team. The gap likely comes down to familiarity. Which is perhaps why the one thing practitioners agree on is this: get at least one session in beforehand. Feel it once. Don’t discover it at kick-off.

Catching their breath

For Mexico, whose base camp sits 15 minutes from the Azteca, thin air is not a challenge to manage; it is simply home. Their squad has trained and competed at altitude throughout their careers, and even those based in European leagues will largely be returning to conditions they grew up in.

The advantage has been clear. Mexico have won every match at altitude in this tournament, playing all four matches on home soil at the Azteca or in Guadalajara. That is not to say altitude places no physiological demand on them — it does. But familiarity, and bodies conditioned over years to perform in it, represents a significant competitive advantage over visiting teams arriving from sea level. One more match at the Azteca remains, against England.

For those who have faced Mexico at altitude, the experience tends to stay with them. Former France defender Bacary Sagna, whose squad undertook an altitude training camp in the French Alps before the 2010 World Cup in South Africa, still recalls France’s 2-0 defeat to Mexico in Polokwane — at 1,312 metres (4,300 feet), well below the Azteca.

“The Mexico players are used to it; they are born in it,” Sagna said. “Even though we prepared, I still found it difficult — short of breath. You have to prepare differently and plan for the game differently. I had the feeling they were running everywhere and we couldn’t.”

For most teams, those preparation decisions were made before the tournament. But for England, facing Mexico at the Azteca on Sunday after arriving from sea level in Atlanta with just four days between matches, the question is different — not how to prepare over weeks, but how to manage days.

If a team knows it will play at moderate altitude, the evidence is relatively consistent: arrive early and adapt there. FIFA’s expert consensus recommends around one to two weeks for Mexico City’s altitude, with more recent research broadly supporting that timeframe for meaningful physiological adaptation.

That approach has a name: live high, train high (LHTH). Go to the place you will play, live there, train there, and the body gradually adapts.

But living high and training high is now just one option in a larger toolbox. Live high, train low (LHTL) is widely considered the gold standard. Research suggests 10 to 14 days can increase haemoglobin mass by up to four per cent. The challenge is logistics: true LHTL requires altitude bedrooms or hypoxic chambers that only the best-resourced federations can realistically access. As Dr Ortega Gallo puts it bluntly: “Live high, train low might be the gold standard — but where on earth do you find a place or facility that does that?”

Live low, train high (LLTH) is probably the most accessible option — players stay at sea level while completing targeted sessions in simulated altitude environments, from altitude chambers to portable hypoxic units pitch-side.

Where LHTL works through the blood, LLTH works through the muscles, training them to use oxygen more efficiently. Sessions typically involve cycling, running or repeated sprints in a chamber or with hypoxic units — and the most football-specific version, repeated-sprint training in simulated altitude conditions, has been shown to improve agility and direction-change performance beyond equivalent sea-level training.

The attraction is flexibility — LLTH can be integrated at home, during a pre-tournament camp or from a sea-level base camp, and many universities and national institutes already possess altitude chambers. But every session in a chamber or with a hypoxic unit is time not spent on the training pitch. What England have done behind closed doors in the lead-up to this match remains unknown.

Get in, get out (GIGO) is the fourth option — less a formal preparation strategy than a practical response to tournament reality. Once the World Cup is underway, teams no longer have weeks to prepare — only days. England now have just four days between beating DR Congo in Atlanta and facing Mexico at the Azteca: too short for meaningful adaptation to altitude, but long enough to experience some of its disruptive effects. The question, therefore, shifts from how to adapt to when to arrive.

Practitioners who have navigated this firsthand offer different solutions. Dr Ortega Gallo’s recommendation is pragmatic: “Arrive one to two days before the match. You shouldn’t have digestive problems or sleeping issues. You have the chance to do a full training session — to get used to the ball. Maybe a player gets a headache, but give them an ibuprofen — it’s relatively simple to deal with.”

Paulo Victor Gomes, who spent three seasons as an assistant coach at Club América, became more cautious after watching one visiting team arrive almost a week before a match in Pachuca — at 2,430 metres, higher even than the Azteca — complete with oxygen masks and an elaborate preparation plan, only to fade badly. “The less time at altitude, the better,” he says. “But one training session before the match may be important. Not only to get a feel for the ball, but also just to feel the altitude before you have to play.”

What You Should Read Next How World Cup teams cope with travel, lack of sleep and accumulated fatigue Performance expert Alan McCall explains how World Cup teams will try to keep their players fresh in the knockout stages

Balsom and his staff at Tigres took a different view, settling on three days before the 2026 CONCACAF Champions Cup final in Toluca, at 2,670 metres — higher even than the Azteca. “The key was finding a solution that had buy-in from all the major stakeholders: players, coaches, medical and performance staff. It was important everyone understood the plan.”

Three days meant that if altitude disrupted sleep in the first night or two, there would still be time to manage it before match day. Toluca took the lead in the 104th minute of extra time before Tigres equalised 10 minutes later to force penalties. “From a physical perspective, it certainly did not feel as though we were inferior to our opponents at any point during the game,” says Balsom.

Professor Lee Taylor, one of the world’s leading environmental exercise physiologists at Loughborough University, takes a slightly different perspective. Drawing on the best available physiological evidence — much of it from endurance athletes, as direct research in elite football remains limited — he confirms that GIGO is not about achieving meaningful adaptation but avoiding the period when altitude begins to impair performance.

From that evidence, Taylor suggests there may be only a brief window after arrival before those effects become more pronounced. “I think 36 hours is probably the upper threshold of GIGO,” he says. “Forty-eight hours onwards… may be too late.” His interpretation of the evidence would favour arriving on the morning of the match, competing, and leaving immediately afterwards.

The differing recommendations reflect different priorities as much as different evidence. For practitioners like Balsom, the solution has to balance physiology with sleep, logistics, training and coach buy-in. Taylor’s perspective focuses more narrowly on the physiological consequences of altitude itself. What unites them is not the timing but the principle: don’t let players experience altitude for the first time at kick-off. Whether that means one or two training sessions beforehand or, as Taylor argues, simply the pre-match warm-up remains uncertain.

Individual responses vary, and the evidence remains limited. In a World Cup, where preparation time is measured in days rather than weeks, the decision is less about finding the perfect solution than choosing the least imperfect one.

No perfect plan

Mexico arrive at this round of 16 fresher, more familiar with their surroundings and with less travel behind them than England. Unbeaten at the Azteca across three World Cups, with eight goals scored and none conceded across Mexico’s altitude venues in this tournament, they have played every match on home soil and enjoyed the recovery advantages that come with a permanent base just 15 minutes from their stadium.

The altitude is only part of it. The crowd, the familiarity, the accumulated physical and mental freshness — all of it points in one direction: a competitive advantage for Mexico.

England have the science, the staff and the resources to make the most of whatever window they decide to use over the next four days. But the Azteca on Sunday will test something science still cannot fully predict. Preparation can reduce the challenge. It cannot remove it.

As Bacary Sagna put it after facing Mexico, “The way you have to play, you have to adapt.”

England have four days to prepare. On Sunday, adaptation will likely matter more than preparation.

Connections: Sports Edition

Spot the pattern. Connect the terms

Find the hidden link between sports terms