Altitude Anxiety: The Challenge at Mexico City’s Legendary Stadium That Will Open the World Cup
When the national team players step onto the pitch tonight at Estadio Azteca in Mexico City, they will be facing not only 11 opposing players, but first and foremost a situation most of them are not used to, thin air. At an altitude of about 2,250 meters above sea level, Mexico’s capital presents one of the most fascinating physical and tactical challenges in world sport. The stars, the teams and the stories in one place: World Cup 2026, the special page. Estadio Azteca will host three group-stage matches, the opening game between Mexico and South Africa, Colombia against Uzbekistan, Mexico against the Czech Republic, and two more Round of 16 matches.
An intense match at an altitude of more than 2,000 meters brings with it hypoxia syndrome, a lack of oxygen. The heart has to beat faster even with slight exertion in order to supply oxygen to the muscles. Players feel shortness of breath, a burning sensation in the lungs and an accelerated pulse. There is also a drop in stamina. Players who are used to running 12 kilometers in a match will struggle to get past the 9-kilometer mark without complete exhaustion. Because of the thin air, the ball accelerates and “flies,” which is expected to be a nightmare for goalkeepers. Looking for a long-range golazo? Quite likely.
Vomiting, dizziness and dehydration
Dr. Osnat Shtrichman, a senior physician who heads the pulmonary and allergy unit at Beilinson Hospital, explains: “Altitude differences affect both the players and the movement of the ball. For the players, there is a difference between performing a quick sprint, whose energy requirement is based on anaerobic effort, and long-term performance that requires endurance. It is harder for players who are not familiar with this climate.
“The oxygen level is lower, endurance is more difficult, and the main difficulty will not be at the start of the match but in the later stages. Performance is less good and less sharp, the effort is harder and recovery takes longer. It is very hard to stay focused in normal conditions in the closing minutes because less oxygen reaches the brain, and that is much more significant when playing at more than 2,000 meters above sea level.”
So how can you prepare for a match like this?
“FIFA itself issued a memo suggesting that teams arrive in such areas earlier in order to acclimatize to the altitude. There is a possibility of developing altitude sickness, which brings with it exhaustion, vomiting, dizziness and dehydration at a higher rate, so if you adapt to the place it makes things easier for the athlete. In addition, there is a need to double water intake, make sure to eat properly and sleep well. The idea is that the body will accommodate the new environment.”
Are there teams that could benefit from these conditions?
“The biggest winners will be Scandinavian countries that are familiar with such altitudes, and of course the locals such as Mexico and others from South America. I estimate we will see a difference between teams that made the adjustments for the altitude and those that did not do their homework properly.”
Overload on the players
It should be noted that because of the effect of altitude, recovery time is also doubled. After a quick sprint, a player’s muscles produce lactic acid at an increased rate. Because of the lack of oxygen, it takes the body twice as long to return to balance.
Dr. Tomer Cohen, Beitar Jerusalem’s doctor and a senior physician in the orthopedic department at Beilinson Hospital, addressed the loads on footballers: “The World Cup is being played from Canada in the north to Mexico in the south, meaning long and tiring flights, especially since these players have only just finished appearing in European competitions and league battles. This raises the main question of how much these players can be loaded. The one who knows how to distribute forces and workloads will be the one who wins this World Cup, thanks to the combination of the medical staff on the physiological side and the coaches while anticipating injuries. Once you take players from one place to another, the muscle adapts and gets used to its environment, but it needs time.
“There is no doubt that FIFA is pushing the limits too far. Footballers take part in dozens of matches a year at high intensity and eventually break down. Today there is greater ability to monitor injuries, but in the end there are more injuries because the players are squeezed dry.”
