Craig Pickering

The altitude problem: preparing for performance on the top of the world

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Preparing for the World Cup means preparing for some of the most unique demands in sport. In this multi-part series I’m breaking down each one in detail, starting with an article on preparing for heat and humidity that could influence performance at the 2026 FIFA World Cup. This article looks at another environmental factor: altitude.

The impact of altitude

The matches in Guadalajara (1566m of elevation) and Mexico City (2240m) take place at moderate altitudes. To put that in perspective, any performance above 1000 meters in athletics is noted as a potentially assisted performance for speed and power events. Altitude influences performance in football; teams based at altitude gain roughly 0.5 goals per game for every 1000m of altitude compared to low-altitude teams, and which has caused controversy in the past. Playing at altitude reduces aerobic capacity (due to a reduced partial pressure of oxygen), which in turn leads to impaired recovery and greater levels of fatigue. Research has shown that VO2max decreases by between 7-8% for every 1000m above 1500m of altitude; other research in football, from the 2010 World Cup, highlighted that playing above 1200m saw a degradation in running performance, but not technical skills. Overall, playing at altitude saw almost a 21% decrease in high velocity running, and up to a 9% decrease in total distance covered. Like the effects of heat, the negative effects on performance of altitude can be mitigated by prior preparation – and can even provide a benefit. 

Preparing for altitude

Traditionally, altitude training has been comprised of live high, train high (LHTH) and live high, train low (LHTL) models. In LHTH, athletes live and train at altitude (typically between 1600-2500m) for 2-4 weeks. This promotes a variety of physiological adaptations, including increased haemoglobin mass and improvements in VO2max. The downside of LHTH is that, by training at high altitudes, training quality is often significantly compromised. This is where LHTL comes in; here, athletes spend the majority of their time at altitude, but come down to sea level for their important training sessions—allowing session quality to be maintained. This approach has been shown to be effective in footballers, enhancing their overall performance. 

A recent review paper, prepared for the 2026 World Cup, highlighted some innovative altitude preparation strategies. These included live low, train high (LLTH), where players live near sea level, but train at altitude. This allows players to maintain their normal routines, but also maintain their sleep quality – when at altitude, sleep quality tends to degrade. Players can then utilise targeted hypoxic training sessions for 45-90 minutes, at moderate altitude, 2-5 times per week. If this training is just physical focused (e.g., without the ball), then it could even occur in an altitude chamber. A common training method when in hypoxic (i.e., altitude) conditions is repeated sprint training, which has been shown to enhance neuromuscular efficiency and fatigue resistance. Hypoxic training appears to convey adaptations of its own; in one study, players who undertook ten repeated sprint sessions in hypoxia over 5 weeks saw greater improvements in agility than players who did the same training at sea level. 

Another innovative method is live high, train low and high (LHTL+H). This provides the aerobic benefits of large amounts of time at altitude with the neuromuscular and anaerobic benefits on training at sea level. 

Based on the research to-date, the authors of a second recent review paper had the following recommendations for teams playing at the 2026 World Cup:

  • For teams playing at altitude, having a team base at moderate (950 – 1700m) altitude likely confers an advantage over teams staying at sea level. The longer spent at altitude, the greater the adaptations, so early arrival is ideal. 
  • Undertaking 2-3 sessions per week, across 4 weeks, of repeated sprint training sessions in hypoxia (of 3-6 sets of 4-8 reps of maximal efforts lasting between 5-20 seconds with incomplete recovery, at an altitude [real or simulated] of 3000m) appears to enhance neuromuscular efficiency and fatigue resistance. 
  • Most teams are only likely to play one match at altitude; as such, they may play other games in cities where the heat is very high. There is emerging evidence that prolonged heat acclimation (i.e., 5+ weeks) may induce similar adaptations to time at altitude. As a result, teams might be better focused on getting heat acclimation as opposed to altitude exposure. 

Altittude and training for athletics

Of course, altitude training has formed part of the training for endurance athletes within track and field for decades, since at least the late 1960s. It is worth noting that the evidence base is almost entirely endurance-derived — the physiological rationale (increased haemoglobin mass, improved VO2max) speaks directly to aerobic capacity, and most of the research populations are distance runners and cyclists. For sprint coaches, the direct performance benefits are less established; the relevance is more likely to lie in the neuromuscular and anaerobic adaptations from repeated sprint training in hypoxia, and in managing performance at altitude venues rather than chasing sea-level gains. Unlike for the World Cup, the use of altitude training in track and field is to deliver physiological adaptations that enhance performance at sea level. As a result, the most common method is LHTL, allowing athletes to maintain training quality, and hence performance. Altitude training in elite athletes has been well researched, with the following key findings rising to the top:

  • The best altitude for the “live” component of LHTL appears to be above 1800m, but below 3000m. Lower than 1800m, the partial pressure of O2 has not reduced enough to drive adaptations; above 3000m the altitude is likely to significantly impair recovery. Generally, athletes need to spend more than 14 hours per day, for more than two weeks, to see adaptations; with 14 hours per day for 3-4 weeks considered an optimal approach. 
  • Altitude training doesn’t improve performance uniformly, and some people appear to be “non-responders”. 
  • Related to the above point, iron deficiency impairs the response to time at altitude, meaning that pre-camp screening and iron supplementation are often recommended. 
  • As time at altitude is fatiguing, during an altitude camps athletes are more likely to see reductions in sleep quality, dehydration, and be at an increased risk for illness, injury, and overreaching. As such, careful monitoring of these aspects is important. 

Altitude training is wide-spread within track and field, both as means to support performance at competitions at altitude (even at elevations of around 500m), but also a way to enhance performance at sea level. It is well researched, and well-trailed by elite athletes, and represents a performance advantage. 

For track and field coaches, the practical takeaway is straightforward: if you have athletes competing at altitude, the evidence strongly favours arriving early and building in a structured acclimatisation block of at least two weeks. If time doesn’t allow that, a targeted repeated sprint training block in hypoxia in the weeks prior is the next best option. And if neither is feasible, adjusting race tactics and pacing expectations is not a concession — it is the evidence-based response to a real physiological constraint.

Altitude is not a mystery; it is a manageable variable—let’s see how teams manage this at the World Cup. 

Additional resources of altitude

If you’re interested in reading more about the application of altitude training in sport, I’d recommend the below papers: