Altitude Training & Hypoxia: How High Altitude Affects Athletes | Olympics 2026

Altitude and the Olympics: How Thin Air Impacts Athletic Performance

The pursuit of Olympic gold often leads athletes to extreme environments, and for the upcoming February 6th – 22nd, 2026 Milano Cortina Winter Olympics, that environment includes significant altitude. While elite athletes are often conditioned to perform under pressure, the reduced oxygen levels at higher elevations present a unique physiological challenge, impacting everything from cardiovascular function to recovery strategies.

The venues surrounding Cortina d’Ampezzo, Italy, showcase a dramatic range of altitudes. The Tesero cross-country stadium sits at approximately 830 meters (2,723 feet), while the Vertigine downhill start reaches 2,380 meters (7,808 feet). Athletes utilizing the cable car will ascend to 3,244 meters (10,643 feet) atop Tofana Peak, the highest point in the Tofane massif. Other competition sites, such as Livigno’s snow park (1,816 meters / 5,958 feet) and the Antholz-Anterselva biathlon arena (~1,600 meters / 5,249 feet), also fall within the high-altitude zone.

At these elevations, the fundamental challenge is a decrease in the partial pressure of oxygen. “At altitude, there is less oxygen with each breath due to lower atmospheric pressure, meaning fewer oxygen molecules make it into your lungs,” explains Joshua Merson, an associate clinical professor and extreme medicine program director at Northeastern University. The body responds by increasing both breathing rate and heart rate, attempting to maximize oxygen intake and delivery to tissues.

However, this compensatory mechanism isn’t limitless. For athletes unaccustomed to altitude, or those ascending too quickly, the body’s ability to adapt can be overwhelmed. This can lead to hypoxia, a state of oxygen deprivation, triggering an inflammatory response and potentially disrupting blood pressure regulation. Fluid can then leak into areas where it shouldn’t, according to Merson.

The consequences of hypoxia range from mild discomfort to serious illness. Altitude sickness, characterized by headache, nausea, and fatigue, is a common initial response. However, more subtle warning signs can precede these classic symptoms, and ignoring them can lead to more dangerous conditions.

It’s important to note that hypoxia isn’t limited to mountainous regions. Sarah Spelsberg, director of U.S. Operations at World Extreme Medicine, points out that conditions like long flights, heat stress, illness, and intense training can all temporarily reduce oxygen delivery at the tissue level, creating a similar physiological stress.

Understanding these physiological responses is crucial for optimizing athletic performance. Spelsberg emphasizes that the effects of altitude encourage athletes to pace themselves, recognize signs of overexertion or illness, and prioritize recovery strategies like sleep, hydration, and reduced training intensity when performance declines. “Hypoxia awareness helps athletes distinguish productive stress from warning signs, reducing injury and burnout while supporting long-term performance,” she says.

Clinicians working at the Olympic venues will be looking for subtle cues indicating that an athlete is struggling with hypoxia. Merson describes observing changes in behavior – an extroverted athlete becoming quiet, a meticulous gear packer struggling with equipment, or a trained athlete exhibiting labored breathing on flat terrain – as potential early indicators. These cues can appear before the onset of more obvious symptoms like headache or nausea.

Historical examples illustrate the potential impact of altitude on athletic performance. At the 1968 Mexico City Olympics, held at 2,250 meters (7,382 feet), Australian distance runner Ron Clarke collapsed unconscious during the 10,000-meter race, and U.S. Swimmer Suzy Jones experienced performance issues during high-altitude training in Colorado Springs.

Interestingly, Merson notes that physical fitness alone doesn’t guarantee protection against altitude sickness, suggesting that genetic predisposition may also play a role. The severity of altitude stress also varies geographically. While peaks in New England, such as Mount Washington (approximately 6,300 feet), present some challenges, training venues in Colorado often exceed 10,000 feet, with peaks reaching over 14,000 feet, exposing athletes to significantly thinner air.

For the athletes competing in Milano Cortina 2026, pre-acclimatization will be key. While the article doesn’t detail specific training regimens, the implication is that athletes will have prepared for these conditions to mitigate the physiological challenges posed by the altitude. The ability to recognize and respond to the body’s signals will be just as important as physical conditioning in the pursuit of Olympic success.