England's Players Prepare for Altitude Challenge in Mexico City

England’s players will try just about everything to handle the altitude in Mexico City on Sunday. Just not that.

On the eve of their World Cup round-of-16 clash with Mexico at the Estadio Azteca, Thomas Tuchel found himself fielding one of the more surreal questions of his tenure: were England really considering using Viagra to combat the thin air?

“The information to support it didn't reach me, so that's not true,” Tuchel replied with a laugh, brushing aside the suggestion before it could gain any more oxygen.

The Azteca sits roughly 7,220 feet above sea level, a stadium built in the clouds and famed for draining the legs and lungs of visiting teams. As the game has edged closer, several outlets have floated the idea that England might lean on a legal pharmaceutical boost, noting that Viagra does not appear on the World Anti-Doping Agency’s list of banned substances.

That speculation draws on a 2006 study which found the drug “significantly improved the cardiovascular and exercise performance measures of trained cyclists at high altitude” thanks to its impact on blood flow. It is, as the science keeps reminding football, a pill with more than one purpose.

This is not even new territory for England. The national team has been here before, batting away similar stories in the build-up to the 2010 World Cup in South Africa. Back then, a 2009 report prompted the English FA to issue a formal denial.

“The England medical staff are conducting detailed research with a variety of experts ahead of next year's World Cup,” that statement read. “However, there has been no discussion with regard to Viagra and certainly no plans for the players to take it in South Africa at the tournament.”

Different continent, different World Cup, same rumour.

Away from the sideshow, Tuchel’s focus is on more conventional medical updates. The news is positive on Jarell Quansah, who missed the last-32 win over DR Congo with an ankle problem but has come through training unscathed.

“You saw that Jarell trained, Jarell trained fully, is fully available,” Tuchel said, pleased to have another defensive option restored just as the tournament tightens.

Reece James is a more delicate call. The right-back, nursing a hamstring issue, will be assessed again on matchday before any decision is made on his involvement.

“Reece can maybe make it onto the bench, he needs a last assessment from the doctors and medical opinion if this makes sense,” Tuchel explained.

So England head into the altitude with their medical team weighing muscle fibres and recovery times, not pill dosages. The science will still matter at 7,220 feet, but it will be the familiar kind: conditioning, rotation, and how long those England legs can last in the rarefied air of the Azteca.