England’s preparations for them FIFA World Cup The round of 16 meeting in Mexico took an unusual medical turn, with reports suggesting that the players were given the option of using Viagra to help combat the effects of playing at high altitude. The knockout fixture will be held at Mexico City’s iconic Estadio Azteca, which stands some 7,350 feet (2,240 meters) above sea level. At that altitude, the thin air contains less oxygen, making it difficult for athletes to sustain high-intensity efforts, recover between sprints and maintain peak physical performance. According to reports, the medical team in England is investigating several methods to help the players adapt to the difficult conditions, with Viagra emerging as one of the approved options. Although the drug is best known for treating erectile dysfunction, it also works by dilating blood vessels, which improves blood circulation. Medical experts have long studied whether that effect can help athletes cope with the reduced oxygen levels encountered at high altitudes. The drug is not banned by the World Anti-Doping Agency (WADA), meaning that athletes are allowed to use it during competition and outside of it. WADA has been investigating Viagra’s potential impact on sports performance for years due to its influence on blood flow. However, studies have not produced conclusive evidence that it offers a significant performance-enhancing benefit at or near sea level. Its potential advantage is believed to be particularly high-altitude environments, where good circulation may help reduce some of the physiological challenges caused by low oxygen availability. For England, any use of the drug is aimed at helping the players adapt to the conditions in Mexico City rather than gaining an unfair advantage in the game. A big challenge awaits the Three Lions. Mexico have built a fearsome reputation at the Estadio Azteca, losing just two of their 89 matches at the famous venue. Their last loss there came in 2013, and they have carried that dominance into this World Cup by winning all four of their matches so far. England, in contrast, had to contend with difficult moments during the tournament. Their Round of 32 encounter against DR Congo required a dramatic comeback, with captain Harry Kane scoring twice late on to seal a 2-1 victory and book a place in the last 16. Mexico secured their knockout spot with a convincing 2-0 victory over Ecuador, setting up an interesting Round of 16 competition in one of the most demanding areas of world football, where England’s preparations include every possible step to cope with the unique challenges posed by the altitude.