On the Road to Cortina 2026: Performance Osteopathy at the World Championships
At Midtown Wellness, we are proud to have a team that operates at the very highest levels of international sport. We believe that the insights gained from treating elite athletes in high-pressure environments directly enhance the care we provide to our patients in Covent Garden every day.
Reflections from Saint Moritz and Altenberg
By Lorenzo Ricco
This winter, I had the opportunity to travel to Saint Moritz in Switzerland and Altenberg in Germany as a performance osteopath for the Women’s Belgian Olympic Bobsleigh team during the IBSF World Championships. These races were a key part of the qualification pathway for the Cortina 2026 Olympic Games, covering monobob, women’s two, men’s two, and four-man bobsleigh disciplines.
Being called in to support the team at this stage of the season was something I was genuinely grateful for. Championship environments always expose the true demands of high-performance sport—physically, mentally, and organisationally—and this season was no exception.
A Season That Tested the Margins
The team’s season had been far from linear. Performance fluctuated due to strategic and organisational mistakes at federation level, which placed additional pressure on the athletes. As often happens in elite sport, these external stressors eventually expressed themselves physically.
Mid-season, the pilot sustained a hamstring injury, significantly complicating the qualification pathway. In bobsleigh, where explosive sprinting, timing, and technical precision are non-negotiable, a hamstring injury doesn’t just affect speed. It affects confidence, trust in the body, and decision-making under pressure. From that point on, the road to Cortina became considerably steeper than originally planned.
Performance Under Constraint
I was not brought in simply to treat an injury; I was brought in to help performance survive under constraint. At that point in the season, fatigue was everywhere—physical, mental, and emotional. This is often the moment when people assume the job is about having good hands, but previous experiences have taught me otherwise.
When stress is high and margins are thin, everything matters. This includes the tone of my voice, the timing of a conversation, and the confidence I project when uncertainty is unavoidable. In those moments, my mindset can be just as powerful as the treatment itself.
I know this because I have been there. During my own competitive years, I was always the "hype man"—the one who lifted the room when legs were heavy and doubts started creeping in. That instinct never left me. I bring it into every treatment room because I learnt that, at the elite level, belief can become a performance tool.
An Osteopath’s Perspective on Priming
Pre-race and post-race treatment can look very different from one athlete to the next. Pre-race work walks a fine line because it can meaningfully enhance performance, but if misjudged, it can just as easily hinder it. The challenge is knowing how much is enough without doing too much. Every decision is shaped by the athlete in front of me, their mindset, their body, and their individual preferences.
Post-race treatment is just as individual and often even more variable. It is guided by what comes next, such as upcoming races, travel demands, and the overall strain placed on the body. The goal shifts from readiness to recovery, adapting to whatever the athlete needs in that moment.
Clinical Focus and Integration
Throughout the championships, my work involved the acute and ongoing management of the hamstring injury, balancing tissue recovery with the realities of the competition schedule. I focused on neuromusculoskeletal optimisation to ensure the pilot could sprint, load, and drive with minimal compensatory patterns.
Pain modulation and load tolerance were also key, particularly in cold environments where tissue stiffness and reactivity are amplified. This required constant integration with coaching to align treatment decisions with technical and strategic needs. Most importantly, I aimed to keep spirits high and remind the team that they had everything they needed to succeed.
Final Thoughts
At this level, osteopathy is not about chasing perfection. It is about maximising what is available on that day without increasing long-term risk. Elite performance is rarely built in ideal conditions. More often, it is forged in imperfect ones where decisions must be made calmly and with purpose.
Watching these athletes day after day is deeply humbling. They give everything they have time, energy, and money chasing a dream that offers no guarantees. In environments like this, you truly understand what "team" means. It is a lived experience where trust, sacrifice, and shared responsibility carry everyone forward when it matters most.
Book a Session with Lorenzo
Lorenzo brings this same high-performance mindset to his patients at our Midtown Wellness Covent Garden clinic. Whether you are recovering from a sports injury or looking to optimise your daily movement, you can book a consultation with Lorenzo online.
