Winter Sports Science: Milano‐Cortina 2026 and the Road Ahead

A century after the inaugural Winter Games in Chamonix, sports science has fundamentally reshaped how athletes train and compete on snow and ice. The 12 papers in this Topical Issue represent the current frontier of this evolution: the result of an international collaboration involving 46 researchers from 15 countries. By uniting clinical expertise with the physiological and medical challenges defining elite performance, this collection provides a visionary roadmap for the modern Winter Olympian. The review by Skattebo et al. 1 synthesizes current evidence on the central and peripheral physiological determinants of endurance performance, with an emphasis on the limiting factors of maximal oxygen uptake and its fractional utilization. By utilizing examples from winter Olympic endurance sports, the review examines how these physiological determinants interact with the specific terrain, techniques, and environmental factors encountered during the Milano–Cortina 2026 Games. In endurance-dominant sports such as cross-country skiing and biathlon, Sperlich and Holmberg 2 emphasize that performance is limited not only by maximal oxygen uptake and fractional utilization, but also by pacing, terrain, drafting, carbohydrate availability, and the capacity to reproduce high-quality efforts under altitude and cold stress. Conversely, in other winter disciplines, they argue that endurance may serve primarily a “feeder function.” While the Milano–Cortina 2026 Winter Games were the most gender-balanced to date, scientific evidence guiding the training and health of elite female athletes remains disproportionately limited. The narrative review by Sandbakk et al. 3 summarizes the biological bases of sex-related performance differences, training responses, and key health risks. While absolute performance differences persist, contemporary evidence indicates that effective training principles are largely shared across sexes and that women exhibit comparable physiological adaptations to men post-puberty. These findings emphasize the need for sport-specific, individualized training alongside female-specific health monitoring and prevention. The review by Zoppirolli et al. 4 maps performance determinants and training characteristics across all Olympic snow sports, revealing a field of uneven scientific maturity. While cross-country skiing, biathlon, and alpine skiing are relatively well-characterized, disciplines such as ski mountaineering, freestyle skiing, and snowboarding remain underexplored—particularly regarding sex-specific physiology, biomechanics, and training responses. The authors argue that closing these gaps through multidisciplinary, sex-informed research is essential for evidence-based athlete development, both for the Milano–Cortina 2026 cycle and future Olympic iterations. In a review of Olympic ice sports, Sperlich et al. 5 categorize disciplines by their primary performance demands. These include high-volume “gliding” sports such as speed skating, where biomechanical efficiency and physiological capacity must be simultaneously optimized; “exposure-driven” gravity sports such as bobsleigh and luge, where start velocity disproportionately determines race outcomes; and “arena-based” sports including ice hockey, figure skating, and curling. This review identifies significant gaps in sex-specific evidence and formalized training structures. In a structured narrative review, Edholm et al. 6 reframe pacing in Olympic winter endurance sports as a dynamic, integrated process shaped by interactions between physiology, psychology, and environment. By introducing a unifying framework of continuous decision-making under real-world constraints, the authors demonstrate how terrain, competition, and cognitive–affective factors jointly influence pacing—offering direct implications for athlete preparation and race execution at the highest level. Shifting to the metabolic requirements of such efforts, Ørtenblad et al. 7 examine carbohydrate availability and glycogen metabolism as central determinants of training quality and race-day performance in Nordic disciplines. The exceptionally high whole-body energy turnover in these sports—driven by course profiles, sub-techniques, and snow conditions—places extreme demands on glycogen stores in both upper- and lower-body musculature. Notably, the review observes that while carbohydrate availability is essential, excessive loading may be counterproductive under certain exercise demands. To assist practitioners, the authors provide evidence-based guidance on the amount, timing, and context of intake required to support both training adaptation and competitive success. Finally, Reitzner and Brodin 8 urge a systems perspective on the athlete's immune system and suggest viewing it as a “biosensor” of health and performance. A key contribution of their review is their proposed concept of the regulatory competition between high-intensity exercise and the energy demands of immune function—a tension with immediate consequences for recovery and health maintenance. By advocating for human research in immunology using elite populations, they suggest that immune monitoring can be leveraged as a naturally integrated measure of systemic readiness and physical performance status. Boraxbekk et al. 9 propose “Computational Sports Medicine” as a novel framework that positions the brain at the center of athletic performance. Using alpine skiing as a primary example, this narrative review underscores the importance of working memory updating in dynamic environments and integrates cognitive neuroscience with physiological and biomechanical measures. By moving beyond purely descriptive approaches, the framework offers objective metrics, predictive models, and “what-if” simulations with practical applications in individualized training, injury prevention, and return-to-play decisions. Addressing one of alpine skiing's most consequential clinical challenges, Spörri et al. 10 provide a scoping review of return-to-performance following ACL injury. This synthesis maps the current state of research, identifies key factors for recovery, highlights knowledge gaps, and synthesizes evidence- and expert-informed practice recommendations for return-to-performance after ACL injury. It highlights persistent neuromuscular deficits, high secondary injury rates (19%–47%), and largely neglected psychological and perceptual-cognitive challenges. The authors propose a multi-domain, criteria-based return-to-performance framework with phased on-snow progression, emphasizing that time-based protocols alone are insufficient for safe, full recovery. Runciman et al. 11 examined injury patterns in Para Alpine skiers across the 2014, 2018, and 2022 Paralympic Winter Games. Among nearly 500 athletes tracked, nearly one-third sustained injuries, with a notably higher incidence during pre-competition periods. Acute injuries—often resulting from collisions or loss of control—predominantly affected the head, neck, and knees. These findings highlight the urgent need for improved safety protocols, targeted training, and protective measures specifically tailored to the unique risks within the Paralympic movement. Excellence in Olympic winter sport is a system-level phenomenon, emerging from the dynamic interplay between physiological, technical, and environmental factors. As this issue is finalized in the wake of Milano–Cortina 2026, the focus shifts toward the French Alps 2030. These future Games will demand exceptional adaptability across broad geographical corridors and a changing climate. Progress now depends on how effectively we integrate technological innovation with athlete health and operational resilience. The science gathered here represents a vital step toward navigating that future. The Guest Editors wish to express their sincere gratitude to Prof. Hans-Christer Holmberg, whose vision was instrumental in conceiving this Special Issue and whose expertise in winter sports science has shaped its scientific direction. His role as one of the leading scientists in winter sports science is evident throughout these pages, and this issue would not have taken the form it has without his strong passion, foundational ideas and sustained enthusiasm. The authors have nothing to report. The authors declare no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.