Observe Lewis Hamilton’s pre-race rituals, and you cannot help but notice a petite lady attending to every detail, from carrying his helmet and gear through ensuring he’s hydrated to psyching him to a state of battle readiness.

Long before they hit the grid in whatever country Formula 1 decamps Angela Cullen, a Switzerland-based New Zealander, will have sorted the five-time champion’s diet and sleep patterns, overseen convenient travel plans and freed his mind to concentrate on the formidable tasks that separate world champions from those who don’t even make it to the top level despite having outer-worldly talents.

Although an integral part of Team Hamilton, Angela is employed by Hintsa Performance, and seconded to the driver. She’s one of over a dozen Hintsa-appointed ‘minders’ in the paddock, all charged with keeping their drivers in top condition: mentally, physically and psychologically.

“Angela comes from a musculoskeletal therapies background and she’s very good at that,” explains Dr Luke Bennett, the 46-year-old CEO of Hintsa Performance (Motorsport), originally founded in the nineties by Dr Aki Hintsa, a Finnish orthopaedic and trauma specialist.

Hintsa, who died from cancer in November 2016, worked with his country’s winter sports teams, then spent time in war-torn Ethiopia where he studied the resilience of that country’s long-distance athletes, including the legendary Haile Gebrselassie.

Inspired by what he saw, Hintsa created his ‘planetary philosophy’: physical activity, nutrition, recovery, biomechanics, mental energy and general health revolve around a ‘core’, which comprises identity, goals, and control. Today Hintsa coaches F1 drivers and Fortune 500 executives alike.

“Our coaches come into a race weekend hopefully having done the physical preparation,” says Bennett, an Australian doctor who worked in critical/intensive care. “We have a really small block of time at the beginning of the year, pre-season, that gives us about six weeks – if we’re lucky – to have the main block of physical training for the year.”

Thereafter he joined his country’s ‘Royal Flying Doctor’ service in medical retrieval roles, also providing trackside trauma services at the Australian Grand Prix for 11 years and briefly the Korean F1 round. He has also officiated on Australia’s World Rally Championship events and rounds of the Australasian Safari – effectively the Dakar of the down-under – before joining Hintsa Performance.

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“The rest of the season consists of opportunistic interventional work in small blocks, two, three or four days at the most, where we keep topping up physical fitness. So the drivers arrive in good shape.

“The coaches will be managing the programme particularly on Thursday, the media day, and liaising with team staff, marketing staff, looking at schedules and, depending on where the season is at [and] where the championship is at, perhaps tweaking that in collaboration with the team.

“They make sure the appropriate meals are served at the appropriate time, keep the drivers hydrated, get them to bed at the appropriate time – all these little things that add up to a championship performance.” They even operate special routines to combat jetlag.

Hintsa first came into Formula 1 in the late nineties with compatriot Mika Hakkinen, then mounting his first title challenge after recovering fully from horrific injuries suffered at the end of 1995.

“[The accident] was some years before, but certainly I think Mika’s idea was to bring Aki in as a medical assistant, but also with a very deliberate strategy to manage the environment around him, and that was very successful,” says Bennett.

“To look after Mika’s family, to manage his key relationships in the paddock, and that’s a tradition that’s a really key part of our work where it continues today.”

That final phrase provides the ‘core’: “To some extent it’s relatively straightforward to provide a physical training programme or sleep and nutrition advice to drivers, but our point of difference really is what we call our ‘core work’.

“We typically take on drivers often in their teens, when they are youngsters in Formula 4 or 3. So we’re really shaping them as young adults and mentoring them to an extent. We’re lucky now in that we provide the trainer or the physiotherapist for 10 of the Formula 1 drivers and we’re closely integrated with another three or four in terms of medical or other services.

“A big part is helping them to integrate properly into this complex motorsport culture; managing their families; often there’s strong parental influences around motorsport; their key relationships with engineers and team management. These things make a real difference to performance on the track over the long term.”

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At the time McLaren was a notoriously ‘controlling’ team under Ron Dennis – arguably the ultimate F1 micro-manager – but the pair co-operated successfully, Bennett explains.

“Aki was very close to Ron. They worked together [for] many years. There was a huge amount of respect there. Aki worked with Mika; he sort of became part of the McLaren infrastructure.

“Subsequently he brought Lewis through in the early parts of his career, and Ron came to respect Aki’s judgment over that time, as he saw the work with some of the younger drivers. Through Kimi [Raikkonen] as well.

“There’s a very special place for a team doctor in Formula 1. It’s a great privilege, actually. The medical work that we do in the day-to-day lives of everybody travelling in this wonderful circus is an important part of the glue that not only translates into driver performance but also team performance, championship performance.”

As subsequent McLaren drivers migrated across the grid, they stayed with Hintsa. “Aki was in the paddock for over 15 years in the end. Lewis moved to Mercedes, Kimi moved on to Ferrari. Aki famously worked quite closely with Sebastian [Vettel], and that led to very important work with the Red Bull infrastructure as well. I guess it just grew organically and naturally over the time.”

But Hintsa did not advise Raikkonen to wear shades 24 hours a day…

The broad perception is that Hintsa is focussed purely on physical preparation, but, as Luke points out, it’s a massive step from F4 to F1. “We’re starting to get [F4] drivers to think about the basics of nutrition, which is important.

“It gets much more sophisticated when they’re at [F1] level, but we get them thinking about how they manage their travel and their sleep. You start to introduce those themes of what are their long-term goals? What is their purpose? What actually are they aiming for and how are we going about the steps of achieving that?

“A 16-year-old or 17-year-old F3 driver is in some ways the same as other 16 or 17-year-olds on the street. They need close mentoring and need people to guide what they’re doing, to help them accelerate those life experiences that get us all where we are by the time we’re in our thirties and forties.”

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Bennett described the ‘core’ areas as “physical preparation, sleep, nutrition – biomechanics we treat separately – general medical, health care, and then what we call mental energy – managing a driver’s cognitive mode not only over a race weekend, but over a season.

“It’s a hugely socially complex environment. There are the demands of marketing and commercial imperatives, there’s many, many hours of engineering meetings over a race weekend, and there’s all the stuff that goes on in the background of a driver’s career pathway from season to season.

“I would say 80% of the job of our coaches on a race weekend is keeping the driver in the right frame of mind, and managing their time and all of the demands that are around them.”

Thus a large part of Bennett’s job is matching drivers and coaches: “It’s absolutely clear that every driver is an individual with their own strengths and weaknesses; all of our coaches actually bring their own individual strengths and interests as well.

“So the real art of what we do – there are hundreds and hundreds of interventions you can make for any given athlete – but the art of what we do is selecting those that will fit the needs of that driver and importantly, as you referenced the attention span of a given driver, and the thing that will give you the maximum benefit at that time in their career.

“It’s about really making continuous small changes that stick, small changes that are going to be incorporated into a daily or an annual routine, and have a sustained benefit.”

Given the time driver and coach spend together, they surely need to ‘mesh’ with each other?

“We have a recruitment process that incorporates at least four interviews, so we feel like we know the coaches reasonably well by the time we agree to employ them.

“So we think a lot about the personality of the coach, the needs and the personality of the driver, and sometimes we’ll introduce a driver to two or three coaches and they can spend a little bit of time with each and make a selection,” explains Bennett, stressing that the fit is not purely about age.

“This job is a constant process of matching people’s roles. It’s not just the personalities, but a coach may have a young family, they may have some limitations. There may be geographical limitations, where they live, where the driver lives. There are many, many variables to line up.”

F1 is all making small differences so inevitably Hintsa’s contribution is measured to an extent by driver performance.

“If you take it over the entirety of a driver’s career, especially if we’ve been able to be involved before their time in Formula 1, I’m absolutely certain we can sometimes be the difference between them making it to Formula 1 or not.

“Obviously a driver has to have talent, I think that’s first and foremost. But having natural talent is really just the beginning. I’m sure you could name many examples of talented drivers who aren’t here. Our job really is to make sure that talent is realised.”

Hintsa Performance has grown enormously, and although its ‘core’ business remains motorsport, the company has expanded into executive coaching and other sports that “suit our model”, Bennett explains. “We’ve looked at things like cycling, and equestrian sports, sailing, we’ve had discussions with football teams, but predominantly motorsport.

“Our heritage really is in Formula 1 and to some extent Formula 1 gives us a halo project for our coaches, it gives us a laboratory for our research and our coaching and it certainly is a wonderful branding opportunity for us as well.”

The company, for example, handles the entire curriculum for the inaugural W Series, having four trainer-coaches and physiotherapists looking after the 20 drivers. “This season I think it’s fair to say they’ve gone in with a preliminary format, which is working really well and we would love to think that we will expand that involvement as the series grows and as it achieves more commercial success.”

The company has also just published the first-ever scientific paper with data from Formula 1 in an American Sports Medicine Society journal. It compared the rigours in competing in various top motorsport series.

“We did a comparison of a small sample of Formula 1, NASCAR and IndyCar drivers, and you can see from that that the ‘VO2 max’ (oxygen intake), body fat percentage and neck strength of Formula 1 drivers is generally superior to other motorsport categories.

“I think in terms of general fitness, these guys in Formula 1 are probably at the fitness of high-standard age group athletes – triathlon or marathon sports. Their fitness is very specific to their task. And this idea of strength and resisting very high, particularly lateral, G-forces is something that you don’t really see in a lot of other sports, but it’s something they do extremely well.”

A significant increase in cornering speeds since 2017 has brought with it a rise in G-forces. This has required Hintsa to condition its contracted drivers to cope with heads (or kidneys) that weigh up to four times their normal weight during cornering or braking.

“Classically the head gets most of the attention in that regard,” says Bennett. “If you can imagine, your 4kg skull and brain become 20, 30 kilos.

“The other really big theme we face is trying to develop strength without adding muscle mass. That’s something our coaches are continuously grappling with. We’re really, really fortunate this year to have had a change in the regulations, which I think is a wonderful legacy of [late FIA race director] Charlie Whiting.”

A new rule for this season stipulates a minimum driver weight, including their seat and safety gear, of 80 kilograms. “We raised some concerns about driver weight, and Charlie and his team acted very quickly to address that in a very fair way.

“I have absolutely no doubt that our drivers are more healthy and happy this year for having that extra kilo or two of bodyweight to play with.” Among the drivers who’ve praised the change is Valtteri Bottas, who says he is now closer to his natural weight and believes that has allowed him to stay healthier. The fact he’s enjoying one of his strongest seasons to date may be no coincidence.

A driver’s health and strength are inevitably vital factors when their body faces the greatest challenge in motorsport: withstanding a heavy crash.

“Most of the science around trauma management comes from the study of road car trauma. I think we know that fortunately big accidents in Formula 1 are relative uncommon, and injuries relatively rare.

“But we know that when a driver is really tightly attached to the chassis of the car, and when the chassis does not deform in a way that these carbon fibre tubs are constructed, the mechanisms of forced transmission to organs is a bit different.

“I think part of our job as a doctor in Formula 1 is to very carefully monitor a driver who ostensibly self-extricates and walks away from the scene; monitor them over the next 24 to 48 hours to ensure there’s no subtle organ injury.”

If you’re a motorsport fan with suitable medical expertise, Hintsa may well be interested. “We have a recruitment round usually a couple of times per year – look out on the website for any specific roles which are being advertised for performance coaching.

“We predominantly recruit from the sports science community. Sports science is very strong in the UK, Scandinavia and Australia. We have employed more physiotherapists recently, and in fact people with dual qualifications in physiotherapy and sports science are like gold. They really add great fit for this motorsport environment and a great skills set.”

RacingLines