If there was one image that summed up Italy's win over England, perhaps it was when midfielder Raheem Sterling dropped to the pitch in the second half due to cramps and Azzurri players Giorgio Chiellini and Claudio Marchisio were the first to come over and help him stretch out his legs.

Italy prepared an extensive plan to deal with the heat and humidity of the World Cup's Amazon venue of Manaus and that may have provided the difference in the Azzurri's 2-1 win.

"We prepared well in Coverciano (Italy's training base back in Florence) and you could see that," coach Cesare Prandelli said. "They had cramps midway through the second half, and that shows that our work paid off."

At Coverciano, Italy set up a makeshift sauna right next to the training pitch to replicate the conditions in Manaus. Players went in and rode stationary bikes then came out and dipped their arms in a huge bucket of ice-cold water to recuperate.

The Azzurri players were also provided with specially designed refrigerated gloves to aid recuperation after training sessions and matches in intense conditions.

"The lads were placed under extensive observation," team physican Enrico Castellacci said Sunday. "We're fortunate to have great physical trainers and we studied everything down to the most minimal details. ... We didn't leave anything to chance."

Italy's superior fitness was witnessed with the winning goal five minutes into the second half. Antonio Candreva dribbled past Leighton Baines to provide a perfect cross for Mario Balotelli to head in at the far post as defender Gary Cahill struggled to keep up with the Azzurri center forward.

The temperature was 30 degrees C (86 degrees F) and the humidity was at 61 percent for the Manaus match — not quite as severe as expected but stifling enough that Italy criticized FIFA for not allowing time outs during the game.

"They didn't allow time outs but they were fairly lenient and when the lads came near the bench for breaks we were allowed to distribute water to them," Castellacci said.

The longtime Azzurri physician estimated that players lost at least two liters (more than four pints) of liquid during the match.

"It's different for each player as everyone has different metabolisms," he said. "And it's not just a matter of how much liquid was lost. You also have to look at the loss of electrolytes and mineral salts."

While the England game started at 6 p.m. local time, Italy next faces Costa Rica in the northeastern coastal town of Recife on Friday at 1 p.m. local time (1600 GMT).

"At least in Manaus there was shade," Castellacci said. "Having kickoff at 1 p.m. is not suited for a football match here."

Returning to the previous match for a moment, Castellacci offered his sympathies for England physiotherapist Gary Lewin, who dislocated an ankle while celebrating Daniel Sturridge's first-half equalizer.

Lewin received treatment on the pitch before being carried off on a stretcher and was taken to a Manaus hospital. He will now return to England.

"I want to offer my best wishes to the England physical therapist," Castellacci said. "This comes from my heart, to a colleague who has seen his World Cup ruined."

Italy, meanwhile, is putting its refrigerated gloves back on and is rehydrating for its next test.


Andrew Dampf can be followed at www.twitter.com/asdampf