Study and Research


Formula 1 differs from other sports in that the fitness and mental trainers working in this sector were not professional racing drivers themselves. It’s like a top-level skier being coached by someone who had never put on a pair of skis! Unlike other professionals involved in motor sport, Dr. Ceccarelli realized that this aspect was an important stumbling block in the work with the drivers and in order to make up for this shortcoming immediately launched a research project aimed at investigating in depth every aspect of psycho-physical stress undergone by a driver, and then develop a training methodology that was tailored to the specific needs of the drivers.

Principal Studies and Research carried out in over 25 years of trackside assistance 

1989 was the first year in which Dr. Riccardo Ceccarelli worked as a doctor at the Formula 1 circuits on behalf of Leyton House Racing. In that year, thanks to the pioneering work of Dr. Ceccarelli, the first real medical and scientific research in F1 designed to put the driver at the centre of attention began. As in all other sports, and finally in motor sport, the physical and psychological performance of the drivers were studied in detail and specific training systems were developed. This study continues, uninterrupted, to the present day. The first trials were carried out with the assistance of Ivan Capelli to whom a heart rate monitor was fitted for the German Grand Prix at Hockenheim, however due to its size and the narrowness of the cockpit, the instrument had to be attached to the seat belt, the only place where it could go. The experiment was not well received by the team who felt that the driver could have been in some way disturbed by the presence of the monitor, which further showed the limited interest in the paddock in studying the performance of the drivers. This was to be a constant factor during the following years of the research program.

Research continued into 1990 using smaller monitors sometimes hidden under clothing to avoid difficulties with the various Team Managers who were not always very understanding or cooperative. The recordings were made during races and an increasing number of drivers were involved in order to obtain a quantity of data that would make the work statistically reliable. Besides the Leyton House Racing drivers, Ivan Capelli and Mauricio Gugelmin, Finnish driver JJ Lehto was involved as in that year Dr. Ceccarelli also began a partnership in Formula 1 with Scuderia Italia.

In addition to recording drivers’ heart rates during races, in 1991 Dr. Ceccarelli expanded his research and started taking blood samples from drivers immediately before and immediately after races. Again this research was completely innovative for the world of Formula 1.

With the samples Dr. Ceccarelli analyzed variations of about 30 blood parameters induced by the mental and physical stress of race of a Formula 1 race. Among other objectives, the research was aimed at developing a proper diet, including hydration and minerals, which has a scientific basis and not simply left to the drivers’ tastes or worse still, to the imagination of certain unqualified individuals hanging around in the paddock.

The analysis of the variation of certain hormones allowed for the first time an evaluation of the extent of the mental and physical stress undergone by a driver during a race. Several drivers willingly participated in this experiment out of curiosity for the results. Among these were some champions of motor sport even though they were not in an official working relationship with Dr. Ceccarelli. The execution of the study presented numerous difficulties, for example it was necessary to set up at each circuit a small laboratory, hidden so as not to provoke the inevitable complaints from the Team Managers. Furthermore there was the practical problem of going through airports and getting past amazed customs officers with a dripping portable fridge tucked under his arm, full of blood samples!

1992 saw Dr. Ceccarelli’s next innovation, the first experiment in which a driver wore a heart rate monitor directly connected to the data acquisition system of the car.

The study was born out of the need to synchronize the cardiac activity of the driver with the dynamics of the race in a perfect correlation of space and is of strategic importance and the first important step towards a thorough and reliable analysis of the extent of psychophysical stress associated with various racing situations.

With these tools it finally became possible to examine the driver’s work in the smallest details and with greater precision at every moment during the race, metre by metre, seeing clearly the heart rate while the driver is in a corner, on a straight, braking, undergoing lateral G-forces, overtaking and during an accident.

In 1993 Dr. Ceccarelli moved to the Minardi F1 Team where he was able to further his research in a favourable environment as the Team Principal, Giancarlo Minardi, was among the first to understand the importance of medical research into the driver’s performance. With the full cooperation of engineers and drivers it became much easier to collect a mass of data. Pierluigi Martini was particularly willing and took over from Ivan Capelli as the leading driver involved in the scientific research.

In 1994 Formula Medicine was founded with the aim of providing a structure able to provide drivers with a complete team of specialists each working in his own particular sector as was already happening in all other sports at the highest levels. Another important motivation was to drive out of the paddock the unqualified and under qualified once and for all. In this year Dr. Ceccarelli made contact with the Institute of Clinical Physiology at the CNR (National Research Centre) in Pisa that resulted in the development of pioneering technologies but had a significant drawback in that they were ahead of their time for the mentality of Formula 1 in those days. Working with engineer Remo Bedini the first in-car electrocardiograph was designed and made giving not just the heart rate but also the electrocardiograph of the driver while driving. Further development led to this instrument being connected directly to the in-car data acquisition systems. This was an enormous step forward in considering the driver to be a professional sportsman. The first prototype was rather bulky and weighed in at 500 grams and was tested by Michele Alboreto at the Japanese Grand Prix, this was the first time in the history of Formula 1 that the electrocardiograph of driver was taken during a race together with the other data collected from the car.

In 1995 following the wave of enthusiasm from the successes of the previous year, the collaboration with the CNR continued in the field of cardiology in Formula 1. A new electrocardiograph was made with the weight passing from 500 grams to 20 grams and much less bulky in adherence to the need expressed by the team to keep to the minimum the weight of parts. The data provided from the new acquisition system lead to sensational and totally unexpected discoveries: violent gravitational acceleration and deceleration, in fact, can cause physical repercussions which were totally unpredicted.

An example was the detection of a sudden and dramatic fall of the heart rate, which in one second goes from 160 to 60 beats, continues at this rate for 2-3 seconds before returning immediately to around 160. This unexpected and surprising phenomenon recurred regularly in the exact same stretch of track for all 70 laps of the race. Similar occurrences have not been found in any other sport and neither in aerospace medicine is there evidence of a reaction so striking and repeated. The astonishment of cardiologists at several international conferences at which the results were presented underlines the importance of this discovery.

Thanks also to the development done in close collaboration with Minardi F1 Team and the technicians of Magneti Marelli, the instrument was able to transmit the real-time heart activity of the driver in which the electrocardiogram was shown on live TV at various sporting events, such as the Italian Grand Prix at Monza, a race of the Touring Car Championship at Vallelunga and the Venice Marathon. Dr. Ceccarelli and his team who worked in this project succeeded in achieving what others had already tried to do but failed despite having considerable technical and economic resources. To date nobody has been able to replicate in Formula 1 or in any other sports events of international importance the transmission of the electrocardiogram in real time with a tool so miniaturized so as not to compromise the performance of the athlete.

1995 was a year full of innovations and Formula Medicine, following an intensive period of work in the search to develop more specific training, built the first driving simulator able to reproduce the physical stresses to which the driver is subject during a race. The idea arose from the need to develop more specific and advanced training and the contribution of Formula 1 driver Nicola Larini was crucial to the development and testing of the system. 20 years on simulators have taken over in motor sport and become essential in driver training. In this field, as always, Formula Medicine took the first pole position. To build the simulator Giancarlo Minardi provided a Formula 1 car, Giancarlo Luigetti, responsible for sports activities of Magneti Marelli, provided telemetry data recorded in races and Alberto Ciardelli, director of Eta Beta Information Technology, was responsible for developing the complex hardware. Under the supervision of Formula Medicine all thi s material was put together and four electric motors were installed to accurately reproduce the stresses on the driver’s body through the steering and helmet entirely similar to those that occur in a Formula 1 race. Given the power that the electric motors are capable of exercising on the neck and the leading drivers who use the simulator, the main problem was to find someone willing take the responsibility to insure such a complex piece of equipment! For this reason, three different levels of security were implemented in the simulator, including one specially designed by Aldo Costa, the young Technical Director at Minardi who later became one of the leading architects of the success of Ferrari and Mercedes in Formula 1. The simulator was officially presented to the press and drivers at the Bologna Motor Show, at the Magneti Marelli stand, proving a great success with both the public and the experts. Also in 1995, Dr. Ceccarelli, among his other activities, was appointed chief medical officer for Team Ford in the World Rally Championship.

1997 was Jarno Trulli’s first season in Formula 1 and this was an important moment for Formula Medicine as he picked up the baton from Pierluigi Martini and before him from Ivan Capelli and became the leading driver involved in their medical research program.

The working methods continued to advance and the results coming from research carried out at the circuits were compared with data collected by doctors in the laboratory and for the first time a driver, Jarno Trulli, was subjected to an extremely thorough series of clinical investigations. The evaluation of the data collected by Formula Medicine with the CNR of Pisa, given its size and complexity required the presence of a driver even in the analysis phase and Jarno cooperated fully collaborating in this work. The results obtained were groundbreaking were made public on the occasion of major international medical congresses.

In 2000 Toyota Racing announced its future participation in the Formula 1 World Championship and contacted Dr. Ceccarelli in order to secure his services and starting a partnership that saw the Japanese team make its debut for the 2002 season. With the support of the team, new and more modern means of monitoring of Formula 1 drivers were developed.

In 2002 the Toyota Young Drivers Program was inaugurated aimed at finding potential champions and Formula Medicine was given the responsibility for the preparation of the drivers. This role gave a new impetus to the research program concerning the mental and psycho-physiological performance in motor sport, with the difference that this time it involved not only already established drivers but also the young hopefuls. As a result of this new assignment Formula Medicine aimed at developing new methods of evaluation in the field of sports psychology, based on objective values ​​and not on the opinions of individual specialists. This approach, unique in motor sport, led to the creation of a modern and specific Mental Training, based solely on numbers. The results of this type of innovative work were shown with the stunning victories of Ryan Briscoe in the Italian Formula Renault 2000 Championship and European Formula 3. During this period Formula Medicine pioneered a new philosophy of working practices with the objective of including all team members in the program of psychophysical preparation as all team members have an impact on a team’s performance. Even engineers are therefore required to undergo medical check-ups and evaluation similar to those of the drivers and their heart rates are recorded, as are the pit lane mechanics during races in order to ascertain their resistance to stress.

While continuing its partnership with Toyota, Formula Medicine expanded its operations in motor sport and in 2003 began working with the Renault F1 Team responsible for all matters relating to medicine and fitness. Renault participated in the full Formula Medicine program for the monitoring of not only the drivers but also all team members at race weekends.

The same medical and scientific research promoted and developed by Formula Medicine in Formula 1 was now extended to the FIA GT and Touring Car Championships to evaluate the impact on the drivers not only coming from the various mechanical stresses, but also and especially to problem of heat due to closed car interiors with temperatures exceeding 70°C! The partnership with Team BMS Scuderia Italy saw consecutive titles in the GT World Championships in 2003 and 2004. Recently more and more drivers are turning to Formula Medicine, which as a consequence has enabled a widening of the research on track. Some drivers from F3000 International, including Robert Doornbos, Enrico Toccacelo, Raffaele Gianmaria, Esteban Guerrieri and Ferdinando Monfardini, underwent systematic heart rate recording with surprising results as their values ​​exceeded those of their colleagues in Formula 1 detected in the same weekend at the same circuits. 2003 also saw the start of further scientific research which lasted for 5 years and was an extremely innovative and complex study, to date still the only one of its kind in the world of motor sport and for the results obtained was the most important of all the research conducted by Formula Medicine. This research allowed Formula Medicine to go even deeper into the study of the brain activity of racing drivers and was a collaboration with the Department of Experimental Pathology and Medical Biotechnology of the University of Pisa, led by Prof. Peter Pietrini and the Department of Clinical Physiology of the CNR, and relied on the use of a modern functional magnetic resonance imaging. This examination investigated the morphology and brain activity of a group of 12 professional drivers carrying out several tasks requiring high mental effort. Another group of 12 people, not racing drivers, but persons of the same age and physical constitution, were tested likewise and the results were then compared. It was expected that the supermen drivers with their lightning reflexes would show a much better mental performance than the control group but the results were surprising and revolutionary. To everyone’s surprise there was no difference between the two groups in terms of reaction time but further analysis showed that there was a difference in the way the two groups used their brains.

Among the various differences analyzed, one of the most important was the ability of the driver to be much more economical in terms of mental energy consumed. These results and further research led to the to development of tools and methodologies for a highly sophisticated and specific mental training; thus was born “Mental Economy Training®”. Once again, Formula Medicine developed new systems through innovative medical research, aimed at improving the health and the performance of Formula 1 drivers.

2006 also marked the start of another prestigious job in Formula 1. The previous year Dr. Ceccarelli, on his own initiative, carried out a series of inspections to evaluate the level of safety at circuits during Formula 1 tests. A worrying picture emerged and the GPDA (Grand Prix Drivers Association) asked Dr. Ceccarelli to continue and intensify his investigation. His report in 2006 gave evidence of serious and widespread shortcomings and this resulted in all 11 Formula 1 teams deciding to give Formula Medicine the task of carrying out checks on the safety standards at the circuits during Formula 1 testing and to propose the improvements to be made and so a new department at Formula Medicine called “Safety” was created. The aim is to standardize all circuits to a level of efficiency that guarantees the maximum possible safety for the drivers and teams. By the end of 2014 after 9 seasons Formula Medicine Safety had been present at 88 tests at 15 different circuits using 10 doctors and 4 paramedics, all highly trained in first aid and resuscitation.

In 2009 Formula Medicine assisted in the completion of a project begun in 2005 in collaboration with a scientific research centre in Pisa ( CNR ). Some young drivers who were already being followed by Formula Medicine made themselves available during the season to test a special shirt that recorded the ECG, heart rate, respiratory activity and accelerations in 3 axes. The unusual feature of this shirt is the absence of electrodes and cables as it is made entirely of fabric and in a practice session of Formula 3 in September of 2009 at Monza the shirt was tested and gave results of the highest quality. This tool was an important step in the research conducted by Formula Medicine aimed at investigating the performance of drivers while driving.

In 2010-2011 Formula Medicine, working with the University of Pisa and the CNR at Pisa, began its “Mental Economy Project” in which data collected over a five year period using Functional Magnetic Resonance Imaging was used to develop tools and methodologies highly specific to the needs of the driver. The intention was to teach drivers how to improve brain performance but with the lowest possible expenditure of mental energy (“maximum yield at minimum expense”). To achieve this it was necessary to create a set of tools able to simultaneously analyze brain performance and expenditure of mental energy.

The first in the series was a special console with four screens and two computers, called “MentalBio“, which was completed in February 2010 but shortly after was improved with the addition of two more consoles. This type of instrumentation was unique in the world of driver training.

In 2012 Formula Medicine entered into another important collaboration becoming the partner of BMW Motor sport which was about to return to the Deutsche Tourenwagen Masters (DTM, German Touring Car Championship). Formula Medicine was placed in charge of medical treatment, fitness training and mental training for all BMW drivers that periodically travel to Formula Medicine’s headquarters for check-ups and for the training camps. Furthermore Dr Ceccarelli and 3 physiotherapists attended race meetings providing on-circuit assistance. Their debut season could not have been better as BMW achieved a historic “en plein” winning all the trophies up for grabs: the drivers’ championship with Bruno Spengler, the manufactures’ championship, the team championship and best rookie with Augusto Farfus.

In 2013 the important collaborations extended further when Formula Medicine entered into a working relationship with 7 Formula 1 teams, Force India, Lotus, Marussia, Mercedes, Red Bull, Toro Rosso and Williams each have two doctors from Formula Medicine to constantly monitor the health of all members of these teams, amounting to more than 500 people. At the end of each race each team receives a detailed report of the treatment provided and a statistical analysis of the incidence of various illnesses and ailments analyzed at all the teams with the purpose of studying practices to be implemented as a preventive measure. The figures achieved by the end of year are impressive: 1,354 people treated at the 19 race weekends for a total of 2,259 interventions.

2014 also saw Formula Medicine confirmed both for the DTM and in F1 with the same teams.

For 2015 the program of medical and scientific research carried out successfully by Formula Medicine over many years will continue to explore new and more ambitious areas for research and investigation.  

Currently research at Formula Medicine’s headquarters is directed to potential use of Electroencephalography (EEG) as a method of investigation into aspects of the driver’s character and his range of moods and emotions and to then integrate it into “Mental Economy Training®”. As for the monitoring of the driver on the track, in the course of 2015 new tools using advanced technology will be tested able to significantly increase the body parameters recorded.