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Fatigue is a part of life and we're all familiar with it. But
it can be difficult to describe and people express it in a variety
of ways, using terms such as tired, weak, exhausted, weary,
worn-out, fatigued, burnt out, wiped, etc. Health professionals
describe fatigue using terms such as asthenia, fatigue, lassitude,
prostration, exercise intolerance, lack of energy, and
weakness. |
Generally we can put the many ways that people express and
experience fatigue into two categories, physical and mental.
Although these two kinds of fatigue are sometimes difficult to
separate and aspects of each can be involved when one feels tired,
they're separate enough in most of our minds. Physical fatigue is
just that, our physical bodies are tired because of either too much
physical work, including not enough time to recover from physical
work, or lack of sleep, including jet lag. Mental fatigue can occur
when we're emotionally or psychologically worn out and not coping
with the stresses and strains in our lives.
In a nutshell we have limited amounts of energy and reserves,
and when these are taxed, either physically or mentally, or more
commonly both, we experience fatigue. And when we're fatigued we
need to recharge our batteries in one way or another. We deal with
the fatigue of our active days and physical activity by resting and
by getting a good night's sleep. If we don't rest enough or get
enough sleep then we suffer from fatigue until we do. In a way it's
the same with mental fatigue only in this case we need to get some
relief from whatever is causing it. In some cases, such as in
chronic fatigue syndrome, the two types of fatigue run in together
and we get debilitating mental and physical fatigue.
As well, certain medical conditions cause fatigue. A common
example, especially in women, is anemia. Other causes of fatigue
include chronic illness, heart and lung problems, cancer, diabetes,
hormonal disorders, and a variety of other conditions. If you
experience chronic fatigue then the first thing you should do is
see your doctor and make sure everything is OK.
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While we could go on ad infinitum about the different causes
and effects of fatigue and how to deal with them, we're going to
limit the discussion in this article to the fatigue associated with
exercise. What it is, why it happens and what we can do about
it. |
Assuming that there are no underlying problems, then we can
divide the fatigue that we experience as a result of exercising
into two types, peripheral and central. While the research in the
area of fatigue has focused mostly on peripheral fatigue, research
in central fatigue has been increasing although it mostly revolves
around serotonin and the central fatigue hypothesis.
Peripheral fatigue deals with the capacity of muscle to do
physical work. In this type of fatigue we're dealing with an
impairment in the normal functioning of the nerves and muscles
involved in muscle contraction. This covers the gamut from the
transmission of the impulses from nerves to muscle to the actual
contractile apparatus of the muscle itself.
Central fatigue, on the other hand, involves the central nervous
system, from our brain to the connections to the nerves that are
involved in muscle contraction. Central fatigue can be the result
of changes in various neurotransmitters in the brain secondary to
changes that occur in the body and mind.
Most fatigue associated with exercise usually involves some
degree of both peripheral and central fatigue. The degree that each
is involved is often difficult to determine as the contribution of
each to fatigue may vary between activities and even within the
same activity. For example, when doing a multiple sets of an
exercise using weights, the fatigue in the initial sets taken to
failure may be mostly peripheral, while the fatigue experienced in
later sets may more of a central component.
The problem with examining fatigue associated with a
bodybuilding type of weight training, is that it's not necessarily
valid to extrapolate from studies on fatigue done using endurance
or high intensity exercises that have different execution
variables. For more information on these variables and their
applicability to bodybuilding see the well done recently published
review on the application of studies done on fatigue to
bodybuilding.
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Peripheral Fatigue - The mechanisms of fatigue
within muscle (peripheral fatigue) are well studied and include
impairments in neuromuscular transmission and propagation down the
sarcolemma, dysfunction within the sarcoplasmic reticulum involving
calcium release and uptake, availability of metabolic substrates
and accumulation of metabolites, and actin-myosin cross bridge
interactions. |
The more important causes of physical fatigue, in my view, have
to do with 1. systemic changes such as overheating and dehydration.
And 2. the availability and accumulation of various compounds.
1. Systemic factors that may cause peripheral
fatigue
Dehydration - While not as important as in
endurance events, dehydration can cause fatigue even with
resistance training. Dehydration doesn't have to be extreme to
impair performance and as little as a three to four pound loss of
water weight (something that's not too hard to imagine in a
vigorous workout) can increase fatigue.
Pure water is not the best way to rehydrate during and after
exercise. To restore the body fluids you sweat out during exercise,
you should consume a beverage that contains some appropriate
electrolytes, including sodium and potassium, and some glucose and
perhaps a buffering agent. Sodium and potassium are volumizing
agents and help to maintain blood volume and increase the
absorption of water from the GI tract. It's important, therefore to
drink fluids before, during and after exercise to prevent
dehydration and overheating.
Overheating - Body temperature increases with
exercise, in some cases as high as 104 degrees even with resistance
training. Since large volumes of blood are diverted to the skin to
try and cool the body down, the circulatory system may become
burdened and result in an increased temperature which in turn
results in decreased performance and fatigue.
The best way to deal with this is to make sure you're well
hydrated and to decrease clothing worn so that sweat evaporates
readily cooling the body off.
2. The availability and accumulation of various
substrates, metabolites and metabolic byproducts.
First of all it's important that there are no vitamin or mineral
deficiencies as these can impact on performance and cause fatigue.
For example, even marginal deficiencies in potassium, calcium,
magnesium and zinc can cause fatigue, as can deficiencies of
various vitamins including the B vitamins, folate, vitamins A, C
and E.
It's useful to examine the changes that take place in the muscle
during exercise and compare these changes with the resting
condition. As well, we can suggest ways in which any changes that
may impact on performance and fatigue can be corrected, and as such
reverse the fatigue and decreased performance.
Changes that take place with exercise over the resting
state include:
- Decreased ATP levels
- Decreased levels of phosphocreatine (PCr)
- Increased levels of ADP and Pi
- Increased pH or acidity
- Increased lactate concentrations
- Increased ammonium levels
- Decreased muscle glycogen
- Strategies to combat fatigue
Based on the principle in which any differences from the resting
state may be responsible for fatigue and decreased performance, one
way to determine the cause or causes of fatigue, although limited,
is to increase or decrease the concentration of a substrate which
is depleted with exercise but is required for contraction or the
absence or accumulation of substance that may fatigue. Keep in mind
that because it's likely that a number of changes are responsible
for fatigue, there may be a number of individual strategies that
will have an effect on decreasing fatigue. In all likelihood, the
best approach to combating fatigue is one in which a variety of
strategies are combined. Some of the more popular strategies
are:
* Creatine ingestion with the purpose of increasing PCr levels
in the muscle cells, along with an increased ability to form PCr
when needed. The ingestion of creatine, usually in the monohydrate
form has been shown to increase levels of both creatine and PCr in
muscle cells, and to result in increased performance and decreased
fatigue. Interestingly enough a recent study has also shown that
creatine supplementation also reduces mental fatigue in humans.
* Use of a buffer solution to combat the acidosis. Several
studies have implicated acidosis as a likely cause of fatigue,
especially during high-intensity intermittent exercise and likely
during high volume resistance training. In my view and according
the literature, buffer solutions that might prove useful are ones
containing either bicarbonate or the non bicarbonate natural
buffers of vertebrate muscle including inorganic phosphate,
protein-bound histidine residues, and the dipeptide carnosine.
* Increasing muscle glycogen content and increasing the use of
free fatty acids as the primary muscle fuel. Using strategies to
maximize glycogen levels but restricting the use of glycogen for
those times when it's needed the most, the times when only
anaerobic energy has to be produced, and fat adapting muscle so
that fat is used as the primary fuel, increases performance and
decreases fatigue.
Use of antioxidants - Oxidant and radical
damage to skeletal muscle membranes has been implicated in the
fatigue process and several studies have found that the use of
antioxidants, such as vitamin E, increases muscle contractile force
and decreases fatigue.
Central Fatigue
In addition to focusing on the causes of muscle fatigue, recent
research has also centered on mental fatigue during exercise. This
is commonly called central fatigue because it results from impaired
function of the central nervous system. Although central fatigue
does not affect your muscles directly, it can reduce your capacity
to perform.
The basis behind the central fatigue hypothesis is the theorized
correlation between levels of the amino acid tryptophan in the
brain, which is a precursor for the neurotransmitter serotonin, and
the degree of mental fatigue. When tryptophan enters the brain, it
leads to increases in serotonin levels, which can depress the
central nervous system, causing sleepiness and fatigue.
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One of the ways that has been suggested for fighting off the
increases in tryptophan entering the CNS is the use of branched
chain amino acids (BCAA) during exercise. Most of the blood
tryptophan in the body is loosely bound to albumin, one of the
blood proteins, with a certain amount free. |
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The free tryptophan is transported, along with other amino acids
(such as the branched chain amino acids leucine, isoleucine and
valine) into the CNS. Thus tryptophan levels in the brain, and
subsequently serotonin levels, increase when there is an increased
ratio of free tryptophan to the total BCAA concentration. The more
BCAA present the less tryptophan enters the brain and less
serotonin is produced. The end result is less central fatigue. The
process is much more complicated than what I've just described and
there are many other players that can influence brain serotonin
levels. Also there is still some controversy about whether the
central fatigue hypothesis is even valid. Nevertheless, there are
now intriguing theories and some evidence to support a possible
role of nutrition in central fatigue during rest and exercise.
Stimulants - One of the ways to combat fatigue,
both central and peripheral, is through the use of stimulants such
as caffeine and ephedrine, either alone or in combination. Studies
have shown that these compounds are effective in increasing both
strength and endurance, and in allaying fatigue.
The bottom line is that using several of the strategies I've
mentioned will help you combat fatigue and make your training more
productive and satisfying.
References:
1 Lambert CP, Flynn MG. Fatigue during High-Intensity
Intermittent Exercise: Application to Bodybuilding. Sports Med
2002; 32(8):511-522.
2 Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J
Appl Physiol 1992; 72(5):1631-1638.
3 Vandenberghe K, Goris M, Van Hecke P, Van Leemputte M,
Vangerven L, Hespel P. Long-term creatine intake is beneficial to
muscle performance during resistance training. Journal of Applied
Physiology 1997; 83:2055-2063.
4 Volek JS, Kraemer WJ, Bush JA et al. Creatine
supplementation enhances muscular performance during high-intensity
resistance exercise. Journal of the American Dietetic Association
1997;97:765-770.
5 Watanabe A, Kato N, Kato T. Effects of creatine on
mental fatigue and cerebral hemoglobin oxygenation. Neurosci Res
2002 Apr;42(4):279-85.
6 MacDougall JD, Ray S, Sale DG McCartney N, Lee P,
Garner S. Muscle substrate utilization and lactate production
during weightlifting. Canadian Journal of Applied Physiology 1999;
24:209-215.
7 Coombes JS, Rowell B, Dodd SL, Demirel HA, Naito H,
Shanely RA, Powers SK. Effects of vitamin E deficiency on fatigue
and muscle contractile properties. Eur J Appl Physiol 2002;
87(3):272-277.
8 Jakeman PM. Amino acid metabolism, branched-chain
amino acid feeding and brain monoamine function. Proc Nutr Soc
1998; 57(1):35-41.
9 Graham TE. Caffeine and exercise: metabolism,
endurance and performance. Sports Med 2001; 31(11):785-807.
10 Bell DG, Jacobs I, Zamecnik J. Effects of caffeine,
ephedrine and their combination on time to exhaustion during
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77(5):427-33.
by Dr.
Mauro Di Pasquale