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Muscle pain and chronic fatigue are common phenomena. Understanding these conditions can improve one's approach to exercise, training, and overall physical health.
Early muscle pain, often experienced during physical activity, acts as a warning signal indicating the maximum performance limit of the muscles. This discomfort usually subsides once the activity is stopped or the intensity is reduced. The pain is thought to be triggered by chemical changes in muscle fibrocells, including a drop in pH and an accumulation of oxygen free radicals. These biochemical alterations can lead to structural damage in muscle fibres, laying the groundwork for late muscle pain.
Delayed Onset Muscle Soreness (DOMS) is a common phenomenon that occurs after intense or unfamiliar physical activity, especially exercises involving eccentric contractions (where muscles lengthen under tension, such as lowering weights). DOMS typically sets in 12 to 24 hours post-exercise, peaks around 24 to 72 hours, and gradually subsides.
The soreness is caused by microscopic damage to muscle fibers and surrounding connective tissues. This damage triggers an inflammatory response, leading to swelling, stiffness, and sensitivity in the affected muscles. While uncomfortable, DOMS is a normal part of the body's adaptation process, helping muscles grow stronger and more resilient.
Although DOMS cannot be completely avoided, especially when trying new activities or increasing intensity, the discomfort can be managed with several evidence-based strategies:
Importantly, DOMS is not a sign of injury, but a natural part of training adaptation. Over time, as the body adjusts to the workload, the intensity of DOMS tends to decrease.
The fierce competitiveness of some sports, coupled with factors like technological advancements and economic incentives, has led to a dramatic increase in training volumes and intensities. This escalation often results in a negative impact on the body, leading to what is known as overtraining syndrome or chronic fatigue.
Overtraining syndrome is defined as a persistent reduction in performance due to excessive stress from training, competitions, and external factors, which persists even after an appropriate period of rest. This condition is often confused with overreaching, a state of excessive fatigue that results in a short-term performance decline and requires a shorter rest period.
There are two hypothesized types of overtraining: sympathetic and parasympathetic, each associated with distinct patterns of autonomic nervous system imbalance and commonly observed in different athletic populations.
More often seen in power and anaerobic athletes, such as sprinters, weightlifters, or high-intensity interval trainers. It is characterized by an overactivation of the sympathetic nervous system, which governs the body’s "fight or flight" response. Symptoms may include elevated resting heart rate, increased blood pressure, irritability, sleep disturbances, and reduced appetite. These athletes may feel restless or anxious, with a constant sensation of being “wired” despite fatigue. The body remains in a heightened state of arousal, which can impair recovery and performance.
More commonly observed in endurance athletes, such as long-distance runners, cyclists, and swimmers. This form reflects a dominance of the parasympathetic nervous system, which is responsible for "rest and digest" functions. Athletes experiencing this type often report unusually low resting heart rate, chronic fatigue, decreased motivation, depressive symptoms, and poor performance despite continued training. Unlike sympathetic, which is more acute in nature, parasympathetic overtraining tends to develop gradually and is harder to detect, often requiring longer recovery periods.
Recognizing an athlete suffering from chronic fatigue before the condition escalates is crucial. Symptoms indicating a general state of malaise can provide initial clues. These include frequent mood changes, sleep disturbances, lack of appetite, weight loss, lethargy, inattention during training, increased effort during training sessions, and post-training muscle soreness (DOMS).
Clinical signs confirming the diagnosis can be derived from an analysis of blood pressure and heart rate at rest, during, and after exertion, as well as metabolic measures such as the concentration of lactic acid in the blood in response to maximal and submaximal intensity exercises. These alterations often result from an imbalance of the autonomic nervous system.
