|
A certain degree of fatigue is normal in an athlete training hard for their sport or event. However, excessive and persistent fatigue and feelings of legarthy with a reduced sporting performance, often indicate a more serious problem.
There are many possible causes of chronic fatigue and in order to narrow down the possibilities the coach or sports medicine practitioner must ask the right questions:
 Is there a constant feeling of fatigue, or does this occur before or after training/competition, at a particular venue (may suggest an allergy) or in warm weather (possible dehydration)
Does the patient fall asleep during the day?
How long has this tiredness been present? (try to establish if it first occurred after a competition, trip abroad or illness etc)
Are there any associated symptoms? (sore throat or a cold may indicate upper respiratory tract infection)
Are there any respiratory symptoms (such as a post-exercise cough or chest tightness) which may indicate exercise induced asthma or lower respiratory tract infection?
Causes of fatigue
As already mentioned there are endless causes of persistent fatigue. Some of the most common are listed here:
Overtraining syndrome
Viral illness
Inadequate diet low in carbohydrate or protein intake
Depletion of iron stores (Anaemia)
Chronic fatigue syndrome
Other conditions to look out for:
Dehydration
Exercise-induced asthma
Allergies
Jet lag
Psychological stress
Medication
Hypothyroidism
Diabetes
Pregnancy
Eating disorders
Infections
Neuromuscular disorders
If the answer to the problem is not immediately apparent, as it is not with so many of these cases, investigations should be undertaken to get to the bottom of the problem
Medical examination
In case the current fatigue problem is due to an undiagnosed medical condition, a thorough medical examination should be performed. This should include a complete medical history and subjective assessment of the current condition (including gastrointestinal, neuromuscular and menstrual (in females) symptoms).
An examination should include resting heart rate and blood pressure as standard, along with any other examinations the clinician feels may be beneficial.
Further investigations and tests may be necessary and can include:
Urine tests (to test glucose and protein levels)
Blood tests (haemoglobin, white cell count, urea, electrolytes, Vitamin B12, thyroid function)
Chest x-rays/Electrocardiogram (ECG)
Lung spirometry
Training diary
Keeping a diary of the training performed each day, along with the symptoms and feelings of fatigue can be a key diagnostic aid. This can help to see if the athlete gets enough rest and if there has been a recent change in training methods, intensity or volume. The amount of sleep and rest should be recorded each day, as should social events and other commitments.
Nutrition diary
A nutrition diary should also be recorded daily and should include everything consumed, including supplements, drinks and alcohol. This can help determine if the athlete eats enough in general, consumes adequate volumes of carbohydrate and protein to support their training or has any allergies or intolerance's.
Chronic Fatigue Syndrome
What is Chronic fatigue syndrome?
Chronic fatigue syndrome (CFS) is a hotly debated condition, to the extent that some medical professionals debate its very existence. CFS has previously been known as Neurasthenia and Myalgic Encephalomyelitis (ME). The condition can be variable in severity and affects around 4 in every 1000 people, most commonly women.
The development of CFS in athletes is not uncommon, especially in those who combine full-scale training, with job and family commitments and those who continue to compete with a viral illness.
What are the symptoms of CFS?
There are a number of definitions of the condition, with all highlighting fatigue which interferes with daily living, lasting for a period of over 6 months. Diagnosis of CFS is difficult as the cause is unknown. It is therefore usually by exclusion of other conditions, that the diagnosis of CFS is made. The following symptoms are common:
 Chronic mental and physical exhaustion
Impairments in short-term memory and concentration
Muscle pain
Headaches
Multi-joint pain
Tender cervical or axillary nodes
Sore throat
Sleep which does not refresh
A persistent feeling or discomfort following any exertion
Management of CFS
The natural course of CFS usually shows a gradual improvement over the course of months, or sometimes years. Treatment should be focused on relieving symptoms and usually psychological support.
Exercise is often used as a treatment method, albeit initially at an extremely low level, so that the individual can complete the activity and not suffer adverse affects over the following 48 hours. Research has found that a graded exercise program increases the sense of fatigue and perception of health in the individual with CFS.
Anti-depressant medication can also be used to reduce feelings of depression and anxiety, as well as to improve the quality of sleep.
|
Chronic Fatigue
بواسطة: 
