By Dr. Stefano Casali
Early muscle pain
It arises during exercise and tends to fade quickly and disappear after it has been interrupted. It is an "alarm bell" that warns of the maximum performance limit tolerable by the muscles, so it is better to reduce the intensity of the effort or stop it. This type of pain is probably induced by the chemical modifications that occur in muscle fibrocells (lowering of the pH, accumulation of oxygen free radicals). The same biochemical alterations are at the base of the structural damages that occur in the same muscle fibers later and that are the basis of late muscle pain.
DOMS or Delayed Onset Muscle Soreness
It is an important and characteristic syndrome. According to some authors the cardiac muscle could also be affected by fatigue (cardiac fatigue); this phenomenon has been demonstrated only in athletes who dedicate themselves to very long duration races such as ultramarathon or Hawaiian triathlon (Ironman = 4 km of swimming, 180 km of cycling and marathon). The heart of these athletes, examined immediately after arrival, shows a certain degree of reduction in its ability to contract, which disappears in the subsequent checks carried out 24-48 hours later. In addition, substances such as Troponin T and I cardiacs have been found in the blood, which are found only in cases of myocardial damage as in infarct.
Chronic fatigue (overtraining syndrome)
One of the most characteristic aspects of the sport practiced at the highest level is represented by the difficulty not only to excel in competitions, but also to maintain long top positions in national and international rankings. The enormous increase in the number of individuals capable of competing at the highest levels, the participation in the events of talents from Third World countries, the great economic incentives, the improvement of equipment and materials thanks to new technologies are some of the factors that can explain the increased competitiveness and with it the difficulty of winning. This phenomenon has had numerous implications on a practical level, among these of medical sports interest is the considerable increase in volume and intensity of training. It is very unlikely that an excess of workloads in training and the number of official competitions will not have negative repercussions on the body. Although overtraining syndrome is studied by several authors, one of the most controversial aspects is precisely the definition of overtraining which can be defined as the condition in which "the athlete is stressed by training, competitions and external factors to the point of meeting to a reduction in its performance that remains even after an appropriate period of rest or "regeneration".
Distinction between:
state of overtraining real "overtraining";
excessive overreaching fatigue.
The latter is much more frequent than the former and is characterized by a drop in performance after acute exposure to an excessive load but, unlike the former, a rest period of a few days is sufficient to return to normal. The open questions are:
- What amount should be the decrease in performance to be considered significant and how long this reduction should last to talk about ovetraining or overreaching.
- Most scholars believe that to get out of this condition a few days of rest are not enough, but a long period of weeks or months is needed.
- If overtraining affects not only endurance athletes like marathon runners, but also athletes dedicated to other types of disciplines such as football, tennis or basketball.
- How much they play in addition to a wrong schedule of training and competitions, also external factors (psychological pressure, infections, traumas, time zone changes and climate) very important in high-level competitions.
Diagnosis of chronic fatigue
It is important for a trainer to recognize an athlete suffering from this syndrome, it is necessary to recognize the symptoms before the condition becomes serious and forces the athlete to interrupt his performance for a long time.
In addition to the obvious drop in performance, a first indication is given by the appearance of symptoms that indicate a state of general malaise.
The athlete
He complains of frequent mood swings, sleep disturbances, lack of appetite, weight loss;
Become listless, apathetic, inattentive during training;
The workouts are carried out with increasing "effort";
Often after training or competitions there remains an annoying muscle pain (late muscle pain or DOMS).
First confirmation of suspicions
From a careful analysis of the behavior of arterial pressure (PA) and heart rate (CF) at rest, during and after exercise;
From simple metabolic measures such as the measurement of the concentration of lactic acid in the blood in response to exercises of maximal and sub-maximal intensity.
The alterations of BP and CF depend largely on an imbalance in the autonomic or autonomic nervous system.
Hypothesis of two types of overtraining syndrome: sympathetic and parasympathetic
Power athletes sympathetic type syndrome
Resistance athletes parasympathetic type syndrome
