At night he couldn't fall asleep, though he was completely exhausted. Once asleep, he would wake up and remain awake for several hours. During the day, exhausted, he felt like he could fall asleep, literally, while riding his bike.
With low-intensity training and lots of rest, he did a race. He was surprised when he placed reasonably well. Seven weeks after his initial fall into the chasm of fatigue, he seemed to recover and began racing again—though he would never be as strong and as fast as he was before he was struck with CFS.
Factors Contributing to CFS
Each athlete's individual story could easily be expanded to give you more details. It was hard for me to pare them down because each one was so compelling. I asked the athletes to tell me what factors they thought contributed to their fall to CFS and though no two athletes had identical circumstances, the combined list follows:
- Escalating success in sport. Every one of the athletes was at the top of their respective sports when struck with the disease.
- Pressure to win or succeed. This includes internal pressure, sponsor pressure, media pressure and pressure to make Olympic teams. The less obvious pressure came from the whispers of fellow athletes. There was a perception (or reality) that other athletes were talking about their bad performances and they were "washed up."
- Excessively high training volume
- Excessively high intensity training
- Excessive travel and race schedule
- Viral or bacterial illnesses
- Physical injuries
- Low-nutrient diet
- Low-calorie diet
- Emotional stress due to family issues or a relationship with a significant-other
- Emotional stress due to school, work or other obligations
- Not listening to signals that the body needed to rest and recover. This included high resting heart rates and the inability to achieve heart rates and training paces that were otherwise achievable.
Factors Contributing to Recovery From CFS
Some athletes felt they didn't have success with some of the items on the list below, while others credit one or two particular items as key to recovery. What worked for one athlete didn't work at all for another.
- Resolving viral and bacterial infections with antiviral or antibiotic medications
- Resolving physical injuries to 100 percent, rather than just good enough to get through another race
- A system of family, friends and coaches that gave unwavering and unconditional support, no matter the measurable achievements of the athlete-person
- Nutrient-dense foods that included fresh vegetables, fruits, whole grains and meats
- Complete rest
- Low-intensity and low-volume aerobic training
- Vitamins and herbal supplements
- The inner strength to rest, no matter what the training plan has scheduled
Signals or Tools to Avoiding Another Fall
Each athlete said there were signs and signals that they needed to pay attention to in order to stay out of the pit of fatigue. Again, no two athletes had exactly the same set of signals. Now, when the athletes begin to notice changes they take time off to rest and recover. Sometimes it's as easy as backing off of the volume or intensity of training, rather than complete rest. Other times it must be complete rest.
- Sleep disturbances
- A feeling of overall body fatigue
- Mood changes
- Night sweats
- Fatigue in muscles that doesn't get better in a day or two
- Unusual heart rates
- Wounds or injuries that don't heal as quickly as in the past
- Training paces that are getting slower
- Careful tracking and manipulation of training volume and intensity
- Reduce training when life stresses increase
- Planned rest periods within a training schedule where volume, intensity and racing are significantly decreased or eliminated
I believe the athletes that are at the highest risk for CFS are those that are highly gifted and very driven—both physically and mentally. Though the athletes I spoke with were national and international level professionals, I suspect gifted age group athletes are at risk for CFS too.
Perhaps one day there will be a test to decisively determine if an athlete has Chronic Fatigue Syndrome. In the best case an easy test, such as a self-administered saliva test, will be developed to determine if an athlete is heading toward trouble. Then steps can be taken to prevent the downward spiral of fatigue.
Between now and when technology can help head off CFS, perhaps an awareness of the disease can help prevent some from falling into the abyss. Share your own experiences with Chronic Fatigue Syndrome in the comments section below or in our triathlon community.