Examining Chronic Fatigue Syndrome

A few years ago, I became interested in Chronic Fatigue Syndrome (CFS) while working with three athletes who had battled CFS and were in the process of beginning to train again. I know two other athletes on a social basis that battled the disease. Through a mutual friend, I interviewed a third athlete when I was composing this column, though I don't know her personally.

The focus of the two-part series is CFS and elite or highly-competitive age group athletes, not CFS and the general population. All of the athletes I know personally were elite-level athletes when the disease struck, and I suspect highly-competitive age group athletes that are at risk for getting CFS may be vulnerable to the same pitfalls as elites.

Chronic Fatigue Syndrome can be described as a condition that is characterized primarily by extremely low levels of energy over a prolonged period of time. One of the athletes I interviewed, H.A., was sleeping 18 to 20 hours per day at the peak of her illness.

A second athlete, W.H., said he felt like he could fall asleep, literally, 30 minutes into a one-hour bike ride. He said it felt like there was an elephant on his back each time he tried to do anything physical. G.D. was driving to his next race when CFS hit him for the second time. He expected to be on the podium at the race, but instead he was admitted to the hospital with fatigue and other symptoms so severe he wouldn't get out of bed for a week.

R.C. said he just felt tired and sick. The kind of sick feeling that looms when you're about to get a cold or the flu, but that feeling doesn't go away—for a long time.

Through investigation, I found there are many factors that may cause CFS in the general population that typically do not apply to athletes—at least the four athletes interviewed for this story. These factors include environmental toxicity, dental amalgams, dental infections, drug toxicity, food-related poisoning and allergies to food or the environment.

An Unknown Fatigue

All of the athletes I previously mentioned were national-caliber competitors when they were struck with CFS. Each one had either been invited to the Olympic Training Center to train as part of a training camp situation or had raced for the national team.

As top-shelf athletes and champions of their sport, they know how to work and how to suffer. They also know the fatigue associated with big blocks of training or racing; but CFS created a fatigue foreign and unwelcome to the best athletes.

The normal fatigue they were accustomed to, and perhaps enjoyed, is the fatigue associated with overreaching. Overreaching can be defined as "an accumulation of training and non-training stress resulting in a short-term decrement in performance capacity with or without related physiological and psychological signs and symptoms of overtraining..."

This kind of fatigue means tired legs one or two days after a strenuous workout; legs that call for your attention walking up a flight of stairs after a tough training block.

Overtraining can be defined as "an accumulation of training and nontraining stress resulting in a long-term decrement in performance capacity with or without related physiological or psychological signs and symptoms of overtraining in which restoration of performance capacity may take several weeks or months."

Often, athletes experiencing overtraining report performances as being sub-par or "stale." This kind of fatigue is often seen after multiple weeks of high volume or high-intensity training. Speed during workouts and races are below expectations. The desire to train or race is minimal and athletes feel "flat."

Beyond Overtraining

The definitions for overreaching and overtraining are borrowed from The Encyclopaedia of Sports Medicine. Extending the definitions, Chronic Fatigue Syndrome in athletes can be described as the third step in the continuum.

Perhaps CFS can be defined as an accumulation of training and nontraining stress resulting in a long-term decrement in performance capacity, with or without related physiological or psychological signs and symptoms, in which restoration of performance capacity may take several months or years.

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