Fatigue

Wherever we set the finish line is where we fatigue.



A year into the COVID-19 pandemic and we are all feeling a bit fatigued, fed up and bored of the whole thing. Increasingly in clinic over the last few weeks the conversation of fatigue has popped up.


Fatigue can be caused by a number of medical conditions such as Anaemia, Sleep Aponea, Underactive Thyroid, Coeliac Disease, Diabetes, Glandular Fever, Chronic Fatigue Syndrome, Depression, Anxiety, Restless Legs Syndrome. All are reasons to feel fatigued. We also know that poor sleep quality in general and dehydration contributes to fatigue. But these are not the only reasons we can feel fatigued.


Some years ago a study was carried out with professional cyclists to get a sense of what psychological factors contributed to fatigue. Once researchers had discovered these ultra-competitive athletes consistent physical fatigue thresholds due to things like their VO2Max scores, anaerobic thresholds, core body temperature and glycogen supply they started to test for psychological factors. At the point of reaching their physical fatigue where every sinew in their body was shouting at them to stop, the researchers would test which psychological incentives would allow the cyclists to carry on even for a few more seconds. Incentives such as a day off training if they could manage 30 more seconds, £500 if they could manage another 45 seconds and the like. What they discovered as the biggest driver to overcome physical fatigue was crowd noise and encouragement from their peers. This in part might explain to some extent the phenomenon of home advantage in sporting events and why Team GB performed so well at the London Olympics.


The scientist Tim Noakes has spent his career looking at how the mind works towards our sense of fatigue. In very brief he and others suggest that the brain works as a central governor limiting our ability to push beyond perceived fatigue to ensure self preservation. This was considered useful as hunter gatherers as they needed to have the energy to turn around and get safely back to base before they became so fatigued physically from the hunt that they became the hunted.


His work has also shown that we will nearly always psychologically fatigue before we physiologically fatigue. In other words our brains will tell us to stop and give up before our bodies need to. You'll know this if you've ever done any meaningful exercise. If you've ever trained to improve your fitness such as doing couch to 5k or pushed yourself on a big cycle, half marathon or marathon training there are many moments you want to stop but you have to somehow find a way to keeping taking step after step.


Wherever we set the finish line is where we fatigue. When we go out for a run we subconsciously pace ourselves. So if you are doing a 5 km run you will feel that the last 500m or so are really hard work but if you go out for an 8 km run or a 10 km run you won't feel the same level of fatigue at the 4 or 5 km mark but you will as you get nearer that finish line you've set yourself.


Life is essentially the same. We set various finish lines for ourselves all the time. This week is a perfect example. Half term. Many of us with school age children look towards that as a marker or finish line. We pace ourselves sub consciously to get to half term and when it comes or as it approaches we feel fatigued, flat, fed up, worn out.


COVID-19 certainly doesn't help. Typically to keep us running beyond that arbitrary finish line we would use the half-term break to have a holiday or socialise with friends - the crowd noise and support of peers mentioned in the experiment above. Unfortunately we can't do that at the moment in the same way and therefore we are all probably feeling more fatigued than usual.


The great challenge with the pandemic is the sense that the finish line keeps moving. We subconsciously pace ourselves to get to whichever date we think things are going to change and start getting "back to normal". The 8th of March is probably the next one that most of us have in mind but most likely we need to consider that particular point like a water station in a marathon rather than the finish line and I suspect there will be a few more of them to come before all this is over.


So, are most of us feeling fatigued at the moment? Is it understandable considering what everyone is going through? Absolutely.


What can be done? It's been said many times over the last year. This is a marathon, not a sprint. As we are approaching a year since we first went into lock down, it's easy to set that as a sort of finish line but in reality nobody really knows where the finish line is. Eventually we will get there and we are getting closer everyday. The vaccine program is getting through remarkable numbers, the knowledge of the virus and methods to treat it are improving all the time and as the weather brightens in the coming weeks and months we will most likely be able to start to meet in small groups outdoors and won't that be great.


In the meantime get some sleep, stay hydrated, do some regular exercise, get some fresh air, talk to people, lose yourself in a hobby, put down the phone or device, ration the amount of news you expose yourself to, challenge your brain and make a list of the things you'll promise yourself you will do when that finish line does appear so it gives you the energy to keep on running.

SPINAL PHYSIOTHERAPY &
SPORTS MEDICINE CLINIC

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