Derman, W, Schwellnus, M P, Lambert, M I et al. · Journal of sports sciences · 1997 · DOI
Doctors who treat athletes need to be able to tell the difference between normal tiredness from hard training and severe, long-lasting fatigue that signals a real medical problem. This article presents a framework to help doctors figure out what's causing persistent fatigue in athletes, including checking for treatable diseases, overtraining, and possible muscle disorders that might not show up on standard tests.
For ME/CFS research and patients, this study is relevant because it highlights that persistent fatigue can stem from underlying muscle pathology rather than purely psychological or training-related causes, and it emphasizes the importance of multidisciplinary evaluation. The proposed diagnostic framework and mention of muscle biopsy findings in fatigued athletes may inform approaches to understanding post-exertional malaise and muscular dysfunction in ME/CFS.
This review does not prove that muscle disorders are the primary cause of chronic fatigue syndrome in athletes or establish prevalence rates for the conditions described. It does not provide controlled comparisons between athlete populations and non-athlete populations with fatigue, nor does it definitively separate ME/CFS from 'fatigued athlete myopathic syndrome' through prospective data.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Spotted an error in this entry? Report it →