Mechanisms underlying fatigue
1. Acidosis and ATP depletion due to either increased ATP consumption or decreased production
2. Decreased effectiveness of Ca2+ on actin and overall less Ca2+ release from the sarcoplasmic reticulum
3. Oxidative stress leading to build up of excess reactive oxygen species (ROS) causing breakdown of proteins, lipids, or nucleic acids and triggering interleukin (IL)-6, a mediator of inflammation
4. Local inflammatory reaction with presence of immune system intermediates increasing perception of pain as a signal to protect tissues from further damage