Injuries and Adrenal Fatigue – Can You Train Through Either?


Author’s Note: I am not a doctor, nor do I claim to be. Information in this post is from my own research from as reputable sites as I could find. If you have better information, please feel free to share, as long as you cite your sources.


Athletes can be a stubborn bunch. Even those of us that should know better, that coach or advise others, tend to not follow the best practices when it comes to injuries.

You know who I am talking about.

When we are training for a specific goal, a target race, the only “A Race” on our schedule, nothing will deter us from those long training days, the early morning sprints around the neighborhood, the sneaking out of work early to get a swim in before a scheduled bike ride. Miles or Time in training equals success on race day, so the inverse must also be true, basically, that time or miles lost during the training period costs us on trace day. We will run through small aches and pains to the point that we are hobbled, then after an evening of ice, compression, and elevation, get right back out there the next day and do it again.

The trick is when is it time to say “enough”?

We are a short-sighted bunch. We either refuse to see the big picture or are so narrowly focused on the end event that we just don’t see it. We only see “today” and do not take into account what happens tomorrow if we continue to train through an injury. A slight tweak in an Achilles is run through until it changes from a “hurt” to an “injury”. When I played football the coach would always ask us as we lay writhing on the ground if we were hurt or injured. Back in the late 70’s when I played this was a HUGE distinction. If you are hurt, you can play, and if you can’t play, then you are replaced, and possibly never getting back on the field. This happened to me my last year of playing against New Smyrna Beach (damn them ‘Cudas). I was chasing a running back (#44 – will never forget that number) down the sideline and leaped at him just as he was about to score, grabbing him by the back of the shoulder pads (something that is illegal in today’s game). I snapped him backward (though not in time since he did cross the goal line) and I went flying into the spectator area, which was very close to the sidelines. I rolled a number of times before coming to a sudden stop against the concrete. When I got up I felt that my knee was off, but I limped back into the huddle for the extra point attempt. Back in these days, there was very little kicking, so they went for 2, using the same running back and I met him coming through the middle of the line, just as he planted his helmet directly to the same kneecap.

I couldn’t get up. My knee would not bend. A couple of teammates helped me to the sideline and sat me on the bench. My Defensive Backs coach came over and asked if I was OK. I told him “I can’t bend my leg”. He shook his head at me, swore, and yelled “Ingram … get in there for Harris” and walked away. I sat there for a few minutes, scared to pull my pants up to see what was there before the trainer came over. I leaned against the trainer we had as he pulled up my pants. My kneecap was about an inch off center. He looked at me and said “grit your teeth” which I did as he grabbed the knee and pushed it back in place, telling me it was “just dislocated” and would be OK. “Just ice it”. Since we lost that game (we played on Thursday nights) we had a practice the next day. I hobbled into my head coach’s office and told him I didn’t think I could go. All the coaches looked at each other, and then he said “fine … sit on the bench” without ever looking at me. I walked away, hearing them laughing when I closed the door, and never saw the starting lineup again.

So, when I feel a tweak, it is my first instinct to try to push through it. One day, to me, could mean not making the lineup, in this case, not starting the race. When I hear of others that have a nagging issue I am the first one to tell them to sit out, to rest, that losing one training day is better than losing the whole year, but I am the worst culprit. I am not alone. I know coaches who say the same thing to me yet are out running or biking on injuries themselves. As I said .. we are our own worst enemies.

Sometimes the injuries are evident, like a sprained ankle, a plantar fasciitis issue, a swollen knee, but often they are not, especially when we are dealing with true adrenal fatigue (AF). Once your cortisol levels drop to zero, there is no recovering from that other than taking time off. You cannot “train through it”. The issue is recognizing AF is not always easy, because it can feel amazingly like just being tired, or over-trained. So you take a day off, maybe two, and then hit it as hard as you can once more. And it is just as bad, or worse, than before.


What is Adrenal Fatigue?


From the Adrenal Fatigue website, AF is defined as a collection of signs and symptoms that results when the adrenal glands function below the necessary level, most commonly associated with intense or prolonged stress. As the name suggests, its paramount symptom is fatigue that is not relieved by sleep but it is not a readily identifiable entity like measles or a growth on the end of your finger. You may look and act relatively normal with adrenal fatigue and may not have any obvious signs of physical illness, yet you live with a general sense of unwellness, tiredness or “gray” feelings. People experiencing adrenal fatigue often have to use coffee, colas and other stimulants to get going in the morning and to prop themselves up during the day.

Adrenal fatigue can wreak havoc with your life. In the more serious cases, the activity of the adrenal glands is so diminished that you may have difficulty getting out of bed for more than a few hours per day. With each increment of reduction in adrenal function, every organ and system in your body is more profoundly affected. Changes occur in your carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. Many other alterations take place at the biochemical and cellular levels in response to and to compensate for the decrease in adrenal hormones that occurs with adrenal fatigue. Your body does its best to make up for under-functioning adrenal glands, but it does so at a price.

Pretty scary stuff right? I wonder how many of you reading this right now are walking around with it and never knew it? Dr. John Tinterra, a medical doctor who specialized in low adrenal function, said in 1969 that he estimated that approximately 16% of the public could be classified as severe, but that if all indications of low cortisol were included, the percentage would be more like 66%.

And this was in 1969 … you know … BEFORE the internet, 24/7/365 work days, terrorism, the ongoing conflicts in the Middle East, Donald Trump, etc. Imagine what the numbers would be today??

The problem is this; although adrenal exhaustion is a real medical condition that can be measured through blood tests, adrenal “fatigue” is not. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms, and there is no test that can identify adrenal fatigue (http://www.hormone.org/hormones-and-health/myth-vs-fact/adrenal-fatigue).

Eric Metcalf, MPH writes (and reviewed by Dr. Brunilda Nazario) on WebMD that:

Adrenal fatigue is a term that’s used by some to say that fatigue and other symptoms are caused by a poorly working adrenal gland in people who are under mental, emotional, or physical stress. But it’s not a proven medical condition. Your adrenal glands make hormones. One of these is cortisol, which helps your body deal with stress. According to the adrenal fatigue theory, if your life is too stressful, your adrenal glands may not pump out enough hormones, leading to a wide variety of symptoms. But there’s no evidence to support this theory. (http://www.webmd.com/a-to-z-guides/features/adrenal-fatigue-is-it-real)

Robert Vigersky, MD, a past president of the Endocrine Society, says the symptoms are very common in people in general. Though people often blame their hormonal glands, such as the adrenals or thyroid, for their tiredness, Vigersky says in many cases fatigue is due to common problems such as:

  • Poor sleep habits
  • Poor diet
  • Stress at work or home
  • Depression

All of these can affect your energy level without involving your adrenal glands. Fatigue is also a symptom of many diseases such as anemia, arthritis, diabetes, and heart failure, says Janet McGill, MD a hormone specialist at Washington University in St. Louis.

I know this … I fit into every symptom of adrenal fatigue but mine is due to 2 of the 4 (maybe 3 of the four) common problems, in addition to having psoriatic arthritis and no thyroid due to cancer. Adrenal Fatigue is a new buzzword (much like Celiac, where people want to be Gluten Free, but most are not actual Celiac diagnosed … ) so when someone throws that at you … take it for what it’s worth and get checked out before buying supplements. Do your homework, and do what is best for you using an intelligent mind. Lots of information is at your fingertips these days. There’s no excuse for being misinformed. And remember, just because the medical establishment doesn’t recognize something as a disease doesn’t mean it is not real (for example Fibromyalgia and Thyroid Disease were not recognized for a long time, and the effects of Low T is not agreed upon as well).

And if you’re tired … how about resting?

Just a thought …

Stress and the Modern Human

Stress can be a hard thing to describe to people, especially if they are one of the few that either (a) handles stress well, or (b) has very little stress in their life.

Most people can do neither, and those that are (b) are known as psychopaths.

We ALL have stress in our life. To say we don’t would be, as they say these days, #FakeNews.

Stress is a silent killer. It causes all kinds of problems physically and mentally, but the thing with stress is that it takes a long time for it to kill you. Often it sneaks up slowly over the course of years. People that report having little to no stress are often the most stressed when tested.

But also, while stress is inevitable for all of us, suffering is not.

Our bodies are built to handle stress. When a threat is perceived, the amygdala surveys the scene and determines your response, be it curling into the fetal position or just “letting it go”.  When the amygdala detects a threat it activates the sympathetic nervous system or SNS. The SNS can raise blood pressure and blood sugar to prepare your body for that stressor being perceived. So, like a chain reaction, the amygdala alerts the hypothalamus, which alerts the pituitary, which tells the adrenal gland to release cortisol.

Cortisol is your friend and your enemy. Acute, short-term release of cortisol is necessary and actually good for you. It increases vigilance, memory functions, and immune functions, and redirects blood flow to the muscles, heart, and brain. Our bodies are designed to accept this release is short bursts and small doses. This is what allowed our ancestors to escape attacks from wild animals. But what has happened these days is the stressors are constant. We no longer have wild animals to worry about sporadically, but we have 8-10 hour jobs and endless lines of creditors calling between the hours of 7:30 AM and 9:00 PM. Because fo this constant barrage of stress, our adrenals are pumping cortisol into our bodies without rest. This is what can kill you. Your blood pressure remains high, your brain on constant alert. Eventually, even the fittest person will succumb.

Chronic stress affects your ability to think also. We all have the part of the brain that keeps us out of danger or subconscious, but when constantly under stress and being pumped with cortisol the ability to reason is effected, allowing you to do crazy things that, in a normal state, you would not do. Did we have road rage incidents in 1960 or 1970? Probably, but I am betting that there were much fewer examples, but now when someone cuts you off in traffic or snags a parking spot, or even cuts in front of the line the instinct is now to “lash out” instead of “letting it go”. This is due to stress building up and preventing self-control from taking over.

It also causes the loss of cognitive control, or the ability to inhibit the drive to seek pleasure. This is why those under the highest amounts of stress, usually the lower socioeconomic classes, are the most likely to become addicted to drugs. It is no shock to learn that those lowest on the socioeconomic scale have the highest rates of disease and of cortisol levels.

Now, this is the bad part. Readers of this blog and listeners to the podcast usually have found us because they are either an athlete or aspire to be one. As stated earlier, our bodies are built to accept short bursts of cortisol to remove us from danger, but what if we elevate our blood flow on a constant basis by engaging in endurance sports? You bombard your body with stress, in this case, both mentally and physically, which releases cortisol on a constant basis through long training sessions and 7+ hour events. This can lead to adrenal fatigue, and that can take a while to recover from fully.

But I am not saying you need to stop. What I am saying is that we need to be aware of these issues, and to find balance in our lives. We cannot work 10-12 hours days in a high-stress job, only to leave and put our bodies through 3-4 hours of high-intensity training sessions and not expect that eventually, our bodies are going to quit on us. Be smart and find that pleasure in your life to counter the stressors. Saying to remove stress is a fool’s errand. It cannot be done, and for me to write a list stating that “these are the highest stress-related activities”, though you can find a few of those online, is all ridiculous because stress is a very personal thing. We all perceive it differently.

Be kind to yourself.