Molecular Basis for Exercise-Induced Fatigue: The Importance of Strictly Controlled Cellular Ca²⁺ Handling

The contractile function of skeletal muscle declines during intense or prolonged physical exercise, that is, fatigue develops. Skeletal muscle fibers fatigue acutely during highly intense exercise when they have to rely on anaerobic metabolism. Early stages of fatigue involve impaired myofibrillar function, whereas decreased Ca²⁺ release from the sarcoplasmic reticulum (SR) becomes more important in later stages. SR Ca²⁺ release can also become reduced with more prolonged, lower intensity exercise, and it is then related to glycogen depletion. Increased reactive oxygen/nitrogen species can cause long-lasting impairments in SR Ca²⁺ release resulting in a prolonged force depression after exercise. In this article, we discuss molecular and cellular mechanisms of the above fatigue-induced changes, with special focus on multiple mechanisms to decrease SR Ca²⁺ release to avoid energy depletion and preserve muscle fiber integrity. We also discuss fatigue-related effects of exercise-induced Ca²⁺ fluxes over the sarcolemma and between the cytoplasm and mitochondria.