title: Lactate: Friend or Foe.
abstract: Lactic acid has played an important role in the traditional theory of muscle fatigue and limitation of endurance exercise performance. It has been called a waste product of anaerobic metabolism and has been believed to be responsible for the uncomfortable "burn" of intense exercise and directly responsible for the metabolic acidosis of exercise, leading to decreased muscle contractility and ultimately cessation of exercise. Although this premise has been commonly taught, it is not supported by the scientific literature and has led to a great deal of confusion among the sports medicine and exercise science communities. This review will provide the sports medicine clinician with an understanding of contemporary lactate theories, including lactate's role in energy production, its contributions to metabolic acidosis, and its function as an energy substrate for a variety of tissues. Lactate threshold concepts will also be discussed, including a practical approach to understanding prediction of performance and monitoring of training progress based on these parameters.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Sports Medicine, 2701 Prairie Meadow Dr, Iowa City, IA 52242(∗). Electronic address: mederic-hall@uiowa.edu.
authors.forename: Mederic M
authors.initials: MM
authors.lastname: Hall
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Sports Medicine, 2701 Prairie Meadow Dr, Iowa City, IA 52242(†).
authors.forename: Sathish
authors.initials: S
authors.lastname: Rajasekaran
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Sports Medicine, 2701 Prairie Meadow Dr, Iowa City, IA 52242(‡).
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Thomsen
authors.affiliation: Stead Family Department of Pediatrics, University of Iowa Sports Medicine, Iowa City, IA(¶).
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Peterson
mesh_terms: D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D018763:Muscle Fatigue / Q000502:physiology*; D018482:Muscle, Skeletal / Q000378:metabolism*; D010101:Oxygen Consumption; D010807:Physical Endurance / Q000502:physiology*
chemical_list: D019344:Lactic Acid