OBJECTIVE: A study was conducted to investigate the effects of fatigue on the ability of human musculoskeletal system to deal with the onslaught of the heel strike initiated shock waves. DESIGN: Running on a treadmill at the anaerobic threshold level for 30 min was used to acquire the experimental data on the foot strike initiated shock waves. BACKGROUND: Muscles act to lower the bending stress on bone and to attenuate the dynamic load on human musculoskeletal system. Fatigue may diminish their ability to dissipate and attenuate loading on the system. Knowledge of the effects of fatigue on the ability of the human musculoskeletal system to attenuate the shock waves may help in design of the training procedures and exercises. METHODS: Twenty-two young healthy males participated in this study. Each one was running on the treadmill at the speed corresponding to his anaerobic threshold for 30 min. The heel strike induced shock waves were recorded every 5 min on the tibial tuberosity and sacrum. The data obtained were analyzed in both temporal and frequency domains. RESULTS: The results reveal significant increase in the dynamic loading experienced by the human musculoskeletal system with fatigue. This may be attributed to the inability of the fatigued system to provide an efficient way to attenuate shock waves. CONCLUSIONS: The analysis of the recorded signals suggests that fatigue contributes to the reduction of the human musculoskeletal system's capacity to attenuate and dissipate those shock waves. This capacity appears to be a function not only of the fatigue level, but also of the vertical location along the skeleton. RELEVANCE: Fatigue during running may affect the ability of the human musculoskeletal system to attenuate and dissipate the heel strike induced shock waves. The study of the fatigue effect on shock wave attenuation provides information that may benefit the runner.