Learn Italian: Faccio fatica a capire questa lingua. - I struggle to understand this language.

Literally, it means "I make fatigue" or "I make effort." The noun fatica translates to effort, strain, or fatigue. In Italian, the phrase fare fatica is the standard, everyday way to express "to have a hard time" or "to struggle" with doing something.

Why is there an a before capire? Could I just say faccio fatica capire?

You need the a. The expression fare fatica strictly requires the preposition a to connect it to an infinitive verb (the base form of a verb, like capire). In Italian, many verbs and expressions require a specific preposition (usually a or di) before a following action.

Can I use the single verb faticare instead of the phrase fare fatica?

Yes, absolutely! Faticare is a regular verb that means "to struggle" or "to toil." You could rewrite this sentence as Fatico a capire questa lingua, and it means the exact same thing. Notice that faticare also requires the preposition a before the next verb.

Since this lesson is about pur + gerund, how would I add "Even though I study" to the beginning of this sentence?