Overtraining syndrome

Overtraining syndrome (OTS) occurs in athletes when intensity of training excedes the body's ability to recover. It is common in nearly every sport and fitness activity. "The most common causes of overtraining are quick increases in frequency, intensity, or duration of training sessions, or a combination without the necessary recovery."

Overtraining syndrome vs ME/CFS
Overtraining syndrome has the symptom of fatigue which is a symptom of some Chronic fatigue syndrome (CFS) criteria such as Oxford criteria and Fukuda criteria which often misdiagnose other conditions that have chronic fatigue.

Training Peaks notes the similarity of OTS and other diseases including CFS.


 * "You’ll be in the early stages of the overtraining syndrome. That will be marked by symptoms like:


 * relentless fatigue
 * poor training performance
 * lethargy
 * low motivation
 * bad attitude about life in general


 * If you keep pushing it beyond this fatigue you’re likely to experience full-blown overtraining which is similar to having a disease such as mononucleosis, chronic fatigue syndrome, or Lyme disease. It isn’t pretty. And it may take you weeks if not months to shed the overtraining symptoms."

There have been media reports of athletes with Myalgic encephalomyelitis (ME) who have recovered after rest, supplementation, diet changes, and the mind.

Physiological

 * Altered resting heart rate and blood pressure.
 * Back, knee, ankle, and foot injuries.
 * Bad attitude about life in general.
 * Chronic fatigue
 * Decreased efficiency of movement and physical performance.
 * Decreased lactate response
 * Decreased maximum work capacity
 * Frequent nausea/gastrointestinal upsets
 * Headaches
 * Hormone imbalance includes elevations of cortisol with secondary lowering of testosterone and DHEA levels.
 * Impaired muscular strength
 * Inability to meet previously attained performance standards or criteria.
 * Increased frequency of respiration
 * Insatiable thirst
 * Insomnia
 * Joint aches and pains
 * Lack of appetite
 * Lethargy
 * Low motivation
 * Lower percent of body fat
 * Premenstrual syndrome and menopausal symptoms may be secondary complaints for women, but amenorrhea (Menstrual disruptions) is a common problem.
 * Mental and emotional stress, including mild or clinical depression and anxiety is not uncommon.
 * Muscle soreness and tenderness
 * Prolonged recovery from exercise
 * Reappearance of previously corrected mistakes.
 * Sexual dysfunction may be a problem for both sexes, typically producing reduced sexual desire and sometimes infertility.

Psychological

 * Changes in personality
 * Decreased self-esteem and motivation to workout.
 * Depression
 * Difficulty concentrating during work, school, or training.
 * Easily distracted during tasks.
 * Emotional instability
 * Fear of competition
 * Feelings of sadness and depression.
 * General apathy
 * “Giving up” when the going gets tough.
 * Mood changes

What personal trainers and fitness professionals should do to combat OTS

 * Keep accurate and detailed records of each client’s workout. This allows the personal trainer to effectively monitor and adjust training volume and intensity depending on an individual’s current training status.
 * Be sure clients know to eat a healthy diet, drink enough fluid to stay hydrated, and get enough sleep for optimum performance every day. Each day’s habits contribute toward overall health and well-being.
 * Encourage and allow clients to openly communicate about concerns, both physical and mental.
 * Physical training is affected by emotional health. Explain to your clients and students that job stressors, interpersonal relationships, and other environmental stressors may have a harmful effect on physical performance. Maintaining health and wellness in all areas of life will help to prevent OTS.
 * OTS is most successfully treated with rest and/or meaningful changes in the volume and intensity of a client’s present exercise program. The rest and decrease in exercise needs to be individualized for each client. For instance, some individuals may just need one or more recovery days added to their weekly program. Other individuals may need a significant drop in exercise volume (number of sessions, exercises, sets and reps) in addition to lower exercise intensities (heart rate in cardiovascular exercise and %1RM in resistance training). Indeed, other clients may need sustained days of rest from all physical activities to recover from OTS.
 * Highly fit individuals sometimes find complete rest a greater source of stress. Personal trainers should initiate alternative activities that keep individuals “active,” but aid in recovery. Emphasis toward lower intensity physical activities such as walking, stretching, mind-body programs, and balance, core and stability training may be very suitable program options.
 * An appointment with a physician specializing in sports medicine may be the final direction if OTS persists.

Change training routine

 * Decrease training time by 50 to 70 percent, or more if necessary.
 * Immediately cease all anaerobic training and competition.
 * A helpful remedy for an overtrained athlete is walking, which can gently stimulate circulation and aerobic muscle fiber activity, and offers mental benefits much like those of meditation. Walking also helps redevelop the aerobic system—the first phase of retraining.
 * Retraining, that is, building the aerobic base, should last three to six months and does not include any anaerobic training or competition.

Diet and nutrition

 * Eliminate all high-glycemic foods, especially sugar and other refined flour. Moderating carbohydrate intake overall can also be helpful as high carbohydrate diets may further elevate cortisol levels.
 * Consume smaller, more frequent meals to help control blood sugar and cortisol, especially for those with symptoms of depression, fatigue, hunger and poor sleep.
 * Adequate caloric intake is very important—never get hungry. Include moderate amounts of protein (especially eggs and meats) and healthy fats.
 * Overtraining may disrupt the normal balance of fats in the body, which help control inflammation, one reason why inflammatory-related injuries are common. Eliminate the intake of omega-6 vegetable oils (soy, peanut, safflower, canola, corn), which can promote inflammation. EPA (fish oil) supplements can help reduce inflammation. (If serious inflammation exists, reduce all dairy fats too, including milk, cream, butter and cheese.)
 * Caffeine consumption may be contraindicated for overtrained athletes. Avoid stimulants such as coffee, tea, soda, and chocolate (beware of caffeine-containing, over-the-counter and prescription drugs).
 * Zinc may help control the abnormally high levels of cortisol, but timing is important when supplementing with zinc. Cortisol should be measured throughout the day to determine abnormal peak levels; then the zinc supplements should be taken two to three hours prior to cortisol peaks.

Syndrome recognition

 * Oct 19, 2011, The Tired Athlete: Understanding Fatigue and Recovery by Joe Friel via Trainingpeaks


 * May 6, 2015, The overtraining syndrome by Dr. Phil Maffetone via MAF


 * Overtraining: Undermining Success? by Paige Kinucan and Kravitz, PhD. via University of New Mexico


 * Overtraining: its effects on performance and psychological state via Exercise Med


 * Overtraining Can Kill You: The 3 Stages of Overtraining, Part 1 by Andrew Read via Breaking Muscle


 * Overtraining Can Kill You: The 3 Stages of Overtraining, Part 2 by Andrew Read via Breaking Muscle

Notable research

 * 2004, Does overtraining exist? An analysis of overreaching and overtraining research. via PubMed.org


 * 2005, Reversal in fatigued athletes of a defect in interferon γ secretion after administration of Lactobacillus acidophilus via British Journal of Sports Medicine


 * 2012, Overtraining Syndrome - A Practical Guide via Sports Health, SAGE