Overtraining syndrome

Overtraining syndrome (OTS) occurs in athletes when intensity of training exceeds the body's ability to recover. It is common in nearly every sport and fitness activity. Ashley Crossman, for Active.com, writes: "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 is the "breaking-down rather than building-up; usually as a result of improper rest intervals between exercise sessions."

Overtraining syndrome vs ME/CFS
Overtraining syndrome is marked with prolonged fatigue which can result in it being diagnosed as chronic fatigue syndrome (CFS), as there are no laboratory tests to confirm.

Joe Friel, endurance sports coach, notes in Training Peaks 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 diagnosed with myalgic encephalomyelitis (ME) or CFS who have recovered in a relatively short period of time after rest, supplementation, and diet changes.

Physiological

 * Altered resting heart rate and blood pressure
 * Back, knee, ankle, and foot injuries
 * 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

 * Bad attitude about life in general
 * 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

Syndrome recognition

 * Oct 19, 2011, The Tired Athlete: Understanding Fatigue and Recovery


 * May 6, 2015, The overtraining syndrome


 * Overtraining: Undermining Success?


 * Overtraining: its effects on performance and psychological state


 * Overtraining Can Kill You: The 3 Stages of Overtraining, Part 1


 * Overtraining Can Kill You: The 3 Stages of Overtraining, Part 2

Notable studies and articles
"'Overtraining in Sport' is a comprehensive text on the physiological, biomedical, and psychological aspects of overtraining and overreaching in sport. Thirty-three researchers contribute 17 chapters to this multidisciplinary review of recent findings. The research crosses many disciplines, and information is presented in a direct manner with background information provided for those who may not have a comprehensive understanding of each subject area. 'Overtraining in Sport' is a reference for exercise psychologists, sport psychologists, strength and conditioning coaches, and anyone with a serious interest in the potential effects of training too often or too intensely." "Athletes experience minor fatigue and acute reductions in performance as a consequence of the normal training process. When the balance between training stress and recovery is disproportionate, it is thought that overreaching and possibly overtraining may develop. However, the majority of research that has been conducted in this area has investigated overreached and not overtrained athletes. Overreaching occurs as a result of intensified training and is often considered a normal outcome for elite athletes due to the relatively short time needed for recovery (approximately 2 weeks) and the possibility of a supercompensatory effect. As the time needed to recover from the overtraining syndrome is considered to be much longer (months to years), it may not be appropriate to compare the two states. It is presently not possible to discern acute fatigue and decreased performance experienced from isolated training sessions, from the states of overreaching and overtraining. This is partially the result of a lack of diagnostic tools, variability of results of research studies, a lack of well controlled studies and individual responses to training.The general lack of research in the area in combination with very few well controlled investigations means that it is very difficult to gain insight into the incidence, markers and possible causes of overtraining. There is currently no evidence aside from anecdotal information to suggest that overreaching precedes overtraining and that symptoms of overtraining are more severe than overreaching. It is indeed possible that the two states show different defining characteristics and the overtraining continuum may be an oversimplification. Critical analysis of relevant research suggests that overreaching and overtraining investigations should be interpreted with caution before recommendations for markers of overreaching and overtraining can be proposed. Systematically controlled and monitored studies are needed to determine if overtraining is distinguishable from overreaching, what the best indicators of these states are and the underlying mechanisms that cause fatigue and performance decrements. The available scientific and anecdotal evidence supports the existence of the overtraining syndrome; however, more research is required to state with certainty that the syndrome exists." "This is the first evidence of a T cell defect in fatigued athletes, and of its reversal following probiotic therapy." "OTS remains a clinical diagnosis with arbitrary definitions per the European College of Sports Science’s position statement. History and, in most situations, limited serologies are helpful. However, much remains to be learned given that most past research has been on athletes with overreaching rather than OTS."
 * 1998, Overtraining in sport. (Abstract)
 * 2012, Prevention, diagnosis and treatment of the overtraining syndrome: Joint consensus statement of the European College of Sport Science (ECSS) and the American College of Sports Medicine (ACSM) (Full text)
 * 2004, Does overtraining exist? An analysis of overreaching and overtraining research. (Abstract)
 * 2005, Reversal in fatigued athletes of a defect in interferon γ secretion after administration of Lactobacillus acidophilus (Full Text)
 * 2012, Overtraining Syndrome - A Practical Guide (Full Text)

Learn more
"The United States National Institutes of Health (NIH) has issued a draft report that highlights the dire need for scientific research that will help find a cure for the millions of people suffering from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) worldwide. The report also highlights the fact that the decades-old UK Royal Society of Medicine’s Oxford criteria for ME/CFS are severely “flawed,” and that continuing to use these criteria may “cause harm.” Further, the NIH report says that the Royal Society definition should “be retired” and replaced with a single case definition agreed to by the ME/CFS community."
 * 2015, US NIH Report Calls for UK Definition of ME/CFS to be Scrapped (Oxford criteria)
 * Wikipedia