Overtraining syndrome

2021-09-01T07:59:21Z

HarryPatel:/* Psychological */

{{Cleanup|reason=Sources do not meet scientific guidelines: website articles from coaches that don't cite sources, used in place of peer reviewed scientific research.|date=July 2019}}

'''Overtraining syndrome''' (OTS) occurs in athletes when amount or intensity of training exceeds the body's ability to recover. It is common in nearly every sport and fitness activity.{{citation needed}}

The terms overtraining syndrome, burnout and chronic fatigue syndrome are often incorrectly used.<ref name="Derman2000" /><ref name=":6" />

Ashley Crossman 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."<ref>{{Cite web|url=https://www.active.com/health/articles/what-is-overtraining|title=What Is Overtraining?|last=Crossman|first=Ashley|date=2012-04-03|website=ACTIVE.com|language=en|access-date=2019-02-28}}</ref>

Overtraining is the "breaking-down rather than building-up; usually as a result of improper rest intervals between exercise sessions."<ref>{{Cite book|url=https://books.google.com.ua/books?id=YnoEdRqG_nQC&pg=PA53&redir_esc=y#v=onepage&q&f=false|title=Exercise Motivational Triggers: Be Your Own Personal Trainer|last=Baldwin|first=Dave R.|date=2002|publisher=iUniverse|isbn=9780595216031|editor-link=|location=books.google.com|pages=58|language=en|chapter=|quote=Over-training: breaking-down rather than buidling-up; usually as a result of improper rest intervals between exercise sessions.|editor-last2=|editor-link2=}}</ref>

==Overtraining syndrome vs ME/CFS ==
Overtraining syndrome is marked with prolonged [[fatigue]] which can result in it investigations for [[chronic fatigue syndrome]] (CFS), or other fatiguing illnesses, as there are no laboratory tests to confirm OTS. However, [[chronic fatigue syndrome]] is a distinct neurological disease with symptoms affecting many bodily systems, and should not be confused with [[idiopathic chronic fatigue]], which is long-lasting fatigue with no known cause.<ref name="who">{{Cite web|url=https://icd.who.int/browse10/2016/en#/G93|title=ICD-10 Version:2016|website=icd.who.int|access-date=2019-07-13}}</ref>

Joe Friel, endurance sports coach, notes some similarity between OTS and symptoms of fatiguing illnesses, including [[Chronic fatigue syndrome|CFS]]:

<blockquote>"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 generalIf 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."<ref name=":1">{{Cite web|url=https://www.trainingpeaks.com/blog/why-am-i-so-tired/|title=The Tired Athlete: Understanding Fatigue and Recovery|website=www.trainingpeaks.com|access-date=2019-02-28|date=Oct 9, 2011|last=Friel|first=Joe|authorlink=|last2=|first2=|authorlink2=|archive-url=|archive-date=|url-status=}}</ref></blockquote>

==Media reports of athletes and CFS==
There have been unverified 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.<ref>{{Cite web|url=https://inews.co.uk/news/health/marathon-runner-quit-work-me-cfs-diet-change/|title=Marathon runner housebound after developing ME claims diet change gave him his life back|last=Tanner|first=Claudia|date=2018-07-13|website=inews.co.uk|language=en-GB|access-date=2019-02-28}}</ref><ref>{{Cite news|url=https://www.thetimes.co.uk/article/muslim-fighter-with-me-who-left-an-arranged-marriage-to-win-world-title-svxhhzt57|title=Muslim fighter with ME who left an arranged marriage to win world title|last=Broadbent|first=Rick|date=2017-12-02|work=The Times|access-date=2019-02-28|language=en|issn=0140-0460}}</ref><ref>[http://www.abc.net.au/7.30/committee-reviews-potentially-harmful-and-old/10010408 Video Mark 6:18 - Committee reviews 'potentially harmful and old fashioned' chronic fatigue treatments - by Andy Park and Clare O'Halloran - ABC 7.30]</ref><ref>{{Cite web|url=http://www.abc.net.au/7.30/committee-reviews-potentially-harmful-and-old/10010408|title=Committee reviews 'potentially harmful and old fashioned' chronic fatigue treatments|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=Jul 18, 2018|website=abc.net.au|archive-url=|archive-date=|url-status=|access-date=|quote=LAYNE BEACHLEY, FMR WORLD CHAMPION SURFER: Well, at first I just thought it was a natural part of being fatigued and being an extreme athlete.}}</ref><ref>{{Cite news|url=https://www.thetimes.co.uk/article/nathan-douglas-london-2012-was-the-darkest-period-of-my-life-vxt5gftcx|title=Nathan Douglas: London 2012 was the darkest period of my life|last=Broadbent|first=Rick|date=2019-02-27|work=The Times|access-date=2019-02-28|archive-url=|archive-date=|url-status=|language=en|issn=0140-0460|quote=|author-link=}}</ref> However, scientific studies and case reports on this are lacking. Dietary changes and rest have not been found to be a cure for ME/CFS, and no dietary changes or supplements have been found to be an effective treatment in clinical trials.<ref name="ICP2011primer" /><ref name="canadianconsensus" /> In ME/CFS, a healthy balanced diet is suggested and nutritional tests should be run prior to diagnosis to identify any alternative causes of fatigue or impairment.<ref name="ICP2011primer" /><ref name="fukuda1994" />

==Symptoms==
===Physiological===
*Altered [[resting heart rate]]
*Back, knee, ankle, and foot injuries
*[[Chronic fatigue|Fatigue]]
*Decreased physical performance
*Decreased [[lactate]] response
*Decreased [[maximum work capacity]]
*Frequent [[Gastrointestinal system|gastrointestinal]] upsets
*[[Headache]]s
*[[Hormone]] imbalance includes elevations of [[cortisol]] with secondary lowering of [[testosterone]] and [[Dehydroepiandrosterone|DHEA]] levels
*A decrease in [[muscular strength]]
*[[Insomnia|Early waking and sleep problems]]
*Lack of appetite
*Lower percent of [[body fat]] than pre-illness levels
*[[Premenstrual syndrome]] and [[menopause|menopausal]] symptoms may be secondary complaints for women, but [[amenorrhea]] is common
*[[Myalgia|Muscle soreness]] and tenderness, or tight muscles
*Reappearance of previously corrected mistakes
*[[Sexual dysfunction]] may be a problem for both sexes, typically producing reduced sexual desire<ref>{{Cite web|url=https://philmaffetone.com/the-overtraining-syndrome/|title=The overtraining syndrome|last=Maffetone|first=Dr Phil|date=2015-05-06|website=Dr. Phil Maffetone|language=en-US|access-date=2019-02-28}}</ref><ref name=":2" />

===Psychological===
*Decreased motivation to [https://geniusgeeks.com/best-workout-apps/ workout]
*Difficulty concentrating during work, school, or training
*Fear of competition
*Mood changes, especially feelings of sadness and [[depression]] or clinical depression<ref name=":2">{{Cite journal|url=https://www.unm.edu/~lkravitz/Article%20folder/overtraining4.html|title=Overtraining: Undermining Success|access-date=2019-02-28|last=Kinucan|first=Paige|authorlink=|last2=Kravitz|first2=Len|journal=ACSM's Health & Fitness Journal|volume =11|issue=4|date=2007|pages=8-12|authorlink2=|archive-url=|archive-date=|url-status=}}</ref>

==Differences from CFS==
Overtraining syndrome includes a much narrower group of symptoms, can only be caused by repeatedly overexercising, and unlike CFS, is not either neurological in nature or a common cause of significant and long term disability affecting all aspects of life.

===ME/CFS symptoms not present in overtraining syndrome ===
* [[post-exertional malaise]], which is not limited to exercise, is the hallmark symptom of ME/CFS, and may be delayed by up to 3 days
* [[chronic pain]] is common, and may include [[joint pain]] or [[neuropathic pain|nerve pain]] rather than just [[muscle pain]]
* the minimum level of impairment for diagnosis is typically only being able to function at 50% of their previous level in everyday day, although this depends on the diagnostic criteria used
* some patients are housebound or bedbound, and 25% of ME/CFS patients are wheelchair users
* typically functioning is lower than that patients [[multiple sclerosis]] and class 3 heart failure
* [[co-morbidities]] frequently occur, including [[POTS]], [[IBS]], [[fibromyalgia]], [[Hashimoto's thyroiditis]], and [[migraine]]s
* [[:Category:digestive_signs_and_symptoms|digestive symptoms]], which are persistent and may include [[nausea]] or vomiting, even at rest, new onset [[irritable bowel syndrome]] or [[gluten sensitivity]]; in particularly severe cases some patients require a feeding tube
* endocrine symptoms may include [[thyroid]] problems, inability to regulate body temperature, and unexplained weight loss or gain
* [[:Category:Sensitivity signs and symptoms|sensory overload]] symptoms, including [[photophobia]], [[hyperacusis]], touch sensitivity and even [[allodynia]] are fairly common in ME/CFS
*[[exercise]] or over-exertion causes noticeable [[cognitive dysfunction]]
*[[concentration]] is significantly impaired, and too much mental activity causes [[post-exertional malaise]] and an increase in symptoms such as pain, [[muscle weakness]], dizziness and gastrointestinal symptoms; some patients with [[ME/CFS]] are unable to watch TV due to severe cognitive dysfunction
* [[Severe and very severe ME#verysevere|Very severe ME/CFS]] can be life-threatening and a number of people have died
* Prognosis is very poor, most people do not fully recover from ME/CFS; in overtraining syndrome most recover within weeks or months<ref name="Derman2000" />
* ME/CFS can occur in sedentary people
* ME/CFS is a [[Female predominant diseases|female predominant disease]]
* [[ME/CFS]] is most commonly caused by a virus or bacterial disease, although severe injury and other events are also common
* overtraining, inadequate food intake and poor [[nutrition]] are not among the many pre-onset [[:Category:Triggers and risk factors |triggers or risk factors]] commonly reported; nutritional deficiencies must be ruled out as a possible cause before diagnosis
* significant brain and spinal cord changes have been found in patients with [[ME/CFS]], including in autopsies of patients who have died from the illness
* [[paralysis]] is reported in some patients
*symptoms may not be diagnosed unless present for at least 6 months, in the most commonly used diagnostic criteria<ref name="canadianconsensus">{{Citation
| last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers
| last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain
| last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir
| last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson
| last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas
| last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner
| last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested
| last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry
| last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi
| last10 = Powles | first10 = A C Peter | authorlink10 = A C Peter Powles
| last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey
| last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande
| title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols
| journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | page = 7-115
| date = 2003
| pmid =
| doi = 10.1300/J092v11n01_02
| url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf
}}</ref><ref name="ICP2011primer">{{citation
| last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers
| last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande
| last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir
| last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas
| last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick
| last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell
| last7 = Staines | first7 = D | authorlink7 = Donald Staines
| last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles
| last9 = Speight | first9 = N | authorlink9 = Nigel Speight
| last10 = Vallings | first10= R | authorlink10= Rosamund Vallings
| last11 = Bateman | first11= L | authorlink11= Lucinda Bateman
| last12 = Bell | first12= DS | authorlink12= David Bell
| last13 = Carlo-Stella | first13= N | authorlink13= Nicoletta Carlo-Stella
| last14 = Chia | first14= J | authorlink14= John Chia
| last15 = Darragh | first15= A | authorlink15= Austin Darragh
| last16 = Gerken | first16= A | authorlink16= Anne Gerken
| last17 = Jo | first17= D | authorlink17= Daehyun Jo
| last18 = Lewis | first18= DP | authorlink18= Donald Lewis
| last19 = Light | first19= AR | authorlink19= Alan Light
| last20 = Light | first20= KC | authorlink20= Kathleen Light
| last21 = Marshall-Gradisnik | first21= S | authorlink21= Sonya Marshall-Gradisnik
| last22 = McLaren-Howard | first22= J | authorlink22= John McLaren-Howard
| last23 = Mena | first23= I | authorlink23= Ismael Mena
| last24 = Miwa | first24= K | authorlink24= Kunihisa Miwa
| last25 = Murovska | first25= M | authorlink25= Modra Murovska
| last26 = Stevens | first26= SR | authorlink26= Staci Stevens
| title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners
| date = 2012
| isbn = 978-0-9739335-3-6
| url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf
}}</ref><ref name="fukuda1994">{{Cite journal|last=Fukuda|first=K.|author-link=Keiji Fukuda|last2=Straus|first2=S. E.|author-link2=Stephen Straus|last3=Hickie|first3=I.|author-link3=Ian Hickie|last4=Sharpe|first4=M. C.|author-link4=Michael Sharpe|last5=Dobbins|first5=J. G.|author-link5=James Dobbins|last6=Komaroff|first6=A.|author-link6=Anthony Komaroff|date=1994-12-15|title=The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group|url=https://www.researchgate.net/profile/Michael_Sharpe2/publication/247808895_The_Chronic_Fatigue_Syndrome_A_Comprehensive_Approach_to_Its_Definition_and_Study/links/0c96053201643bfc4b000000/The-Chronic-Fatigue-Syndrome-A-Comprehensive-Approach-to-Its-Definition-and-Study.pdf|journal=Annals of Internal Medicine|volume=121|issue=12|pages=953–959|issn=0003-4819|pmid=7978722|via=|publisher=American College of Physicians}}</ref><ref name="who" /><ref name="Chu">{{Cite journal|last=Chu|first=Lily|author-link=Lily Chu|last2=Valencia|first2=Ian J.|author-link2=Ian Valencia|last3=Garvert|first3=Donn W.|author-link3=|last4=Montoya|first4=Jose G.|author-link4=Jose Montoya|author-link5=|date=Jan 14, 2019|title=Onset patterns and course of myalgic encephalomyelitis/ chronic fatigue syndrome|url=https://www.frontiersin.org/articles/10.3389/fped.2019.00012/abstract|journal=Frontiers in Pediatrics|volume=|issue=|pages=|doi=10.3389/fped.2019.00012|quote=|via=}}</ref> [https://www.frontiersin.org/articles/10.3389/fped.2019.00012/abstract (Full text)]

===Overtraining signs symptoms not present in ME/CFS ===
* mood changes - these are not a diagnostic symptom,<ref name="ICP2011primer" /> and not any more common than in other chronic illnesses {{citation needed}}

== Syndrome recognition ==

Overtraining syndrome remains poorly defined.<ref name="Derman2000" /> In 2012, the European College of Sport Science (ECSS) and the American College of Sports Medicine published a joint statement to help clarify OTS.<ref name="jointstatement2012" />

*[https://www.unm.edu/~lkravitz/Article%20folder/overtraining4.html Overtraining: Undermining Success?]<ref name=":2" />

*[http://www.exercisemed.org/research-blog/overtraining-its-effects-on.html Overtraining: its effects on performance and psychological state]<ref>{{Cite web|url=http://www.exercisemed.org/research-blog/overtraining-its-effects-on.html|title=Overtraining: its effects on performance and psychological state {{!}} Exercise Medicine|website=www.exercisemed.org|access-date=2019-02-28}}</ref>

== Notable studies and articles ==
* 1998, Overtraining in sport.<ref name=":3">{{Cite book|url=https://psycnet.apa.org/record/1997-36577-000|title=Overtraining in sport.|location=Champaign, IL, US |publisher=Human Kinetics|editor-last=Kreider|editor-first=Richard|editor-last2=Fry|editor-first2=Andrew|date=1998|website=psycnet.apa.org|language=en|archive-url=|archive-date=|url-status=|access-date=2019-02-28|editor-last3=O'Toole|editor-first3=Mary Louise|last=|first=|isbn=|editor-link=|pages=|chapter=|quote=|editor-link2=}}</ref> [https://psycnet.apa.org/record/1997-36577-000 (Abstract)]

*2000, [https://www.researchgate.net/profile/Wayne_Derman/publication/304013746_The_Differential_Diagnosis_and_Clinical_Approach_to_the_Athlete_With_Chronic_Fatigue/links/5762fb7e08aecb4f6fee0463/The-Differential-Diagnosis-and-Clinical-Approach-to-the-Athlete-With-Chronic-Fatigue.pdf The Differential Diagnosis and Clinical Approach to the Athlete With Chronic Fatigue]<ref name="Derman2000">{{Cite journal|last=Lambert|first=M. I.|last2=Derman|first2=W. E.|date=2000-01-01|title=The differential diagnosis and clinical approach to the athlete with chronic fatigue|url=https://journals.co.za/content/ismj/1/3/EJC48433|journal=International SportMed Journal|language=en|volume=1|issue=3|issn=1528-3356}}</ref>

* 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)<ref name="jointstatement2012">{{Cite journal|last=Meeusen|first=Romain|last2=Duclos|first2=Martine|last3=Foster|first3=Carl|last4=Fry|first4=Andrew|last5=Gleeson|first5=Michael|last6=Nieman|first6=David|last7=Raglin|first7=John|last8=Rietjens|first8=Gerard|last9=Steinacker|first9=Jürgen|date=2013-01-01|title=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)|url=https://doi.org/10.1080/17461391.2012.730061|journal=European Journal of Sport Science|volume=13|issue=1|pages=1–24|doi=10.1080/17461391.2012.730061|issn=1746-1391}}</ref> [https://dspace.lboro.ac.uk/dspace-jspui/bitstream/2134/17104/1/ECSS-ACSM%20Overtraining%20consensus%20ACCEPTED.pdf (Full text)]

*2004, Does overtraining exist? An analysis of overreaching and overtraining research.<ref name=":4">{{Cite journal|last=Halson|first=Shona L.|last2=Jeukendrup|first2=Asker E.|date=2004|title=Does overtraining exist? An analysis of overreaching and overtraining research|url=https://www.ncbi.nlm.nih.gov/pubmed/15571428|journal=Sports Medicine (Auckland, N.Z.)|volume=34|issue=14|pages=967–981|doi=10.2165/00007256-200434140-00003|issn=0112-1642|pmid=15571428}}</ref> [[pubmed:15571428|(Abstract)]]
<blockquote>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.<ref name=":4" /></blockquote>
*2005, Reversal in fatigued athletes of a defect in interferon γ secretion after administration of Lactobacillus acidophilus<ref name=":5">{{Cite journal|last=Henriksson|first=A.|last2=Fricker|first2=P.|last3=Pyne|first3=D.|last4=Pang|first4=G.|last5=D’Este|first5=C.|last6=Dorrington|first6=M.|last7=Callister|first7=R.|last8=Cox|first8=A.|last9=Gleeson|first9=M.|date=2006-04-01|title=Reversal in fatigued athletes of a defect in interferon γ secretion after administration of Lactobacillus acidophilus|url=https://bjsm.bmj.com/content/40/4/351|journal=British Journal of Sports Medicine|language=en|volume=40|issue=4|pages=351–354|doi=10.1136/bjsm.2005.024364|issn=0306-3674|pmc=2577537|pmid=16556792}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2577537/ (Full Text)]
<blockquote>This is the first evidence of a [[T cell]] defect in fatigued athletes, and of its reversal following [[Probiotics|probiotic]] therapy.<ref name=":5" /></blockquote>
*2012, Overtraining Syndrome - A Practical Guide<ref name=":6">{{Cite journal|url=https://doi.org/10.1177%2F1941738111434406|title=Overtraining Syndrome: A practical guide|website=SAGE Journals|language=en|doi=10.1177/1941738111434406|pmc=3435910|pmid=23016079|access-date=2019-02-28|date=2012|last=Kreher|first=Jeffrey|authorlink=|last2=Schwartz|first2=Jennifer B.|authorlink2=|archive-url=|archive-date=|url-status=|volume=4|issue=2|pages=128-138}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435910/ (Full Text)]
<blockquote>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.<ref name=":6" /></blockquote>

== See also ==
*[[Adrenal fatigue]]
*[[Post-exertional malaise]]
*[[Canadian Consensus Criteria]] for ME/CFS
*[[Fukuda criteria]] for chronic fatigue syndrome
*[[Oxford criteria]]

== Learn more ==
* [https://dspace.lboro.ac.uk/dspace-jspui/bitstream/2134/17104/1/ECSS-ACSM%20Overtraining%20consensus%20ACCEPTED.pdf Joint College's Statement (2012)]
* [https://philmaffetone.com/the-overtraining-syndrome/ The overtraining syndrome]
* [http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/ US NIH Report Calls for UK Definition of ME/CFS to be Scrapped]<ref name=":0">{{Cite web|url=http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/|title=US NIH Report Calls for UK Definition of ME/CFS to be Scrapped|last=Swift|first=Penny|date=2015-01-16|website=The Argus Report|language=en-US|access-date=2019-02-28}}</ref> ([[Oxford criteria]])
<blockquote>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 [[ME/CFS|myalgic encephalomyelitis/chronic fatigue syndrome]] (ME/CFS) worldwide. The report also highlights the fact that the decades-old [[United Kingdom|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 [[National Institutes of Health|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.<ref name=":0" /></blockquote>

==References==
<references />

[[Category:Diagnoses]]

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Overtraining syndrome