Overtraining syndrome

DEFINITION: Perceptible and lasting decrease in athletic performance, often coupled with mood changes, which does not quickly resolve following a normal period of rest

• ANATOMY OR SYSTEM AFFECTED: Endocrine system, lymphatic system, muscles, nervous system, psychic-emotional system
• CAUSES: Training overload, stress, inadequate recovery or rest periods
• SYMPTOMS: Impaired performance, loss of coordination, elevated metabolism, body fat loss, chronic fatigue, sleep disturbances, increased thirst, headaches, nausea, depression, muscle soreness
• DURATION: Chronic
• TREATMENTS: None; prevention through rest periods, stress management

Causes and Symptoms

To achieve peak athletic performance, increased effort in training is often required, sometimes to the point of overexertion. Initial periods of overexertion followed by a brief decrease in performance are frequently referred to as overreaching, which is distinguishable from overtraining syndrome by the desired increase in performance following a brief period of rest. Overtraining syndrome appears to develop from an overload of training, psychosocial stressors, and performance without adequate recovery or rest periods.

Diagnosing this syndrome can be complicated because a single diagnostic test or tool has yet to be developed. Symptoms may vary depending on the individual athlete or the sport, so other possible causes for a long-term decrease in performance, such as diet or disease, should be ruled out first. More than eighty-four symptoms or markers have been attributed to overtraining syndrome. Most often noted in diagnosis are impaired performance, variations in heart rate, variations in blood pressure, loss of coordination, elevated basal metabolic rate, decreased body fat, weight loss, chronic fatigue, sleep disturbances, increased thirst, headaches, nausea, elevated C-reactive protein (CRP), hormone changes, excessive production of cytokines, mood changes, depression, increased susceptibility to colds, difficulty concentrating, restlessness, increased aches and pains, and muscle soreness. Sport-specific stress tests conducted to the point of exhaustion may aid in the diagnosis.

Treatment and Therapy

Rest from training, performance, and/or competition is needed. The recovery period may take anywhere from several weeks to years. As the rest period needed to fully recover from overtraining syndrome may vary greatly from one athlete to the next, prevention is seen as the better option. To reduce the risk of developing this condition, a training schedule that alternates high and low training intensities with at least one day of rest is suggested. Other possible preventive measures include managing stress and maintaining a log to track training intensities, diet, and sleep.

Perspective and Prospects

Research on the characteristics of overtraining syndrome, such as how it affects men and women differently or athletes from various sports, continues to offer new insights. More research, especially longitudinal research, is needed to better understand the condition, including the diagnosis, prevention, and treatment. A number of physiological tests to aid in detecting overtraining syndrome, including hormone levels, enzyme levels, and blood plasma changes, have been implemented, but none thus far have proved to be a valid measure for diagnosing this condition.

Bibliography

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