Game day is why athletes play the game. It's the most fun part of any sport - the competition, the bright lights, the opportunity to showcase your best when it's critical. However, the offseason and the pre-season can be long and grueling, espeically if your season only lasts 3 months out of the year. Through such a stretch without the thrill of competition, it may seem impossible to avoid what many athletes refer to as staleness, burnout, chronic fatigue syndrome, or what clinicians define as overtraining syndrome (OTS).1
Definition: Overtraining syndrome is best defined using a spectrum (see Figure 1). Training usually entails an overload that is used to disturb homeostasis, resulting in acute fatigue leading to an improvement in performance. When training continues or when athletes use a short time frame (e.g. training camp) they can experience a brief performance decrement with an eventual improvement in performance and recovery. When athletes do not sufficiently respect the balance between training and recovery, extreme overreaching can occur. If there is prolonged maladaptation with clinical, hormonal and other signs discussed below, overtraining syndrome can occur.1,2
Signs of Overtraining
The initial symptom of OTS is usually fatigue. In time, the symptoms displayed in Figure 2 may develop.3,4
Prevention of Overtraining
1. Use a training log.4
- Track training details such as distance, duration, pace, perceived intensity, heart rate responses, resistance work.
- Use a scale to quantify well-being ratings on fatigue, stress, quality of sleep, muscle soreness, and irritability.
- Identify any causes of stress/dissatisfaction.
- Illness, injury and menstrual cycle for females.5
2. Remember to recover.
It is generally recommended that you should have at least one passive rest day each week.6 The rest day can also act as a ‘‘time-out’’ period and prevent you from becoming preoccupied with your sport. Such distractions from the daily routine of training may alleviate boredom and reduce stress. The general advice is to sleep for the amount of time that is required to feel wakeful during the day, which may vary considerably between individuals.
3. Optimize nutrition.
Prolonged inadequate carbohydrate intake may trigger OTS.7 Theoretically maintaining positive energy balance through carbohydrate supplementation will help replenish glycogen and keep stress hormones in check.8
The best treatment of OTS is prevention, mostly by appropriate periodization of the training program with careful focus on including, and executing, appropriate recovery time into the training program. If you reach the point of OTS, a customized treatment plan is necessary to successfully recover. Concentration should be on relative or absolute rest. Mild cases may recover after only a few weeks of rest or decreased training load. More severe cases of OTS require longer intervals of rest and may not ever resolve.2 If you or one of your athletes continues to have symptoms despite extended rest, he or she should be evaluated by a physician to exclude other causes (ie, infection, anemia, injury).
- Meeusen R, Duclos M, Foster C, et al. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med. Sci. Sports Exerc. 2013; 45:186Y205 .
- Carfagno DG, Hendrix JC.. Overtraining syndrome in the athlete: current clinical practice. Curr Sports Med Rep. 2014 Jan-Feb;13(1):45-51.
- Budgett, R. The overtraining syndrome. British Medical Journal. 1994;309(6952).
- Brukner P, Khan K. Clinical sports medicine, 4th ed. Sydney, Australia: McGraw-Hill, 2012:104-105.
- Hooper SL, Mackinnon LT, Howard A, Gordon RD, Bachmann AW. Markers for monitoring overtraining and recovery. Med Sci Sports Exerc. 1995;27(1):106–12.
- Bruin G, Kuipers H, Keizer HA, Vander Vusse GJ. Adaptation and overtraining in horses subjected to increasing training loads. J Appl Physiol. 1994;76:1908–13.
- Budgett R, Hiscock N, Arida R, et al. The effects of the 5-HT2c agonist m-chlorophenylpiperazine on elite athletes with unexplained underperformance syndrome (overtraining). Br. J. Sports Med. 2010; 44: 280–3.
- Achten J, Halson SL, Moseley L, Rayson MP, Casey AC, Jeukendrup AE. Higher dietary carbohydrate content during intensified running training results in better maintenance of performance and mood state. J Appl Physiol. 2004;96:1331–40.
Disclaimer: This blog is for informational purposes only. Doctors cannot provide a diagnosis or individual treatment advice via e-mail or online. Please consult your physician about your specific health care concerns.
For additional educational content from BridgeAthletic, be sure to check out this post on hydration in the winter season.