Overtraining Syndrome: Recognize and React
Updated: Feb 2, 2022
Now that we understand recovery and how to prioritize it into our training, let's take a look at what happens when recovery isn't allowed to optimally occur.
Just a heads up here, this post is meant to be informative on overtraining syndrome but should not act as or replace medical advice. If you are worried you may have overtraining syndrome, please get in touch with your health care provider.
As we spoke about before, recovery is our bodies' return to a state of homeostasis after incurring stress. In the case of exercise as the stressor, if insufficient time and/or inadequate nutrition is available for recovery, then we will not get the adaptations to the exercise that we would expect to see, and we may even see decreases in performance and decreases in specific aspects of fitness (e.g. strength, speed, power, etc.).
That being said, during training, athletes are often pushed into a state of functional overreaching which, when followed by a period of relative rest to allow for recovery, facilitates improvements in performance. In a state of functional overreaching, we may see similar symptoms to that which we would see with overtraining syndrome, such as a transient decrease in performance and mood disturbance, but the symptoms abate and performance returns to baseline or better than baseline within the pre-planned time. (Read about periodization and how to plan for this recovery here.) This is okay and normal in training for sport.
What is not okay is when we get pushed into a state of non-functional overreaching. In this case, we do not get the expected increase in performance, and symptoms do not abate in the expected time frame. This is especially a problem when we are preparing for peaking for a competition or show run, and we are not able to train as per the plan. The difference in achieving functional overreaching instead of non-functional overreaching is minute and individual. Amongst a group of similar athletes undergoing the exact same training load, some may experience functional overreaching, and some may end up experiencing non-functional overreaching, despite no difference in their external load.
Follow this link to download your free Periodization Template for the Artistic Athlete, a printable resource to help you plan your training to prioritize recovery and optimize performance!
Symptoms of non-functional overreaching can vary widely between individuals, but it is generally characterized by:
Prolonged unexplained decrease in performance, especially a decreased time to
Mood disturbance, e.g. increased irritability,
Increased fatigue, decreased vigour
Sleep disturbance, e.g. insomnia
Hormonal and biochemical imbalances
Increased injury occurrence, overall soreness
The difference between non functional overreaching and overtraining syndrome is small, and tends to come down to the amount of time it takes for symptoms to abate. In the resources I read for this post, it was most often stated that non-functional overreaching gets diagnosed as overtraining syndrome if symptoms do not abate after two weeks of relative rest, and if there is no other cause that can be found to be causing the symptoms, such as but not limited to:
Illness, e.g. upper respiratory tract infections or mononucleiosis
Major psychological disorders
Systemic diseases, e.g. hypothyroidism, anemia or hepatitis
Overtraining syndrome should not be taken lightly, as symptoms can last for months and even years, severely effecting an athlete's career.
How to Recognize and React to Overtraining:
There are many hypotheses as to the mechanisms of the occurrence of overtraining, however, as of yet, there is no single one that is completely accepted, rather it is a combination of factors and mechanisms acting together. I'm not going to get into the specifics of them here, it is some complicated biochemistry that is out of my wheelhouse to try and explain in layman terms. Check out the references at the bottom of page if you are curious, the full text of all the journal articles are free on PubMed.
Aside from an unexplained decrease in performance, symptoms are broad and inconsistent between athletes. There are also many different factors aside from overtraining that could be present and causing these symptoms, and therefore a single diagnostic test for overtraining syndrome is just not yet feasible. It is a diagnosis of exclusion, meaning everything else possible that may be causing the symptoms has to been ruled out, and symptoms must be present for a minimum of two weeks.
We can do our best however to try to prevent Overtraining Syndrome from happening, and here are some strategies to do so:
Questionnaires or scales rating mood, fatigue, stress, and/or rating of perceived exertion can be given to an athlete at their daily training or practices. Whether you use hard or digital copies, they are cheap and quick to administer.
If an athlete is consistently showing high levels of any of these factors, coaches need to consider lightening their training load until ratings normalize.
Heart rate variability is the measure of difference in time between heart beats. While the variation is only a matter of milliseconds between beats, higher variability is actually indicative of healthy autonomic nervous system function (i.e. a balance between sympathetic and parasympathetic activity), while lower variability can be indicative of dysfunction, whether due to certain diseases or due to overtraining.
Monitoring HRV can easily be done through many smart phone or smart watch apps. If an athlete is trending towards a lower HRV, care can be taken to adjust their training as necessary to better accommodate their capacity for load and facilitate recovery.
Recovery Routine and Sleep
Facilitating optimal recovery in between training sessions, and within a mesocycle is extremely important for managing training load. Check out this blog post all about recovery and recovery strategies.
As discussed in the post about recovery, adequate nutrient intake is incredibly important to help our body recover by replenishing substrate lost for energy metabolism, and providing substrate for muscle building and adaptation. Carbohydrate and protein are the most important of the macronutrients to consider for recovery nutrition. Athletes should always have a carb and protein rich meal or snack available within 1-2hrs after training.
Some studies as well have shown that higher carbohydrate intakes facilitate better recovery than diets with low carb intakes, both between training bouts and in states of overreaching.
That Was a Lot, Let's Recap
Overtraining is the verb used to describe training to put us into a state of functional overreaching. Functional overreaching will transiently put an athlete into a state of decreased performance and fatigue, with or without mood disturbance. Performance will return to baseline or increase after a planned time of relative rest to facilitate recovery. If performance remains decreased, and other symptoms do not abate after relative rest, we can be in a state of non- functional overreaching. In this case, it can take up to two weeks to return to previous performance levels.
If symptoms do not abate after 2 weeks, and no other causes can be found to be causing the decreased performance, increased fatigue, sleep and/or mood disturbance, overtraining syndrome may be diagnosed by a qualified medical professional. The tipping point between functional overreaching, non-functional overreaching, and overtraining syndrome is not clearly defined, and will be unique to each athlete. It is affected not just by the exercise load, but also other aspects of internal load such as illness and psychological stress. Overtraining syndrome symptoms can last anywhere from weeks to months to years and can be devastating to an athletic career.
We can mitigate the potential for developing overtraining syndrome by monitoring our mood, fatigue, soreness, perceived exertion and heart rate variability, and adjust training accordingly. Facilitating optimal nutrition and recovery outside training are also paramount to avoiding overtraining syndrome.
Want to talk about how to best plan and facilitate recovery for your athletes? Message me here, and let's chat!
Carfagno, David G. DO, CAQSM1; Hendrix, Joshua C. MS-III2 Overtraining Syndrome in the Athlete, Current Sports Medicine Reports: January/February 2014 - Volume 13 - Issue 1 - p 45-51, doi: 10.1249/JSR.0000000000000027
Soligard T, Schwellnus M, Alonso J, et al. How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury
British Journal of Sports Medicine 2016;50:1030-1041.
Prevention, Diagnosis, and Treatment of the Overtraining Syndrome, Medicine & Science in Sports & Exercise: January 2013 - Volume 45 - Issue 1 - p 186-205
Kreher, J. B., & Schwartz, J. B. (2012). Overtraining syndrome: a practical guide. Sports health, 4(2), 128–138. https://doi.org/10.1177/1941738111434406
Strength and Conditioning: Biological Principles and Practical Applications. (2011). Germany: Wiley.
Vandusseldorp, T. (2014). Heart Rate Variability & Overtraining. Idea Fitness Journal. https://www.ideafit.com/personal-training/heart-rate-variability-amp-overtraining/