Overtraining Syndrome How to Recognize, Avoid and Treat it

Athletes trying to achieve their genetic potential are precariously balanced on a physiological knife edge, with supreme fitness on one side and utter physical collapse on the other. The higher the level of the athlete, the narrower that edge will become, and the harder it is to balance there. Finding the proper balance between training stress and recovery is where training and coaching move from science to art.  In this article, you’ll learn how to recognize overtraining syndrome, avoid it, and treat it.

Not enough training stress, and you will not achieve your potential for this training cycle. The flip side is that an effort to extract a couple more percentage points of performance could put you off that knife edge and over the Over Training cliff resulting in underperforming by tens of percent. This becomes an even more significant challenge for the high-level amateur who must balance the stress of a substantial training load with the additional stressors of life, such as family obligations, school, or a demanding job that most pros won’t have. All of which complicates the job of maintaining this critical balance. Ignore these normal life stresses at your peril.

Start recognizing ots:  some indicators

Overuse injury as an indicator of overtraining

Not all injuries are from overtraining, but any overuse injury is an obvious indication that your body cannot handle the training load. It’s the insidious and demoralizing effect of overdoing structured endurance training.   Injury is a black-and-white example that training has gone off the rails and your body is failing to adapt to the training stimuli. On the overtraining spectrum, you’re lucky if you find yourself dealing with an overuse injury. Injuries are relatively easy to diagnose and treat. Some, like plantar fasciitis, can take months to overcome, but at least you can be proactive in your approach to healing.

Suppose a muscle is exposed to a new training load on a routine basis without adequate recovery allowing for adaptation from the previous training stimuli. In that case, no fitness gains will be seen. More likely, however, is that the cumulative effect of this premature stress will cause tiny injuries that will weaken the muscle or tendon. The muscle/brain connection will then self-inhibit the ability to contract the muscle in an attempt to protect that muscle from further damage. A dedicated athlete can easily overcome this pain and suffering and maintain the overuse. Soon a minor tear will become along with a significant inflammatory cycle leading to scarring. Chronic tendonitis or worse—complete tendon or muscle rupture—can occur.

While these injuries are not necessarily an indication of overtraining, as discussed above, they do point out that the adaptation we seek through training is not occurring. This lack of adaptation can indicate that you are on a collision course with overtraining if some remedial steps are not begun.

FATIGUE AS AN INDICATOR OF OVERTRAINING

 On the other hand, overtraining without injury manifests as fatigue. But it is not your garden variety fatigue. It is a fatigue that takes, at the minimum, several weeks to recover from and, in dire cases, can take more than a year before an athlete can tolerate training loads that once felt easy. In extreme (but all too frequent) cases that go unacknowledged, it can be the end of a promising career. The ultra-running roadside is littered with broken dreams and broken bodies of those who tried to ignore the red flags of Over Training Syndrome (OTS) until it was too late.

This article aims to help you identify OTS as early as possible and take action as soon as you do so. From here on, this article will focus on the non-injury type of OTS.

The problem with the non-injury kind of OTS is that it is a poorly understood and challenging to diagnose medical issue.

If you are familiar with the concept of the Training Effect, the following definition will be easier for you to understand.

A normal training and recovery cycle allows for and results in a super compensation phase where the adaptations induced by the training stimuli result in enhanced performance. Once in OTS, the athlete will never experience the supercompensation phase, no matter how long the recovery

 When in an overtrained state, you become less fit even though you are training at the same or higher level than before. That is because your body has stopped adapting to the normal training stimuli. In this state, what was once a very light training load is intolerable to the overtrained athlete.

Especially in endurance sports, overtraining is responsible for more failed athletic goals and shortens more careers than any other factor. Some athletes struggle with it with several years of stagnation before throwing in the towel.

Endurance athletes find themselves at the highest risk for overtraining due to the high energy demands involved in their daily training regimen. These can exceed 6,000 kcal/day during very heavy training. Unfortunately, most athletes don’t intuitively recognize overtraining. In many cases, it takes so long for the athlete to acknowledge overtraining that by the time it is properly diagnosed, it is too late for anything but the most extreme measures.

 OVER  VS UNDER TRAINED

It is far better to be slightly undertrained than to be slightly overtrained. This is a critical training axiom to keep in mind. If you are undertrained and well rested, you can always draw a bit deeper from the willpower well in training and competition. However, if you are overtrained and tired, no amount of willpower can conjure strength and endurance from an empty well.

MOTIVATION VS COMPULSION

Most endurance athletes fall squarely into the type A personality camp. These people typically adhere to the “more is better” training philosophy, which is, as a general rule, accurate. Strength of will and embracing suffering are, without a doubt, critical attributes for an endurance athlete.

These can also be your worst enemies when they cloud your judgment and become merciless taskmasters. Overtraining is not merely getting stiff and sore from a hard workout or needing a couple of extra days to recover from a particularly demanding race. In the exercise science world, short-term fatigue is called overreaching and is a normal part of the training cycle. When chronic overreaching develops into overtraining, a physiological bridge has been crossed that can be difficult to recross unless the athlete takes drastic action. You need to recognize when you are on the overreaching bridge and turn around before you cross over to the overtraining side. Getting too comfortable with overreaching and being in a sustained deep fatigue state too often and for too long can make an athlete too comfortable with fatigue.

The road to OTS starts with overreaching.

BEGIN TO RECOGNIZE OTS AND LEARN WHAT TO DO

EARLY SIGNS AND THE COMMON RESPONSE

When you step over the OTS threshold, you are entering a murky grey area medical condition that is poorly understood, multi-causal, and hence very difficult to diagnose except by those who have experience with it. Your family doctor is likely to call you a hypochondriac if you present the typical symptoms of overtraining. Even a moderately overtrained endurance athlete is still the picture of health and energy compared to the typical patient your doc sees. Only in the latest stages of OTS will you present typical illness symptoms that are treatable with medical care.

OTS represents a breakdown of your body’s natural adaptation processes. The metabolic, endocrine, and nervous system no longer behave as you have come to expect. To restate from above:  What was once a light training load that your body could easily handle is now an intolerable and destructive stress. This requires complete recalibration of your concept of hard and easy. Overtrained athletes are unprepared for this dramatic shift in thinking and unwilling to accept that they could go so quickly from feeling like an athlete to feeling like an invalid. I have seen this transformation occur in as short a time as a few hours after one particularly demanding workout if the athlete was already poised on that knife’s edge. More typically, it will occur over a few days where decreased performance during training gets noticed.

The first and most common sign of the early stages of overtraining is repeated shortcomings in performance accompanied by a feeling of flatness or low energy. At this point we, sadly, encounter the first and most common misdiagnosis by a coach or athlete. The all too frequent assumption is that this performance decrease is caused by a lack of fitness. After all, you were feeling so good just a couple of days before that; it can’t possibly be overtraining. They don’t see that there has been a surplus of training stimuli. In their eyes, there is a deficit of some training stimuli. Something must be missing from the program.

Fitness built over months does not disappear overnight or in a few days.  Only fatigue can manifest so quickly. 

This should be the first warning that you are looking at OTS.

The resultant response, especially by self-coached athletes, is to add more training of some sort. The thought is that the training program lacks some essential ingredient, and if they just add more of this or that, their lost fitness will return. After they increase their training with no improvement—and usually a further decrease in performance—they continue to seek solutions that involve more training.

Thus begins a dangerous downward trend that can ultimately lead to more than just physical problems. The athlete has invested a tremendous amount of time, energy, and resources in physical preparation. In many ways, this sport and their performance in it may define their persona. When you keep coming up short in training and races and suffer from constant profound fatigue, it will dramatically affect your self-esteem, motivation, and confidence.

Overtraining is more easily recognizable if you are training on measured courses or using measured paces and see your times drop off. It’s much harder to recognize in mountain sports, where the track is different every day. This is one reason that we advise having benchmark workouts you can do to check for progress or regression in your program.

SYMPTOMS

 The earliest effects of overtraining impact the sympathetic nervous system. It starts with the immediate effect of raising your heart rate, both resting and for sub-maximum exertion levels compared to your normal heart rates. You just don’t have your usual pep and vigor and feel flat in training. The stress hormone cortisol levels stay elevated between training sessions (this takes a trip to the doctor to determine). At this stage, you may notice one or more of the following:

• Poor sleep
• Elevated resting pulse, very noticeable when trying to fall asleep
• Night sweats
• Craving for sweets
• One of the easiest-to-notice symptoms is profound leg fatigue when climbing stairs.

See below for a simple “stair” test to monitor recovery.

If nothing is done to mitigate the early overtraining, it can progress to a much more debilitating type involving the parasympathetic nervous system. When the parasympathetic nervous system gets involved, there are more negative hormonal effects and a lowering of the heart rate for all effort levels compared to normal rates.

When this occurs, watch for one or a number of these unpleasant symptoms:

• Persistent, deep fatigue
• Prolonged elevated cortisol levels (requires a blood test)
• Lowered testosterone levels (requires a blood test)
• Decreased heart rate variability (requires a special HR monitor or EKG)
• Irritability
• Depression
• Weight loss
• Amenorrhea (absence of menstruation)
• Insomnia
• Lowered libido
• Loss of enthusiasm and motivation
• Lowered resting and submaximal exercise heart rates

Sounds grim, right? OTS is a condition to be avoided at all costs. The cost of overtraining and under recovering is so much worse than undertraining, it is far better to err on the conservative side.

NOW YOU’VE RECOGNIZED OTS, WHAT STEPS CAN YOU TAKE?

WHAT CAN BE DONE?

This will be a short section because there is only one thing to be done once you recognize that you’ve crossed that metaphorical bridge mentioned at the beginning of the article. That one thing is to STOP training immediately.

What I don’t mean by this is:

• Cut back from 2 to 1 interval session a week
• Reduce the long day from 4 hours to 2 hours

No, I mean STOP! Cease all training. Having now interacted with over two dozen overtrained athletes and their coaches (the first being myself almost 40 years ago), this is the fastest and most surefire method to get the athlete back to training. Anything less than this seemingly draconian approach is most likely to drag on the misery for many more weeks. This is the scenario I have seen play out in almost all the cases of OTS I have witnessed firsthand.

The first and most crucial step is to admit you have a problem. Then attack that problem with the same focus you used in the training that got you here. If you are lucky and catch this minor transgression early enough, you might return to normal in a couple of weeks.   Failure to first recognize and, only later acknowledging the seriousness of OTS will inevitably lead to a prolonged recovery. If you didn’t pay attention and got in deep, you are looking at at least a month or 2 of nearly complete rest. That’s right.  This could take a few months to remedy. Face it: Your season is a bust at this point. All those big plans? Out the window.

AVOIDING OTS LIKE THE PLAGUE

 Hopefully, I have gotten your attention and convinced you that you don’t want to touch OTS with the proverbial 10-foot pole. Some of the lessons I hope you take away:

• Trying to extract that tiny and often useless fraction of a percent performance gain is not worth the risk of falling off the overtraining cliff.
• Pay attention and track how you are responding to and recovering from training.
• Don’t become a slave to your training plan.
• When you feel like Superman or Superwoman, reduce the training load. Reduce intensity, and drop back to aerobic base training for a week or so.
• Use some sort of tracking to monitor recovery status. My simplest test is described below.

 MONITORING

 Several high-tech tools can help you monitor recovery status and now come baked into the hardware of the top-end HR monitor/GPS watches. All that I am aware of rely on HRV (heart rate variability). The science and technology of measuring HRV are based on sound physiology. I’ve seen it report false negatives and false positives too often to have complete faith in it in real-world situations. Since it measures the balance of the sympathetic and parasympathetic nervous systems, it is highly sensitive to the athlete’s mental state. If you are anxious about the test, the result will be a lowered HRV. In my experience, this was a major confounding problem. Athletes were worried about what the test results would show. However, if you can overcome this obstacle, this can be an excellent way to monitor the recovery status. It is worth trying, at any rate.

In my experience, I have found that most athletes can tell when they are tired and when they are fresh….if they pay attention and are sensitive to their bodies during a warm-up. This seems to give about as good feedback as HRV testing, and I think it tunes the athlete into the subtle feedback they are already getting but may ignore it if they become too data-driven.

Another straightforward test that seems to produce results very close to HRV is the lowest resting heart rate (RHR) you can achieve in 5 minutes of lying down and relaxing. Like HRV, this test needs to be performed under the same conditions at the same time every day to give meaningful feedback.

Lastly, I’ll present my fallback Stair Test.  Simply climb the same short set of stairs daily and note how your legs feel at the top. As long as you are consistent: The same stairs, the same length from 10-20 seconds, done at the same time each day and taken (your choice) 1 or 2 or 3 at a time will quickly teach you when you are recovered and when you need more rest or light training. The sensations to be aware of will be a heaviness in the legs, depth of breathing, and elevated heart rate (sensible even without a monitor).

I like this last test because it applies a small load to your body, and you learn to sense your response. It measures (albeit less data-intensively) performance, and I like performance tests better than proxy tests.

Any of these can work. Try them and see what you learn.

Take these warning signs for what they are: your body’s red flags to get your attention that things are amiss. Rather than get caught up in numbers and times, etc., pay attention to the bigger picture of your body’s responses to the training.

Many endurance athletes get a little overtrained at one time or another, hopefully only once. The dramatic wasting effects of overtraining need to be treated with respect when training loads become high.