Overtraining Syndrome: Rest, Recover, and Regenerate

Recovery is an essential aspect of the training process. Put simply, if we aren’t recovering from the stresses we are placing on our bodies, we can’t improve.

We typically discuss various training methods and strategies to help improve sports performance, often overlooking the importance of recovery and what we are doing outside of the gym as a way to maximize what we are doing inside of it.

I’ll admit, talking about recovery may not be as exciting as talking about training or ways to create a program that will lead us to athletic dominance. However, it is an important topic that needs to be covered if you want to get the most out of training and prevent injuries and overtraining.

Overtraining Syndrome

In a nut-shell, overtraining is the accumulation of stress (both training and non-training stressors) which, when not tended to properly, leads to a decrease in performance with physiological and/or psychological symptoms that may take weeks or months to recover from.

I think she missed the warning signs.

Whenever an imbalance between training/competing and recovery occur, there is a possibility for overtraining. On a small scale, some overtraining is thought to be beneficial, and is often referred to as “overreaching” – a process where the athlete purposefully overtrains slightly with the idea that they will increase recovery at the end of the overreaching phase of training and take advantage of “supercompensation”, which occurs when fatigue dissipates and the new level of fitness is able to manifest itself. The needed period of recovery from overreaching may last a few days to a week, and athletes will show signs of overtraining (decreases in performance, fatigue, delayed recovery between training bouts, poor sleep patterns, etc.); however, the athlete should be monitored to ensure that none of these red flags of overtraining get out of control – often athletes will be asked to train to an 8-10% decrease in performance before going into the recovery phase and allowing supercompensation to take effect.

The concept of overreaching is a controversial one, as many coaches don’t want to put their athletes into these overtrained situations, even if it is only for a brief period of time. I also tend to err more on the side of caution and feel that putting someone purposefully into an overtrained state should not be the goal of the training program. Additionally, when working with athletes who play in sports that have long competitive seasons or play multiple competitions per week (baseball, basketball, hockey, football, etc…), the goal should really be to keep the athlete healthy and free from overtraining, so that they can perform optimally come game time.

Stress and Overtraining

Things like travel schedules, long flights across time zones, poor nutrition/food choices on the road, and stresses imposed on the athletes by their coaches all may add more stress on the athlete, leading to a further potential for overtraining/under recovery. If the stress of training and competition is not bad enough, athletes also have to worry about the stress of their everyday lives.  Things like social stress, financial stress, and family stress can all play a role in decreasing one’s ability to recover from training/competition.

Athletes of all ages, from high school through the professional ranks, face life stresses that need to be taken into consideration when evaluating the overall program and the amount of stress you are placing on a given athlete. Bartholomew and colleagues showed that high amounts of life stress impact one’s ability to adapt to a strength-training program, with low-stress individuals showing significantly greater improvements in squat and bench press strength than those with high-stress levels. This study was conducted on 135 undergraduate students who trained twice a week (1.5-hour training sessions) for 12 weeks. This amount of 3 hours of total training per week is a far cry from what is expected of an athlete at the college level (between practice, training and competition) and in most cases, high school athletes are even exceeding this amount of training per week.

Inflammation, Tissue Trauma and Overtraining

Several authors have set out to understand the underlying cause of overtraining syndrome and how the overtraining processes is initiated. Some of the proposed mechanisms have been:

  • Glycogen Hypothesis, which has looked at reduced levels of glycogen as markers of fatigue and overtraining.
  • Central Fatigue Hypothesis, which looks at reduced levels of circulating tryptophan (an amino acid), which causes it to be taken up in the brain to a greater extent. Tryptophan is a precursor to serotonin, a neurotransmitter which, when elevated has effects on the body such as increased need for sleep and reduction in appetite (both are tell-tale signs of overtraining).
  • Glutamine Hypothesis, which seeks to explain the decrease in immune function and increase in illness during periods of overtraining, as glutamine is an important amino acid used for fuel by lymphocytes in the immune system.
  • Hypothalmus and Hypothamic-pituitary-adrenal axis implications, where the blood catecholamine, glucocorticoid and testosterone levels are altered.
  • Lack of day-to-day variations in training, which expose the athletes to “burn-out” and potential overuse injuries.

Together, all of the above theories explain some aspect of overtraining syndrome, yet a definite underlying cause has not been concluded upon.

Researcher Lucille Lakier Smith has proposed the idea that overtraining may begin with (and be caused by) tissue trauma.

First, it is important to note that some level of tissue trauma is not bad. In fact, a little bit of trauma is needed in order to force an adaptation (hence the name Adaptive Microtrauma). If we don’t impose some level of stress on our bodies, then we have nothing to adapt to, and no improvements are made. The pattern then looks like this:

Train (impose a stress on the body) –> Recover from that stress (heal)–> Train again (breakdown a little more) –> Rinse and repeat

Training leads to trauma, which leads to a local inflammatory process and the release of cytokines. Cytokines are basically like messengers which transfer information from cell to cell and, when they are found in increased concentrations in the blood, they can transfer information around the whole body, having a more systemic effect. There are various types of cytokines with some having pro-inflammatory properties and others having anti-inflammatory properties.  Three important pro-inflammatory cytokines are interlukin-1ß, interlukin-6, and tumor necrocis factor – (NOTE: interlukin-6 can have anti-inflammatory properties as well).

During phases of training where recovery is not optimal (overtraining) and inflammation is elevated, or during periods of injury, pro-inflammatory cytokines may play a large role in communicating to the body that something is wrong.

Houston, we have a problem!

In the end, these cytokines may lead to the signs and symptoms that we get when we are in an overtrained state. If we are smart, we heed our bodies warning and back off of the training stimulus to allow for recovery to take place.

Signs and Symptoms

As you can see from the diagram above, overtraining syndrome has a negative effect on many of the bodies’ processes and recovery from severe overtraining can be a substantial task.

Here are a few signs and symptoms to look out for:

Physiological

  • changes in blood pressure
  • changes in heart rate at rest, during exercise, and during recovery
  • increased frequency of respiration
  • increased oxygen consumption at submaximal exercise intensities
  • decreased lean body mass

Psychological/behavioral

  • constant fatigue
  • reduced appetite
  • changes in sleep pattern
  • depression
  • general apathy
  • emotional instability
  • decreased self-esteem
  • fear of competition
  • gives up when the going gets tough

Information processing

  • loss of coordination
  • difficulty concentrating
  • reduced capacity to correct technical faults

Biochemical Parameters

  • rhabdomyolysis
  • negative nitrogen balance
  • elevated C-reactive protein
  • depressed muscle glycogen levels
  • decreased free testosterone
  • increased serum cortisol

Immunological Parameters

  • constant fatigue
  • headaches
  • nausea
  • complaints of muscle and joint aches and pains
  • gastrointestinal disturbance
  • muscle soreness tenderness
  • one-day colds
  • swelling of lymph glands
  • bacterial infections
  • increased susceptibility to and severity of illness, colds, and allergies

Monitoring your training

The question always becomes, “how much stress is too much, and how much is just enough?” Truth be told, the answer is probably going to be found in the individual, as different athletes will adapt better to different training interventions.

Having a training journal and a periodized training program is a great way to ensure that you prevent overtraining, as you can look back at what you have been doing when you start to feel some of these symptoms come on, and in turn, plan properly for future training blocks – which should include blocks of recovery and restoration.

If you are a coach in a team setting, it may be more difficult to properly plan training around the individual. Knowing your athletes is an important aspect of coaching, and many coaches have employed the use of rate of perceived exertion (RPE) scales from the athletes, to help plan training. I talked briefly about this in my article on flexible non-linear periodization.

A recommendation by Robson-Ansley and colleagues is to have athletes complete a session RPE document following a non-steady state aerobic training session (i.e., weight training, interval training, speed work, competition, etc.). The athletes are to complete the document at least 30 minutes following training, to ensure that they make a proper appraisal of the day’s training session, and don’t just rate it as highly fatiguing based on how they felt right after completing the last part of an intense workout.

Conclusion

Overtraining syndrome is a very serious issue that affects many athletes and should be avoided at all cost. Several processes are involved in overtraining syndrome and it appears that tissue trauma due to inadequate rest/recovery may be the potential underlying factor which begins the whole process. There are many signs and symptoms of overtraining and they can affect psychological, physiological and performance processes.

photo credits:  Dan Maudsley, SaticonDreams, nasa hq photo

 

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References

Meeusen R, Duclos M, Gleeson M, Rietjens G, Steinacker A, Urhausen A. Prevention, Diagnosis & Treatment of Overtraining Syndrome. European Journal of Sports Science March 2006;6(1):1-14.

Bartholomew JB, Stults-Kolehmainen MA Elrod C C, Todd JS. Strength Gains after Resistance Training: The Effect of Stressful, Negative Life Events. Journal of Strength Cond Res 2008; 22(4):1215-1221.

Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress. Med Sci Sport Exer 2000;32(2):317-331.

Smith LL.Tissue trauma: the underlying cause of overtraining syndrome?  Journal of Strength Cond Res 2004;18(1): 185-193.

Robson-Ansley PJ, Gleeson M Ansley L. Fatigue Management in Preparation of Olympic Athletes. Journal of Sports Sciences, Feb2009;1-12.

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Patrick Ward is a strength and conditioning coach and licensed massage therapist who has worked with a diverse clientle ranging from professional athletes to general population clients looking for improved fitness over his ten year career. He is the director of sports preparation at Optimum Sports Performance in Phoenix, AZ.

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