The Overtraining Syndrome in Athletes:
The Challenge of Prevention
Athletes are running, swimming, and skating faster, jumping higher, throwing further,
and lifting more than ever before. Records in many events continue to
be broken, and in some events the pace is accelerating. For example, in
just the past five years the world record in the men's 10,000 meters has
been broken eight times by six different runners. Even more startling,
the world record improved by nearly three percent during this period,
whereas during the preceding 30 years it improved by less than two percent!
 Many
factors are contributing to this improvement. Coaches have increased
their knowledge base because of advances in sport medicine and science.
Equipment changes have led to immediate improvements, the most recent
example being the clap skate in speedskating. However, it is generally
accepted that the most important cause of improved performance is the
training that athletes undergo, particularly for events that require
endurance or superior physical conditioning.
As records have progressed, so has the level of training. Some
sport scientists estimate that training loads have increased by 20% over
the past decade, and far greater increases have been noted for some sports
(Raglin & Wilson, in press).
However, there is a limit to an athlete's capacity to endure and
adapt to intense training. Once this threshold is crossed the athlete fails
to adapt and performance declines. Ten to twenty percent of athletes who
train intensively may fall prey to the overtraining syndrome, otherwise
known as staleness (Kuipers, 1998; Krieder et al. 1997; Raglin & Wilson,
in press). Athletes suffering from the overtraining syndrome are unable
to train and perform to their capacity, and may experience a variety of
other symptoms.
The term overtraining itself is fraught with controversy and confusion.
Some coaches and athletes contend that there is no limit beyond which training
becomes counterproductive. The term also has been used inconsistently in
the scientific literature with a variety of labels attached to this condition
(O'Connor, 1997). For the purposes of this paper, the following definitions
will be used.
Overload - A planned, systematic and progressive increase in training
with the goal of improving performance.
Overreaching – Unplanned, excessive overload with inadequate rest.
Poor performance is observed in training and competition. Successful recovery
should result from short-term (i.e., a few days up to one or two weeks)
interventions.
Overtraining Syndrome – Untreated overreaching that results in chronic
decreases in performance and impaired ability to train. Other problems
may result and may require medical attention.
What Are the Causes of Overtraining
Syndrome?
Athletes who fail to adapt to the stress of sustained, long-term, high
intensity training can develop overtraining syndrome. The condition may
also have a rapid onset if high intensity training takes place too early
in the training cycle, before athletes have had time to adapt to the stress
of training. Research has shown that as few as 10 days of increased training
may result in overreaching in some athletes (Costill et al., 1988). Lack
of recovery may also contribute to overtraining syndrome.
The chief cause of overtraining syndrome, however, is a poorly
conceived training program. For example, rapid increases in training volume
and intensity, protracted schedules of high volume training, along with
inadequate recovery and rest will put many athletes at risk of becoming
overreached or developing overtraining syndrome. Failing to consider other
stresses the athlete is experiencing will also increase the risk. But even
the most carefully planned training program can cause problems with some
athletes. Research has shown that athletes with similar fitness levels
respond quite differently to the same training program; some athletes may
thrive on a training program that causes their teammates to develop overtraining
syndrome (Costill et al. 1988; Raglin, 1993).
Other types of stress may compound the stress of training and
increase the risk of developing overtraining syndrome, including the following:
-
Frequent competition, particular if it involves quality efforts (i.e.,
large volumes and/or high intensity work) may contribute, but controlled
investigations of this potential factor are lacking.
-
Monotonous training also has been implicated as a contributing factor;
however, this may be more the result of failing to integrate rest days
into high volume training programs rather than stress resulting from a
lack of variety (Kreider, Fry & O'Toole, 1998).
-
Pre-existing medical conditions such as colds or allergies may result in
athletes becoming more vulnerable.
-
Poor diet may be an especially important contributing factor, particularly
inadequate intake of carbohydrates or dehydration. Hard training can increase
daily caloric requirements to the point to where it can become difficult
to consume adequate quantities of food and water. Thus, during the period
when meeting caloric needs is most crucial, athletes are more likely to
fall short. Coaches should educate athletes about proper nutrition and
monitor caloric intake during heavy training periods. Healthy snacking
between meal times may also aid athletes in meeting their caloric needs.
-
Environmental stress factors like altitude, high temperatures and humidity
can make training more stressful, delay recovery and contribute to the
risk of overtraining.
-
Psychosocial stressors also have been implicated (Urhausen et al. 1998).
Adjustment problems with teammates, coaches, friends and family as well
as work or school obligations, can be major sources of stress for some
athletes--but research is lacking on the extent to which they may contribute
to the overtraining syndrome.
-
Heavy travel schedules can also be stressful. However, research indicates
the effects of travel are complex (O'Connor et al. 1991) and need to be
considered in light of the factors listed above.
In summary, the failure to adapt to overload training is the primary cause
of overtraining syndrome, but a variety of other factors may compound this
stress. The ability to tolerate the complex interaction of overload training
and environmental and psychosocial stressors varies considerably among
athletes. Because even physically similar athletes differ in how they respond
to stress, standardized assessments of training and secondary sources of
stress may not be useful in predicting the risk of staleness in groups
or teams. This variability underscores the importance of regarding each
athlete as an individual. While it may involve significant effort to "get
to know" each athlete on a team, coaches must attempt to understand the
physical and psychological limitation of each individual.
What to Recognize?
 The primary feature of
the overtraining syndrome is an unexpected drop in performance in practice
or competition that cannot be attributed to factors such as illness or
injury. This drop-off may be preceded by a period when performance is
maintained, but at greater cost to the athlete. Other symptoms of overtraining
syndrome include mood disturbances (depression, anger, anxiety), general
fatigue and malaise associated with a loss of energy and vigor, feelings
of heaviness in the limbs. Changes in sleep patterns and appetite also
have been commonly noted and may be useful in diagnosing overtraining
syndrome.
Not only must coaches learn how each athlete responds to training,
they must also ascertain how each athlete responds to extraneous stressors
and their impact on the athlete's ability to tolerate overload training.
Careful observation and record keeping are critical toward gaining this
understanding. Good communication skills cannot be overemphasized, and
the athlete should feel free to disclose any symptoms to the coach without
the fear of recrimination.
It is imperative that coaches identify overtraining syndrome at
its early stages (i.e., overreaching) when short-term interventions may
still be effective. The most important change that may occur with overtraining
syndrome is an unexpected drop in performance in practice or competition.
This performance drop-off may be preceded by a period when the athlete
can still train and compete at expected levels, but with greater difficulty
and increased perception of effort.
Preventing Overtraining
Syndrome
The risk of overtraining syndrome can be reduced if not eliminated
through careful periodization of training. Adequate rest and recovery,
especially during the heaviest training periods is crucial. Coaches may
have to enforce rest because some athletes are unwilling to reduce training
for fear of becoming detrained. Similarly, coaches may need to prevent
athletes from trying to train back into shape too quickly following a layoff.
Proper nutrition and hydration is also especially important during peak
training.
Coaches must "know their athletes," especially because of individual
differences in the ability to tolerate hard training. Careful record keeping
of performance during both practice and competition is crucial. Regular
medical checkups are recommended. Education of athletes cannot be overemphasized;
coaches must teach athletes to "listen to their bodies" and be alert to
signs of overreaching. Parents also should be educated about the signs
of overreaching and the overtraining syndrome.
Treatment
Overreaching - Rest is the primary treatment (Kuipers &
Keizer, 1988). Reduced training may be sufficient for recovery in some
overreaching cases. For overtraining syndrome, a complete break from training
is necessary. Rest does not mean total inactivity, which can be a significant
source of stress for athletes accustomed to training daily. Active recreation
can be effective as a recovery aid and help deter monotony. Proper nutrition
is important even though the athlete is not in training.
Overtraining Syndrome - If overtraining syndrome is suspected
a medical examination should be conducted to rule out illness or disease.
If illness or other factors can be ruled out, then a training break is
necessary. Recovery from overtraining syndrome may take a minimum of two
weeks of rest, but much longer breaks may be needed in more severe cases.
As with overreaching, rest need not mean total inactivity. Planned recreation
is important for athletes who are used to active lifestyles. Resumption
of training should be individualized because there is no universal indicator
of when recovery from overtraining syndrome is complete. Obviously special
care should be taken to monitor the athlete's response to training.
Research has shown that up to 80% of athletes suffering from overtraining
syndrome have significantly elevated levels of psychological depression
(Morgan et al. 1987) and professional psychological treatment is recommended
in such cases. Medical illness resulting from overload training (e.g.,
upper respiratory tract infection) will also require appropriate treatment
(Davis & Hertler-Colbert, 1997). Proper nutrition is an important concern
as overtraining syndrome often results in reduced appetite.
Summary
As athletes and coaches strive to push the limits of human performance
in competition, they must push the limits of the human body and mind in
preparing for competition. The planned and expected pushing of limits in
practice is called overload training. Pushing too hard for too long can
lead to an unplanned and unexpected failure to adapt to training and performance
decline. In the short term, this failure is called overreaching. In the
long term, overtraining syndrome can occur.
Overtraining syndrome is a complex condition whose primary cause
is prolonged overload training without proper recovery. Other types of
stress–competition-related, monotony and tedium, medical conditions, diet,
environment, psychosocial, and travel–can compound the stress of training
and contribute to causing overtraining syndrome.
An unexpected, unplanned drop-off in the capacity to train or
compete at customary levels often indicates that overreaching or overtraining
syndrome has afflicted an athlete, but it is crucial to first rule out
other conditions that also affect performance. Early warning signs that
may precede a loss of performance include mood disturbances, excessive
fatigue, changes in sleep and appetite patterns, and excessive difficulty
and perceived effort in completing normal training bouts.
Planning, monitoring, and communication are the keys to preventing
overtraining syndrome. Coaches must periodize training and recovery programs,
while taking into account external stressors. Testing and evaluating athletes'
training progress on a regular basis can help prevent any unexpected performance
drop-offs and facilitate prompt intervention should a drop-off occur. Communicating
with and teaching athletes to monitor their training and recovery status
may be the most important preventive measure available to a coach.
Rest is the cure for overreaching and overtraining syndrome. Coaches
should consult with medical professionals if they suspect overtraining
syndrome has occurred.
Overtraining syndrome is a pernicious condition which can rob
athletes of valuable seasons and even years during their careers. As those
responsible for planning and conducting training, coaches should strive
to educate themselves on all aspects of training and recovery. This education
process includes developing relationships with appropriate sport science
and medicine experts. Athletes place great trust in their coach's knowledge;
working to continually expand and refine that knowledge is a critical part
of the coach's job.
References
Costill, D.L., Flynn, M.G., Kirwan, J.P., Houmard, J.A., Mitchell,
J.B., Thomas, R. & Park, S.H. (1988). Effect of repeated days of intensified
training on muscle glycogen and swimming performance. Medicine and Science
in Sports and Exercise, 20, 249-254.
Davis, J.M. & Hertler-Colbert, L. (1997). The athlete's immune
system, intense exercise, and overtraining. In: Lamb, D.R. & Murray,
R. (Eds.). Optimizing Sport Performance: Perspectives in Exercise Science
and Sports Medicine. Vol. 10, (pp.269-311).
Fry, R.W., Morton, A.R. & Keast, D. (1991). Overtraining in
athletes: an update. Sports Medicine, 12, 32-65.
Krieder, R.B., Fry, A.C. & O'Toole, M.L. (1998). Overtraining
in Sport. Human Kinetics: Champaign, IL.
Kuipers, H. (1998). Training and overtraining: an introduction.
Medicine and Science in Sports and Exercise. 30, 1137-1139.
Kuipers, H. & Keizer, H.A. (1988). Overtraining in elite athletes:
review and future directions. Sports Medicine, 6, 79-92
Morgan, W.P., Brown, D.R., Raglin, J.S., O'Connor, P.J. &
Ellickson, K. A. (1987). Psychological monitoring of overtraining and staleness.
British Journal of Sports Medicine, 21, 107-113.
O'Connor, P.J. (1997). Overtraining and staleness. In: W.P. Morgan
(Ed.). Physical Activity & Mental Health. (pp. 145-160). Taylor &
Francis, Washington, D.C.
O'Connor, P.J., Morgan, W.P., Koltyn, K.F., Raglin, J.S., Turner,
J.G. & Kalin, N.H. (1991). Air travel across four time zones in college
swimmers. Journal of Applied Physiology, 70, 756-763.
Raglin, J.S. Overtraining and staleness: Psychometric monitoring
of endurance athletes. (1993). In R.N. Singer, M. Murphey & L.K. Tennet
(Eds), Handbook of Research in Sport Psychology. (pp. 840-850), Macmillan:
New York.
Raglin, J.S., & Wilson, G.S. (In press). Overtraining in athletes:
In Emotion in Sports. Y.L.Hanin, (Ed.). Human Kinetics.
Urhausen, A., Gabriel, H.H.W., Weiler, B. & Kindermann, W. (1998).
Ergometric and psychological findings during overtraining: a long-term
folow-up study in endurance athletes. International Journal of Sports Medicine.19,
114-120.
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