What is the treatment for overtraining syndrome?

Treatment for Overtraining Syndrome

The treatment for overtraining syndrome should be individually developed and include relative or absolute rest depending on the clinical situation, along with evaluation for mental health stressors. 1

Definition and Recognition

• Overtraining syndrome is an imbalance between training and recovery, characterized by declining performance despite maintaining normal training, chronic fatigue, and increased vulnerability to infections 2
• The syndrome can be divided into short-term overtraining (overreaching), which resolves within days to weeks, and long-term overtraining (staleness), which may take months for complete recovery 3, 4

Primary Treatment Approach

• Rest is the cornerstone of treatment - the only proven effective intervention for overtraining syndrome 5
• The duration of rest needed depends on severity:
  • For functional overreaching: planned recovery period within training cycle 6
  • For non-functional overreaching: extended rest beyond planned recovery 6
  • For full overtraining syndrome: complete rest for 6-12 weeks or longer 2

Comprehensive Management Strategy

Immediate Interventions

• Implement relative or absolute rest based on symptom severity 1
• Evaluate for mental health stressors that may be contributing to the syndrome 1
• Monitor for signs of chronic fatigue, underperformance, and increased vulnerability to infections 2

Nutritional Considerations

• Maintain optimal nutrition and hydration status to support recovery 1
• Address any energy availability issues, particularly in athletes showing signs of relative energy deficiency in sport (RED-S) 1

Sleep Management

• Prioritize sleep quality and quantity as part of recovery 1
• Address any insomnia with non-pharmacological approaches, as benzodiazepines are not recommended for athletes 1

Monitoring Recovery

• Watch for signs of overexercising during the recovery period:
  • Chronic fatigue that persists throughout the day 1
  • Inability to complete training sessions with reserve 1
  • Sleeplessness despite feeling fatigued 1
  • Joint pain or persistent muscle soreness 1

Return to Training Protocol

• Start slowly and progress gradually after symptoms have resolved 1
• Implement strategies to prevent recurrence:
  • Monitor training loads carefully 1
  • Ensure adequate rest periods between training sessions 1
  • Maintain optimal nutrition and hydration 1

Prevention Strategies

• Implement regular monitoring of training loads to prevent overtraining 1
• Ensure adequate rest periods are incorporated into training programs 1
• Consider using objective markers like blood biomarkers (though their validation for overtraining is still limited) 1
• Watch for early warning signs such as decreased psychomotor speed, which may be an early marker of overtraining 6

Common Pitfalls to Avoid

• Returning to intense training too soon before complete recovery 2
• Ignoring psychological aspects of overtraining syndrome 1
• Failing to address potential underlying causes such as inadequate nutrition or sleep 1
• Relying solely on subjective feelings of recovery without objective measures 1