From the Guidelines
Athletes experiencing overtraining syndrome should immediately reduce their training volume and intensity by 40-60% and incorporate 1-2 complete rest days weekly, as recommended by the American Medical Society for Sports Medicine position statement 1. To address overtraining, it is essential to follow a structured recovery plan lasting 2-6 weeks, depending on the severity of the condition. This plan should include:
- Gradually increasing training load by no more than 10% weekly once symptoms improve
- Ensuring adequate nutrition with sufficient calories, protein (1.6-2.0g/kg body weight daily), and carbohydrates (5-7g/kg for moderate training)
- Prioritizing 7-9 hours of quality sleep nightly
- Managing stress through meditation or deep breathing
- Monitoring recovery using heart rate variability, resting heart rate, and perceived exertion scales Overtraining occurs because excessive physical stress without adequate recovery leads to hormonal imbalances, particularly elevated cortisol and decreased testosterone, causing systemic inflammation and immune suppression, as discussed in the American Medical Society for Sports Medicine position statement 1. Key factors to consider in the prevention and management of overtraining include:
- Psychological factors, such as personality issues and the psychological response to injury and illness
- Athletic culture and environmental factors, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport
- Detection and management of specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, sleep disorders, and attention-deficit/hyperactivity disorder, as outlined in the position statement 1. If symptoms persist beyond 2-3 weeks of reduced training, it is crucial to consult a sports medicine physician, as blood tests may be needed to rule out other conditions.
From the Research
Definition and Causes of Overtraining
- Overtraining refers to prolonged fatigue and reduced performance despite increased training, with roots including muscle damage, cytokine actions, and stress hormone responses 2.
- It is caused by too much high-intensity training and/or too little regeneration time, often combined with other training and non-training stressors 3.
- Overtraining syndrome (OTS) appears to be a maladapted response to excessive exercise without adequate rest, resulting in perturbations of multiple body systems and mood changes 4.
Symptoms and Diagnosis of Overtraining
- Symptoms of overtraining are varied and non-specific, including fatigue, underperformance, mood disturbances, and immune system suppression 2, 3.
- There is no single diagnostic test for overtraining, and diagnosis requires the identification of stress indicators that do not return to baseline following a period of regeneration 3.
- Screening for changes in parameters indicative of overtraining needs to be a routine component of the training program, incorporating markers such as neuroendocrine imbalance, immune system suppression, and muscle damage 3.
Prevention and Treatment of Overtraining
- The best treatment for overtraining is prevention, which involves balancing training and rest, monitoring mood and fatigue, reducing distress, and ensuring optimal nutrition 2.
- An in-depth knowledge of periodization of training theory may be necessary to promote optimal performance improvements and prevent overtraining 3.
- Functional overreaching, a deliberate induction of short-term training-induced decrements in performance, may be necessary to achieve performance super-compensation, but its metabolic consequences are not fully understood 5.
Research Gaps and Limitations
- Despite the importance of understanding overtraining syndrome, there is a lack of high-quality evidence describing the physiological and psychological changes that occur in athletes with OTS 6.
- The ideal testing battery for monitoring overtraining does not yet exist, and real-world settings may facilitate the collection of data on OTS 6.