Table 5. A couple recent studies show promise for discriminating nonfunctional overreaching (NFO) from overtraining syndrome. 1998 Jan; 8(1):18-21. Biochemical markers have been studied in a variety of athlete populations. Increased training leading to a temporary performance decrement and with improved performance after rest, Intense training leading to a longer performance decrement but with full recovery after rest; accompanied by increased psychologic and/or neuroendocrinologic symptoms, Negative due to symptoms and loss of training time, Consistent with extreme nonfunctional overreaching but with (1) longer performance decrement (> 2 months), (2) more severe symptomatology and maladapted physiology (psychologic, neurologic, endocrinologic, immunologic systems), (3) and an additional stressor not explained by other disease, Negative due to symptoms and possible end to athletic career, Decreased glycogen causes fatigue and decreased performance, Low glycogen can be correlated with decreased performance and exercise-induced fatigue, No proven correlation in the literature between low glycogen and overtrained athletes, Increased tryptophan uptake in the brain leads to increased 5-HT centrally and mood symptoms, Exercise correlated with increased tryptophan, 5-HT, and fatigue, Decreased glutamine causes immune dysfunction and increased susceptibility to infection, Glutamine does decrease after prolonged exercise, In vivo, decreased plasma glutamine not necessarily correlated with decreased bioavailable glutamine, Excessive oxidative stress causes muscle damage and fatigue, Resting markers of oxidative stress are higher in overtrained athletes and increase with exercise, Parasympathetic predominance causes many symptoms of overtraining syndrome, A study showed variability in autonomic nervous system forces (through heart rate variability) with exercise versus rest, Decreased nocturnal catecholamines in overtrained athletes in some studies; no change or increased in others, Dysregulation of the hypothalamus and hormonal axes cause many symptoms of overtraining syndrome, Endurance athletes have activation of the hypothalamic-pituitary-adrenal axis compared with controls, Contradictory data in terms of activation of hypothalamic-pituitary-adrenal/hypothalamic-pituitary-gonadal axes in overtrained athletes and levels of ACTH, cortisol, testosterone, Inflammation and cytokine release causes most of the above effects and symptoms of overtraining syndrome, Unified theory accounting for many symptoms of overtraining syndrome and “why” it develops, Little evidence actually verifying increased cytokines in overtrained athletes, Increased training load without adequate recovery, Stressors including personal life (family, relationships) and occupational, Adjust training volume and intensity based on performance and mood, Ensure adequate calories for training load, Ensure adequate carbohydrate ingestion during exercise, Promoting mental toughness or resilience as buffer, Rest period of greater than 6 hours between exercise bouts, Abstinence of training following infection, heat stroke/stress, periods of high stress, Utilize Profile of Mood States (or stress level) and alter training load, Kreher JB, Schwartz JB. It is more common among those participating in individual sports than in team sports. Training and overtraining: an overview and experimental results in endurance sports. Sports Health. However, there is no scientific evidence to either confirm or refute this suggestion. It is suggested that fatigue is a “normal experience” in athletes, whereas decreased vigor can be viewed as maladaptive 63). The overtraining syndrome is a chronic fatiguing illness that affects highly motivated endurance athletes. There is some evidence to suggest that the depletion of glycogen stores (glycogen is what provides energy to our muscles) leads to OTS. The bouts of maximal exercise are separated by 4 hours. One should educate athletes at risk for overtraining that one of the initial signs of overreaching is increased rating of perceived exertion for a given workload 74). The best treatment for overtraining syndrome is rest. Overload and training. Currently, several markers (hormones, performance tests, psychological tests, and biochemical and immune markers) are used, but none of them meet all the criteria to make their use generally accepted. }); 3, 4, 12, 14, 23, 24, 25, 26, 27, 30, 31, 42, 43, 58, 64, 65, 68, 69, 72. Symptoms of overtraining syndrome. Treatment with selective serotonin reuptake inhibitor is suggested by some based on similarities between neuroendocrinologic changes between depression and overtraining syndrome 70). The hallmark of Overtraining Syndrome is decreased athletic performance despite what would otherwise be considered adequate rest (weeks or even months) accompanied by psychological symptoms, including depression and irritability. Overtraining syndrome is prevalent in competitive athletes, such including distance runners, swimmers and those who play ball sports. The recuperation period from Overtraining Syndrome may require months or years. History should include assessment of possible triggers (Table 4) 27). Those who exercise regularly have a longer life expectancy, as well as a better quality of life, than those who are sedentary.When is too much of a good thing not so wonderful? It can be difficult to diagnose and treat. Br J Sports Med. Overtraining Syndrome is not as simple as it may sound. Major components of prevention are screening and education. 2002; 32(3):185-209. The overtraining syndrome is a chronic fatiguing illness that affects highly motivated endurance athletes. 2020 Aug 21;11:1072. doi: 10.3389/fphys.2020.01072. Overtraining syndrome may be the result of another underlying condition, and it sometimes is masked because of symptoms that are similar to other conditions. It is characterized by declining performance when maintaining a normal training program. 2019 Nov;24(13):1828-1838. doi: 10.1177/1359105317705980. Sports Med. Overnight urinary cortisol and cortisone add new insights into adaptation to training. Cortisol has a peak during the day with nadir during night 45). The Gaudiani Clinic physicians enjoy supporting athletes by addressing their training and fueling concerns and work in conjunction with a treatment team to ensure the whole person receives expert and compassionate care. Cross training by incorporating various physical activities into training for a specific sport, thus preventing monotony – a known contributor to OTS. Its signs and symptoms are highlighted, with training, dietary and other lifestyle recommendations to help prevent and treat the condition. eCollection 2020. In the most recent study of 2-bout maximal exercise protocol, reliable differentiation of nonfunctional overreaching (NFO) from overtraining syndrome was achieved. In one of the few studies describing evaluation of underperforming athletes, a cause for repeated infections and/or fatigue was found in 68% of regional- or higher-level athletes 33). It’s not a great place to be. Heavy weeks and months of training should include time for recovery so that you are well rested before important races. Raglin J, Sawamura S, Alexiou S, et al. The diagnosis from history can be made only in retrospect given the definitions of nonfunctional overreaching (NFO) and overtraining syndrome. OTS is most common in elite athletes – those for whom athletic activity is a career, who train five or more hours per day, most days of the week. Exercise boosts the immune system, improves sleep quality and improves memory and cognitive function. However, observation of training load, performance measures, and mood questionnaires can help interrupt the progression from FO to NFO/overtraining syndrome 72). 2020 Sep 1;55(9):885-892. doi: 10.4085/1062-6050-500-19. Ninety-three percent of the athletes reported decreases in performance. Med Sci Sports Exerc. Increased loads are tolerated only through interspersed periods of rest and recovery—training periodization. These clues include the ability to start a training session but the inability to complete and/or a loss of finishing kick 28). However, there are no specific and validated blood markers for nonfunctional overreaching (NFO) or overtraining syndrome 51). 1989;14(4):303-310, Morgan WP, Costill DL, Flynn MG, et al. Lakier Smith L. Sports Med. Privacy Policy, Free Shipping On Orders Over $20 - Free Healthy Snack With Every Purchase, Free Purist Water Bottle With All Orders Over $100 Click Here And Add To Cart. Taking an attitude of "pushing past the pain" can do more harm than good in those who have overtraining syndrome. Aebi MR, Bourdillon N, Bron D, Millet GP. Psychoneuroendocrinology. Eur J Sport Sci. It is unclear which strategy is best, so the motivation for exercise, internal versus external, should be considered when recommending complete versus relative rest. In turn, there is diminished athletic performance and impaired daily functioning. While mood symptoms can coexist with organic processes, the presence of pervasive mood changes in the proper setting may signal nonfunctional overreaching (NFO)/overtraining syndrome versus a primary mood disorder 29). Potential triggers of overtraining syndrome. 2005 Jun;49(3):359-68. doi: 10.1590/s0004-27302005000300006. Please enable it to take advantage of the complete set of features! 2003;34:1-26. Intensive exercise withshortrests andfrequentcompetitionis dangerous. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: A keyword in the recognition of OTS might be "prolonged maladaptation" not only of the athlete but also of several biological, neurochemical, and hormonal regulation mechanisms. Giving your body and mind the proper support and enough time are keys to success in overcoming many health conditions. The distinction between NFOR and overtraining syndrome (OTS) is very difficult and will depend on the clinical outcome and exclusion diagnosis. 2012 Mar;4(2):128-38. doi: 10.1177/1941738111434406. Get the latest research from NIH: thyroid dysfunction, diabetes, malnutrition and eating disorders) have been ruled out. Any overtraining is best treated with rest. It is believed that functional overreaching (FO), nonfunctional overreaching (NFO) and overtraining syndrome represent a disturbance, an adaptation, and eventual maladaption of the HPA (hypothalamic-pituitary-adrenal) axis.