Fatigue and Overtraining Syndrome

Load and overload

Training loads are designed to create a demand or stress on the body to stimulate improvement in performance. Training loads that are managed well often result in improved athletic capacity and performance and a reduction in the risk of injury and illness.

Successful training involves short-term overload but must avoid the combination of excessive overload and inadequate recovery. Overload that is excessive or not well managed and can result in performance decrements, injury and illness.

Overtraining syndrome

Overtraining syndrome is characterised by a long-term performance decrement (usually greater than 2 months) not improved with the usual rest and recovery cycle. It can lead to physical symptoms such as elevated heart rate, weight loss, muscle pain/soreness, elevated blood pressure, gastroenterological distress, delayed recovery from exertion, loss or decrease in appetite, severe fatigue, disturbed sleep, overuse injures and immune system deficits. Restoration of performance capacity may take several weeks or months to achieve.

Overtraining syndrome is a diagnosis of exclusion. Often there has been a recent increase in the frequency, duration or intensity of training prior to the onset of symptoms. The increase in training might be related to preparation for an upcoming competition. All possible causes of fatigue need to be ruled out by the treating medical specialist using a combination of physical examination, blood tests and investigations where indicated. There may be some clues to suggest overtraining syndrome using the athlete’s heart rate. Athletes often know their normal resting heart rate and this may be increased in overtraining syndrome. The maximum heart rate the athlete can achieve during training may also decrease.

Fatigue and recovery

There is no quick fix for overtraining syndrome. Once other causes of fatigue have been ruled out (sleep disorder, nutritional deficiency, anaemia and iron deficiency, psychological condition, thyroid disorder, infection or post viral syndrome), the athlete will need a period of rest to recover. The time needed to recover will depend on how long the symptoms have been present for.

Sometimes decreasing training intensity by 50 – 75% for 1 – 2 weeks is long enough to result in improved performance in training and competition. At other times, a more prolonged and severe reduction in training is needed with only light, non-strenuous, recreational exercise allowed for a period of weeks. This might be up to 30 minutes per day of light aerobic exercise (no more than 65 – 70% of max heart rate) combined with light, weight-based exercises a maximum of every second day (5 exercises, 2 x 12 – 15 reps at 40 – 50% 1RM).

Refraining from normal training is often the hardest part for the athlete. It is a mental challenge for an athlete not to train as hard as possible but inadequate rest and poor recovery are significant factors contributing to their current fatigue and poor performance so rest is the only way to reverse these changes. A review of the athlete’s nutrition and sleep schedule is also important, as they are both significant factors affecting recovery.

Return to competition

Return to competition training shouldn’t start until the physiological and psychological symptoms and signs associated with overtraining syndrome have resolved. Training can then be increased gradually, starting with increasing the frequency of training, then the duration of the sessions and then the intensity. Abrupt increases in training volume or intensity need to be avoided. On return to full training and when performance is back to normal levels (as indicated by time trials or other performance tests), competition can be resumed. Monitoring of the athlete’s sleep, nutrition and other factors related to stress such as education or work and competition- related stress needs to be monitored during this process.

If you have any symptoms of fatigue or overtraining syndrome, a consultation at Shire Sports Medicine can provide an individualised assessment and management plan to help with recovery and ensure both optimal health and performance