WTF Is Overtraining Syndrome?

Possibly one of the most overused and misunderstood terms in strength and conditioning is "overtraining". I recently reviewed one of the most recent research papers to see if science can shed some light on this potential problem for athletes and to see if there are some simple things we can do as coaches to help prevent them overtraining. Leaving the science to one side I think a big step would be to clear up the terminology. I think it is pretty rare to have an athlete that is truely "overtraining". 

What we will see on a daily basis is "Functional Overreaching (FO)" which is simply the stress required for training adaptations to take place. What I think we will also see is "Non-Functional Overreaching (NFO)". I see this from time to time and I recently had a Thai Boxer come to me for some training advice. He was feeling slow, lacked energy and had been battered in his last fight (he ran out of steam!). This was his schedule. He trained 7 days a week, ran 5 miles every morning before breakfast, ran 13 miles on a Friday to maintain weight and went Thai Boxing 5-6 nights a week where he trained on average of 2 hours each night! This guys was suffering from NFO!  (he was probably heading for OTS!). What amazing things did I do to his training? I knocked out the volume (often the biggest problem) and gave him some recovery back. We scheduled 1.5 days full recovery each week, switched the morning runs (largely a waste of time - time that could be better spent in bed recovering!) for some HIIT and ditched the half marathon on a Friday! I'm not kidding you when I say that by the end of the first week I got a text from the Thai Boxer raving to me about how great he felt! I hadn't even started to work with this guy to develop his strength and power but he felt amazing (more strength, power and energy levels!). Just goes to show that if you catch the problem early, recognise some of the underlying problems, signs and symptoms you can make a huge difference to someones wellbeing and stop them slipping into OTS. 

Diagnosing overtraining in athletes using the two-bout exercise protocol British Journal of Sports Med 2010 44 (642-648)   

For a training programme to be effective we need to apply 'stress' to the body to bring about physiological changes and training adaptations. When training volume and intensity is increased for short periods of time it is not unusual for athletes to experience functional overreaching (FO) which in turn will lead to training adaptations and improved performance. Problems start to occur when inadequate recovery is provided to facilitate the training adaptation leading to non-functional overreaching (NFO) which in turn subsequently results in chronic maladaptations and ultimately OTS.   OTS is a term that is often used by athletes and coaches when describing an unexplained drop in performance. Whilst a short-term drop in performance associated with FO should not be ignored, it is important to establish if this decrease in performance is actually due to NFO or OTS.   

The tricky thing is to recognise when an athlete is actually experiencing the beneficial FO and when they have dropped from NFO into the hole that is OTS. At the moment the only way of identifying if the athlete has OTS is, recovery time. The longer the recovery time, the more likely it is that the athlete had OTS! Lets shut the gate after the horse has bolted!   

European scientists have recently got together to see if there is an objective way to identify if an athlete is suffering from OTS and in need of help, or if in fact they are experiencing FO or NFO. They gathered together 10 underperforming athletes (NFO was retrospectively diagnosed in five athletes, and OTS was diagnosed in five athletes) and got each athlete to perform two maximal exercise efforts to measure physical performance and stress-induced hormonal reactions. The researchers kept a track of exercise duration, heart rate and blood lactate, cortisol, adrenocorticotrophic hormone (ACTH), prolactin and growth hormone.   

Results showed that ACTH and prolactin responses are sensitive for the diagnosis of OTS and NFO. Cortisol and GH responses were much less sensitive measures as were resting hormone concentrations. Maximal lactate concentrations at both exercise tests showed a high sensitivity for the detection of OTS, but almost half of the NFO patients did not reach [La]max of 8 mmol.   

The research team concluded that NFO might be distinguished from OTS based on ACTH and prolactin reactions to a two-bout exercise protocol. The two-bout exercise protocol seems a useful tool for prospectively diagnosing underperforming athletes, with an overshoot of adrenocorticotrophic hormone (ACTH) and prolactin (PRL) after the second exercise bout in NFO athletes and suppression in OTS. The pituitary becomes hypersensitive in NFO athletes and then becomes insensitive in athletes with OTS.   

The most important thing is catch the problem early. At the moment we can only make a clear diagnosis retrospectively. Athletes suffering from NFO can take anything up to a year to recover. The nature of OTS means that the maladaptations have been prolonged (the athlete has had signs and symptoms for a long time) and subsequently, the recovery time is typically in excess of a year.   

In an ideal world you will book your athlete in for an appointment with the exercise physiologist to run them through a couple of maximal exercises tests whilst analysing ACTH and PRL!   

In the real world you need to keep a close eye on how your athlete is responding to training. Don't panic at the first signs of fatigue. We need some stress to adapt, but if your athlete is complaining of the following symptoms over a prolonged period of time then you may have an athlete that is experiencing NFO or possibly OTS.   

1.    Fatigue 

2.    Performance decline 

3.    Mood disturbances 

4.    Psychological disturbance (decreased vigour) 

5.    Hormonal disturbances 

6.    Decreased bodyweight 

7.    Prolonged DOMS (delayed onset muscular soreness) 

8.    Disrupted eating patterns 

9.    Increased waking heart rate 

10.Inability to raise your heart rate and maintain it during submax efforts.   

If you think your athletes has NFO or OTS then you can follow these simple steps to help get them back on track.   

1.    See a sports-medicine specialist for an objective evaluation. 

2.    Rest, this may be total rest or light activity. 

3.    Sleep, increase the amount of sleep you get each night 

4.    Develop a long-term plan to return to training and full fitness.   

The key to beating NFO and OTS is developing a programme that progressively overloads the system allowing periods of planned recovery and regeneration.