This “overtraining syndrome” is the name given to the collection of emotion- al, behavioural and physical symptoms that result from overtraining and that persist for weeks to months. Athletes and coaches may also describe this as “burn- out” or “staleness” or as a result of going “too hard, too fast, too often.” Overtrain- ing is marked by cumulative exhaustion that persists even after recovery periods. It has been suggested that 10-20 per cent of athletes who train intensely experi- ence overtraining that results in chronic decreases in performance and impaired ability to train.(1) SIGNS AND SYMPTOMS OF OVERTRAINING Overtraining is different from the day- to-day variation in performance and post-exercise tiredness – Delayed Onset Muscle Soreness – that is common in conditioned athletes. (As an aside, for those who strength train, researchers from McMaster University in Hamilton, Ontario and the Washington University School of Medicine in St. Louis suggest that the “repair and renew” process seems to peak about 24 hours after a workout, when the muscle protein synthesis rate is signifi cantly increased. However, about 36 hours after a workout, the whole pro- cess is almost complete, and muscles are back to routine housekeeping. Although this time is somewhat variable, I suggest that my patients give at least 24-36 hours between bouts of intense exercise.) The most common symptom seen clinically is fatigue, which is typically described as feeling “burnt out.” This feeling often cancels, or limits, workouts and may persist even at rest. The athlete can also become moody, easily irritated, have altered sleep patterns, become de- pressed, or lose the competitive desire and enthusiasm for his or her sport. Overtrained athletes generally present to sports injury practices with physical symptoms that include persistent mus- cular soreness, increased frequency of vi- ral illnesses and most notably, increased incidence of injuries. Many injuries that result from overuse – for example, achil- les tendonitis, shin splints, runner’s knee, ITB syndrome, rotator cuff tendonitis or swimmer’s shoulder – can be caused by too much volume or intensity of train- ing. The body is simply unable to cope with the stresses of the training load and www.canadianchiropractor.ca injuries result. There have been many scientific stud- ies performed on athletes with over- reaching and overtraining syndrome. Although somewhat variable, the find- ings in these studies have described the following symptoms: decreased per- formance in exercise testing, decreased mood state and increased cortisol levels (stress hormone). A decrease in testos- terone, altered immune status, and an in- crease in muscular break-down products has also been reported.(2) REVIEWING THE LITERATURE A review of the scientifi c literature on overtraining reveals that there are two forms of the syndrome that are often de- scribed. The “sympathetic form” is more common in sprint-type sports while the “parasympathetic form” is more com- mon in endurance sports. The specific results from the various measurements mentioned above, taken during exercise testing, differ between the two forms, but decreased overall performance and increased perceived fatigue remain con- sistent. In the parasympathetic form, there may actually be a lower heart rate for a given workload. Athletes training with specifi c heart-rate goals may notice that they cannot sustain the workout at their usual “set point.” Fatigue generally takes over and usually causes the athlete to prematurely terminate the workout. Regulation of glucose may also become altered and some athletes may experi- ence symptoms of hypoglycemia during exercise.(2) There is much controversy in the lit- erature surrounding the exact laboratory results for overtraining and it is possible to have been diagnosed with overtrain- ing syndrome, but have completely nor- mal physical fi ndings and biochemical tests. At this point, there is no single test that will absolutely confi rm the presence of overtraining. Personally, I consider the diagnosis of overtraining syndrome, in any athlete who manifests symptoms of prolonged fatigue, recurrent or persistent muscular injuries and performance that has plateaued or decreased. Still, it is im- portant to exclude any underlying illness that may be responsible for the fatigue. TREATING OVERTRAINING SYNDROME The treatment for overtraining syndrome is, quite simply, rest. The evidence sug- gests that the longer the overtraining has occurred, the more rest that is required. Therefore, the earlier in a sporting sea- son that overtraining can be detected, the sooner the athlete will be able to return to competition. If the overtraining – perhaps over- reaching – has only occurred for a short period of time – i.e., less than a month – then interrupting training for three to fi ve days is reported to provide sufficient rest. As training is resumed, it is recom- mended that workouts be scheduled on alternate days. The overall intensity of the training can be maintained, but the total volume of the work should be lower. Identifying any problems in the Continued on Page 42 Common warning signs of overtraining include: • Burnt-out feeling, overtiredness, feeling, lack of energy • Mild leg soreness/tightness, general achiness • Pain in muscles and joints • Sudden drop in performance • Insomnia • Decreased immunity (increased incidence of colds and sore throats) • Decrease in training capacity/intensity • Moodiness and irritability • Depression • Loss of enthusiasm for the sport • Decreased appetite • Increased incidence of injuries CANADIAN CHIROPRACTOR | APRIL 2008 • 39
Chiropractic + Naturopathic Doctor April 2008: Page 39
