THE BACK PAGE PATIENT CARE Peak performance O Overtraining syndrome diagnosis and treatment BY DR. PENNY KENDALL-REED, ND women equally. Although similar in Glutathione – 250mg twice a day; presentation, it can be distinguished Resveratrol – 100mg twice a day; Se-from OTS. RED-S is predominantly a reniten Plus – 2 capsules twice a day low-energy rather than low-perfor-(to address stress pathway imbalance). mance state; there are stronger food Reduction in activity and training anxiety and body image issues; amenor-needs to be quite profound and sur-prises most athletes. However, rhea is more common as is failure to adhere to an appro-low libido and erectile dys-priate rest and recovery proto-function; bone injury (stress fractures) occur rather than A number of col will result in a high likeli-organic hood of relapse. muscle injury; RED-S is eas-ily reversed with appropriate diseases can nutrition.] present in a Genetics and OTS similar way to Certain individuals may be Performance testing OTS and are faster, stronger, show greater Physical and mental testing endurance or have better agility often appears to be the most relia-overlooked. and coordination. Part of this ble and useful method of relates to training, diet and assessing impending or es-other external factors that tablished OTS. Such tests might be termed “nurture.” include time-to fatigue tests, sport Fifty to 60%, however, is due to “na-specific maximum aerobic function ture,” essentially our genetic makeup. tests and strength or power tests in There is increasing evidence that our Rule out organic disease appropriate sports. The Profile of coding for certain genes has a profound A number of organic diseases can pres-Mood State questionnaire (or POMS) influence on everything from muscle ent in a similar way to OTS and are is a simple test with good reliability in fibre mass and composition to oxygen often overlooked as the population diagnosing OTS. utilization and recovery from injury. tends to be younger and disease uncom-Knowledge of an athlete’s genetic pro-file can be tremendously important in mon: Undiagnosed lung disease Treatment (asthma); Hormonal Disease (Thyroid, Rest, rest and more rest is the key. This terms of training and nutrition. Tuning Diabetes); Anaemia; Infection (hepati-is often incredibly difficult for an athlete diet and fitness protocols to make them tis, HIV, myocarditis, Lyme, EBV); to accept so involving a sports psycholo-more suited to an individual’s “nature” Malnutrition/Eating Disorder (RED-S). gist can be helpful. Allowing cross will not only improve performance, but [RED-S or Relative Energy Defi-training can overcome some of the in-also reduce risk of injury and OTS. ciency Sport is a low-energy state result-evitable despondency resulting from a Genes affecting risk of OTS: ACTN-3 ing from inadequate nutrition relative halted season. Restore sleep, one of the affects sprint vs. endurance muscle fi-to the degree of training. Originally most essential factors in healing and bres; ACE affects muscle blood flow and known as the Female Athlete Triad improve nutrition ad hydration. Con-nutrition; IL-6 affects inflammation, (anorexia, amenorrhoea, osteoporosis) sider the following supplements: Glu-damage, repair and recovery; TNF-alpha it is now known to affect both men and tamine – 5 grams per day; Liposomal affects inflammation and injury. In addition, the following genes affect DR. PENNY KENDALL-REED, N.D., is a naturopathic doctor in Toronto. After graduating from McGill nutrition and tendon function: FTO University in Neurobiology, she earned a degree in Naturopathic Medicine from the Canadian College determines protein requirement; of Naturopathic Medicine, where she received the Dr. Allen Tyler Award for Most Outstanding Clinician. TCF7L2 controls carbohydrate han-Dr. Kendall-Reed is the author of five national bestselling books, and recently released her latest, “Fix dling; APOA2 determines response to Your Genes to Fit Your Jeans,” which she co-authored with her husband, Dr. Stephen Reed. In 2013 she dietary fats; MMP3 and COL1A1 affect was voted Naturopath of the Year and in 2018 was the recipient of the top Naturopathic Doctor Award in sensitive ty of tendons and ligaments to Canada. Dr. Kendall-Reed is the creator of the integrated genetic platform GeneRx.ca. injury. vertraining syndrome (OTS) is becoming in-creasingly common in athletes at all levels. Part of this increase relates to im-proved awareness and diagnosis, but a significant factor is the cumulative and synergistic impact of athletic stress and lifestyle stress. The incidence of OTS in elite runners approaches 60% and even in non-elite competitive runners nearly a third will develop OTS at some point. Preventative management and early recognition are essential to ensure the condition does not progress to a poten-tially dangerous and sport-ending stage. One of the most important challenges in OTS is recognizing it early. Once established, treatment becomes much harder and more prolonged. 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