Over Training Syndrome (OTS) is a condition characterized by excessive fatigue and exhaustion which may occur after prolonged periods of physical or mental exertion. Over time, OTS can lead to severe health problems such as cardiac arrhythmia, hypertension, diabetes mellitus, osteoarthritis and even cancer.
The term “over training” refers to any period of time when the body becomes exhausted due to repeated bouts of exercise without sufficient rest. This type of exhaustion is often accompanied by psychological factors such as depression, anxiety and irritability.
In some cases, it may be difficult to distinguish between normal fatigue and OTS. However, if one experiences both at the same time, they are considered to have Overtrained Syndrome.
Symptoms of Over Training Syndrome (OTS):
Fatigue and exhaustion are common signs of OTS symptoms. They include:
Loss of motivation and energy
Irritability and anger towards others or oneself
Depression, sadness, guilt, fear and other negative emotions (depersonalization) are also common symptoms of OTS. These feelings are sometimes referred to as “Overtraining Fatigue”. Symptoms may not appear immediately after exercise but will gradually worsen with time. Some people experience no symptoms at all while others develop them within days or weeks.
Those who have a history of insomnia sometimes develop a condition known as Delayed Onset Muscle Soreness (DOMS). In many cases, the pain associated with DOMS will be more noticeable than overtraining fatigue. This condition can be quite painful and last for from several hours to several days.
In some cases, OTS can mimic other illnesses such as chronic fatigue syndrome (CFS), fibromyalgia (FM) and cancer. It is also possible for those who suffer from OTS to develop other illnesses as a result of lowered immune system function.
OTS can also cause a reduced flow of oxygen to the brain. This can lead to a variety of psychological conditions such as anxiety, depression, mood swings and psychosis.
Diagnosing OTS can be a challenge for medical professionals. This is due to the fact that there is no effective medical test or procedure that can identify the condition. It is often diagnosed by ruling out other conditions and the patient’s self- report of their condition.
Many medical professionals rely on diagnostic criteria put forth by the US Institute of Medicine (IOM). In their 2012 report, the IOM identified three diagnostic criteria that could be used to identify OTS. The first two of these include:
The presence of general fatigue that lasts at least two days after an exercise session
The tendency for one’s performance to decline or plateau after a period of training. This can take several weeks or months and may involve any type of training (e.g. aerobic, endurance, strength, speed or anaerobic-based).
While these criteria are based on self-reports of athletes and may not be 100% accurate, they can still be used as a means to diagnose OTS in many cases.
Other health conditions can mimic OTS and should be ruled out by medical professionals before a diagnosis is made. This includes various psychiatric conditions such as depression and anxiety.
How to Treat OTS
As of right now, there is no known cure for OTS and the condition must be managed in order to prevent or reverse its effects. Many endurance athletes believe that rest and tapering are effective in treating the condition and this is true to an extent. The most important factor regarding tapering is not letting the body adapt to a lower level of exercise. Below are a variety of treatment recommendations for recovering from OTS.
Rest: It should go without saying but the best treatment for OTS is to rest from training. This could mean taking a complete break from physical activity or significantly reducing the amount of exercise one does for a given period of time. In many cases, this can be enough to allow the body to recover and reverse the condition.
Decrease Training: As mentioned, tapering is not complete rest. Many athletes and medical professionals are in agreement that it is best to decrease training volume by at least 20-30% for a significant period of time. This may mean cutting back on training sessions per week or perhaps not engaging in long or high intensity workouts. The most important factor is to decrease the amount of stress being placed on the body.
Cross Training: Many athletes who suffer from OTS also engage in other types of physical activity. It may be a good idea to participate in alternative forms of exercise such as swimming, cycling or yoga for a period of time to give your body a rest from the stress of training.
Understand Sleep Needs: Another important factor regarding rest and recovery is getting enough sleep on a regular basis. While this is important for everyone, endurance athletes who train regularly tend to place less emphasis on it. Overtraining can wreak havoc on the body and getting between 7-9 hours of sleep each night can help to improve recovery and regeneration.
Diet: What you eat can have a significant impact on your energy levels as well as recovery time. Studies have shown that athletes with lower carbohydrate stores experience fatigue and reduced performance whereas those who consume adequate carbohydrates have longer endurance times. Dietary needs will vary from person to person but it may be a good idea to increase fruit, vegetables and whole grain consumption as well as limiting the intake of fat and sugar.
Stress: A certain amount of stress is good for athletes as this triggers the body to produce hormones that prepare the body for a challenge. The problem with excessive stress is that it can trigger negative reactions such as increased cortisol and adrenaline levels which are counter productive for athletes. Learning how to manage and cope with stress can help prevent excessive wear and tear on the body. There are many ways of doing this including sports massage, exercise, saunas, acupuncture and yoga.
Treat Underlying Conditions: There are a number of medical conditions that can cause symptoms similar to OTS. These include thyroid problems, iron deficiency, vitamin deficiencies, sleep disorders and depression. Any serious athlete should have a full medical checkup to rule these out before considering OTS as the culprit.
Physical Therapy Exercises: While there are no specific exercises that will prevent overtraining syndrome, it is important to remain flexible and mobile as this will help to prevent injury and reduce recovery time. A program of dynamic stretching before and after exercise has been shown to increase muscle strength, improve balance and joint flexibility.
The following are some of the overtraining signs:
-Loss of Performance
-Increase in resting heart rate
-Decrease in flexibility
-Increase in injuries
-Sudden drop in appetite
-Decrease in motivation to train or do anything in general
Prevention is definitely the best treatment for OTS. Listen to your body. If you feel like you’re running low on energy, take a rest day. If you’re training has slacked off, pick it up again.
If symptoms of OTS appear, the best thing to do is stop training altogether and allow your body time to recover.
Although OTS is rare, it can still happen to people who might otherwise be considered low risk such as youth, beginners and people who listen to their bodies. Take care of yourself out there and don’t push your body if you feel something is wrong!
The most common symptom of overtraining is a loss of performance, which although is not life-threatening (assuming you stop the overtraining) it can be extremely frustrating. You can be super-fit and still over train. Overtraining is not due to lack of fitness but rather due to excessive stress on the body.
Sometimes overtraining can occur without actually doing too much physically – lots of stress at work, family issues, etc can contribute. The key factor here is that too much is being asked of the body with not enough time for full recovery.
The following are some of the physical signs of overtraining:
-Decrease in performance
-Irregular menstrual cycle in women
-Decrease in libido
The following are some of the psychological signs of overtraining:
-Loss of enthusiasm for previous hobbies
-Loss of interest in sport
The best way to deal with OTS is to stop training altogether for a period of time. Everyone is different so it’s hard to give an exact length of time that you should wait but if your symptoms are serious (such as prolonged insomnia) then you should probably see a doctor about it.
The following steps may help you to recover from OTS:
-Decrease your training load by 50%
-Eliminate intervals and speed work altogether
-Do not do any intense workouts for at least a week
-Do not do any hard workouts for at least three weeks
-Reintroduce hard workouts slowly. Start with an easy jog and incorporate more difficult training as you feel able.
You should see significant improvements in your performance after allowing your body time to recover.
If you do not feel any improvements at all a week after stopping training then it is likely that you have suffered some sort of overtraining. At this point you should see a doctor who may suggest that you take 1-2 weeks complete rest before gradually coming back to exercise again.
You can avoid overtraining by ensuring that your body is given adequate rest and recovery time. It is during this time that your body will regenerate and you will be much more likely to improve performance.
You should allow at least 1 full day of rest after a hard training session before performing that type of exercise routine again. You should also ensure that you have 1 full week of rest every 4-6 weeks to allow your body to fully recover.
In addition, you shouldn’t increase the intensity or the duration of your training program by more than 10% every week. If you feel like you’re working harder than usual then it’s best to decrease the load and take more time to rest.
A poor diet can contribute to OTS. It’s important to ensure that your body has all of the nutrients that it requires during periods of hard training.
One of the most common causes of injuries are pulled muscles. Stretching before and after exercise can greatly reduce this risk.
I’m not going to tell you how to stretch since there are already many resources available on the internet. I will just recommend that you try to focus on your calves, thighs, shoulders and groin.
You should stretch for at least 10 minutes.
If you have any pre-existing medical conditions then it is best to get a doctor’s clearance before starting any exercise program. Your doctor will also be able to give you advice on what types of exercise are safe for you to do.
In addition, if you start to feel sick during your workout then it is best to stop and rest. This may also be a sign of OTS so you should wait until you feel normal again before trying to continue.
If you experience injuries and sickness during your training then you should really take some time off to recover. Most people are tempted to push through the pain but this will only lead to more injuries and it will prolong your recovery time.
You may also find that getting adequate sleep becomes a problem when you start to exercise regularly. Most people need between 7-9 hours of sleep each night but if you’re still growing then you may need more.
It’s best to try to stick to a regular sleep pattern as it can have a profound effect on your overall health and performance.
If you feel excessively tired during the day then you may need more sleep. Make sure that you go to bed early enough so that you can wake up in the morning feeling fully refreshed.
Sources & references used in this article:
Psychological monitoring of overtraining and staleness. by WP Morgan, DR Brown, JS Raglin… – British journal of sports …, 1987 – bjsm.bmj.com
Biochemical and immunological markers of over-training by M Gleeson – Journal of sports science & medicine, 2002 – ncbi.nlm.nih.gov
Night heart rate variability during overtraining in male endurance athletes by L Bosquet, Y Papelier, L Leger… – Journal of sports …, 2003 – search.proquest.com
Preventing overtraining in athletes in high‐intensity sports and stress/recovery monitoring by M Kellmann – Scandinavian journal of medicine & science in …, 2010 – Wiley Online Library
Physiological and performance responses to overtraining in elite judo athletes by R Callister, RJ Callister, SJ Fleck… – Med Sci Sports …, 1990 – researchgate.net
Changes in physiological parameters in overtrained Standardbred racehorses by MJ Hamlin, JP Shearman… – Equine veterinary …, 2002 – Wiley Online Library
Overtraining: making a difficult diagnosis and implementing targeted treatment by ALT Uusitalo – The Physician and Sportsmedicine, 2001 – Taylor & Francis
ABC of Sports Medicine The overtraining syndrome by R Budgett – Bmj, 1994 – bmj.com