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Research: Tissue trauma: the underlying cause of overtraining syndrome?

Tissue trauma: the underlying cause of overtraining syndrome?

Smith LL. Journal of Strength and Conditioning Research. 2004 Feb ; 18(1): 185-193.

Abstract: An athlete who trains intensely, yet consistently underperforms, is considered to be suffering from overtraining syndrome (OTS). OTS is a complex state that involves a large variety of signs and symptoms. Symptoms include changes in mood or behaviour, decreases or increases in concentration of different blood molecules, and alterations in immune function. Although several hypotheses have been proposed, each only explains a selective aspect of OTS. Presently, the sole agreement is that OTS is associated with excessive training and insufficient rest and recovery. The hypothesis proposed in this paper suggests that excessive training/competing causes repetitive tissue trauma, either to muscle and/or connective tissue and/or to bony structures, and that this results in chronic inflammation. It is further proposed that traumatized tissue synthesizes a group of inflammatory molecules, cytokines. Cytokines have been shown to coordinate the different systems of the body to promote recovery. Suggestions are made to detect, prevent, and rehabilitate the overtrained athlete.

My Comments:

Since my last two articles were training related - Recovery and Regeneration For Strength Athletes (dealing with the aspect of recovery between workouts) and Organization of Training: High-Low and Undulating Periodization (an article on how to organize your training and giving you ideas about spacing out high stress workouts to promote balance in your training program) – I thought it would be fitting to post this article on over training syndrome.


This article went into tissue trauma and the effects it potentially has on other areas of the body due to an increase in chronic inflammation inflammation from overtraining.

Overtraining usually develops when there is an imbalance between work (especially intense work) and rest. In an nutshell, the body doesn't have the ability to catch up to the amount of stress you are placing on it. So it reaches a state of "burnout" or "staleness". It is not uncommon for an athlete to be training very intensely
and rather than seeing improvements , they end up seeing a decrease in performance. It is important to note that there is a difference between overtraining and over-reaching. Over-reaching is a temporary decrease in performance, carried out for a brief period of time (a few days) after which the athlete rests and allows for a period of "supercompensation" to take place, the end result being a greater increase in performance (hopefully). Overtraining on the other hand is a condition where the athlete is unable to recover after a few days of rest (almost like a chronic state) and it may even take weeks or months for the athlete to be fully recovered (depending on their level of overtraining).

The paper gave some signs and symptoms of overtraining syndrome. There were a lot, so I will just list a few:

Performance Parameters
decreased performance
inability to meet previous standards
prolonged recovery
reduced toleration to loading
decreased muscular strength
decreased maximum work capacity

Physiological
changes in blood pressure
changes in heart rate at rest, during exercise, and during recovery
increased frequency of respiration
increased oxygen consumption at submaximal exercise intensities
decreased lean body mass

Psychological/behavioral
constant fatigue
reduced appetite
changes in sleep pattern
depression
general apathy
emotional instability
decreased self-esteem
fear of competition
gives up when the going gets tough

Information processing
loss of coordination
difficulty concentrating
reduced capacity to correct technical faults

Biochemical Parameters
rhabdomyolysis
negative nitrogen balance
elevated C-reactive protein
depressed muscle glycogen levels
decreased free testosterone
increased serum cortisol

Immunological Parameters
constant fatigue
headaches
nausea
complaints of muscle and joint aches and pains
gastrointestinal disturbance
muscle soreness tenderness
one-day colds
swelling of lymph glands
bacterial infections
increased susceptibility to and severity of illness, colds, and allergies

The paper then went on to give some recommendations for ways to prevent overtraining syndrome. A lot of these recommendations are things that I have talked about in the past, and some of them are things that recently came up in my past 2 articles. Here are a few of the things they said:

- Keep records of exercises, order of exercises, loads or resistance used, volume or exercise and rest between sets. Endurance athletes should record time trials, training details and racing results.

- Don't increase exercise intensity abruptly. Use periodization and a graded approach to training. Don't increase weekly training loads more than 10%.

- Have at least one complete day of rest each week. Also, be aware of the amount of rest needed between sets and exercises during resistance training.

- Vary hard and light days.

- Avoid to many competitions

- Eat a well balanced diet.

- Psychological stress may add to the physical stress of training. Psychological stressors could include competition, work and family pressure, selection pressure, international travel, funding and other life events. If external personal life stresses are high, reduce training load.

- Rest, active or passive, is probably the most important strategy. Rest withdraws the athlete from exposure to the harmful stimulus (training/competition) and simultaneously allows time for healing of any injured tissue. Rest/recovery should be an integral part of an effective training program.

The take home message from all this stuff is that you need to pay attention to your body and to your training. Properly designed training programs should allow for sufficient recovery inbetween intense bouts of training. It has often been said that "One workout wont make an athlete. But one workout can break an athlete." Trying to beat yourself into a pulp in the gym is not the best (or safest) ways to elevate your level of fitness. Understanding the goals and demands of training and learning how to structure your program is a critical aspect in the development of human performance (whether you are training for competition or just training to be an overall healthy person).

Patrick
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