Overtraining syndrome - what we already know
DOI:
https://doi.org/10.12775/JEHS.2022.12.06.020Keywords
Overtraining syndrome, athletes, sportsmenAbstract
Introduction: Overtraining syndrome (OTS) is a state of excess sportsmen's overload caused by too high an intensity of training. The main cause of OTS is too big a training load. Also, they are other risk factors like restrictive diets, inordinate stress, and inflated expectations of a family and a coach.
Description of the state of knowledge: despite numerous hypotheses like dysregulation of hypothalamus and pituitary, inflammatory hypothesis, and glycogen hypothesis the exact cause of OTS is not fully understood. None of these hypotheses explains completely all of the symptoms. In diagnosis, several laboratory tests are required to exclude other diseases. After it, because of possible systemic character diagnostic process of OTS is still problematic. One of the diagnostic methods relies on the measurement of hormone levels. Another potential diagnostic method is the measurement of saliva immunoglobulins and other anti-viral proteins. Also, the measurement of serum cell-free DNA can be used. After the onset of OTS, the most important treatment method is rest, which should last for 6-12 weeks or longer. Nowadays, treatment options are looking for shortenings this time. These options are anti-inflammatory drugs and repeated hypoxia-hyperoxia exposure combined with low-intensity training. Since the only well-established treatment method is prolonged rest, prevention is the most important aspect of OTS management. Adequate education of young athletes and their parents is also important.
Summary: Overtraining syndrome is a serious problem that concerns many athletes. This problem not only affects results and careers but also sportsmen’s life. Because of the wide scope of symptoms, which can be often nonspecific making the correct diagnosis can be difficult.
References
Kreher J. Diagnosis and prevention of overtraining syndrome: an opinion on education strategies. Open access J Sport Med [Internet]. 2016 Sep [cited 2022 Apr 10];7:115–22. Available from: https://pubmed.ncbi.nlm.nih.gov/27660501/
Carfagno DG, Hendrix JC. Overtraining syndrome in the athlete: current clinical practice. Curr Sports Med Rep [Internet]. 2014 [cited 2022 Apr 10];13(1):45–51. Available from: https://journals.lww.com/acsm-csmr/Fulltext/2014/01000/Overtraining_Syndrome_in_the_Athlete__Current.13.aspx
Foster C. Monitoring training in athletes with reference to overtraining syndrome. Med Sci Sports Exerc [Internet]. 1998 Jul [cited 2022 Apr 10];30(7):1164–8. Available from: https://pubmed.ncbi.nlm.nih.gov/9662690/
Koutedakis Y, Sharp NCC. Seasonal variations of injury and overtraining in elite athletes. Clin J Sport Med [Internet]. 1998 [cited 2022 Apr 10];8(1):18–21. Available from: https://pubmed.ncbi.nlm.nih.gov/9448952/
Cadegiani FA, Kater CE. Novel causes and consequences of overtraining syndrome: the EROS-DISRUPTORS study. BMC Sport Sci Med Rehabil [Internet]. 2019 Sep 18 [cited 2022 Apr 10];11(1). Available from: https://pubmed.ncbi.nlm.nih.gov/31548891/
Cadegiani FA, da Silva PHL, Abrao TCP, Kater CE. Diagnosis of Overtraining Syndrome: Results of the Endocrine and Metabolic Responses on Overtraining Syndrome Study: EROS-DIAGNOSIS. J Sport Med (Hindawi Publ Corp [Internet]. 2020 Apr 22 [cited 2022 Apr 10];2020:1–17. Available from: https://pubmed.ncbi.nlm.nih.gov/32373644/
Anish EJ. Exercise and its effects on the central nervous system. Curr Sports Med Rep [Internet]. 2005 [cited 2022 Apr 10];4(1):18–23. Available from: https://pubmed.ncbi.nlm.nih.gov/15659274/
Armstrong LE, VanHeest JL. The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology. Sports Med [Internet]. 2002 [cited 2022 Apr 10];32(3):185–209. Available from: https://pubmed.ncbi.nlm.nih.gov/11839081/
Madigan DJ, Stoeber J, Passfield L. Perfectionism and training distress in junior athletes: a longitudinal investigation. J Sports Sci [Internet]. 2017 Mar 4 [cited 2022 Apr 10];35(5):470–5. Available from: https://pubmed.ncbi.nlm.nih.gov/27055481/
Szivak TK, Kraemer WJ. Physiological Readiness and Resilience: Pillars of Military Preparedness. J strength Cond Res [Internet]. 2015 [cited 2022 Apr 10];29 Suppl 11:S34–9. Available from: https://pubmed.ncbi.nlm.nih.gov/26506195/
Vrijkotte S, Roelands B, Pattyn N, Meeusen R. The Overtraining Syndrome in Soldiers: Insights from the Sports Domain. Mil Med [Internet]. 2019 May 1 [cited 2022 Apr 10];184(5–6):e192–200. Available from: https://pubmed.ncbi.nlm.nih.gov/30535270/
Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, Raglin J, Rietjens G, Steinacker J, Urhausen A. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc [Internet]. 2013 Jan [cited 2022 Apr 10];45(1):186–205. Available from: https://pubmed.ncbi.nlm.nih.gov/23247672/
Cadegiani FA, Kater CE. Hypothalamic-Pituitary-Adrenal (HPA) Axis Functioning in Overtraining Syndrome: Findings from Endocrine and Metabolic Responses on Overtraining Syndrome (EROS)-EROS-HPA Axis. Sport Med - open [Internet]. 2017 Dec 1 [cited 2022 Apr 10];3(1). Available from: https://pubmed.ncbi.nlm.nih.gov/29222606/
Daly W, Hackney AC. IS EXERCISE CORTISOL RESPONSE OF ENDURANCE ATHLETES SIMILAR TO LEVELS OF CUSHING’S SYNDROME? Biol Sport [Internet]. 2005 [cited 2022 Apr 10];22(3):209. Available from: /pmc/articles/PMC6675407/
Cheng AJ, Jude B, Lanner JT. Intramuscular mechanisms of overtraining. Redox Biol [Internet]. 2020 Aug 1 [cited 2022 Apr 10];35. Available from: https://pubmed.ncbi.nlm.nih.gov/32179050/
Kreher JB, Schwartz JB. Overtraining syndrome: a practical guide. Sports Health [Internet]. 2012 Mar [cited 2022 Apr 10];4(2):128–38. Available from: https://pubmed.ncbi.nlm.nih.gov/23016079/
Costill DL, Flynn MG, Kirwan JP, Houmard JA, Mitchell JB, Thomas R, Park SH. Effects of repeated days of intensified training on muscle glycogen and swimming performance. Med Sci Sports Exerc [Internet]. 1988 [cited 2022 Apr 10];20(3):249–54. Available from: https://pubmed.ncbi.nlm.nih.gov/3386503/
Gastmann UAL, Lehmann MJ. Overtraining and the BCAA hypothesis. Med Sci Sports Exerc [Internet]. 1998 Jul [cited 2022 Apr 10];30(7):1173–8. Available from: https://pubmed.ncbi.nlm.nih.gov/9662692/
Common Problems in Endurance Athletes - American Family Physician [Internet]. [cited 2022 Apr 10]. Available from: https://www.aafp.org/afp/2007/0715/p237.html
Gleeson M. Biochemical and Immunological Markers of Over-Training. J Sports Sci Med [Internet]. 2002 [cited 2022 Apr 10];1(2):31. Available from: /pmc/articles/PMC3963240/
Cadegiani FA, Kater CE. Body composition, metabolism, sleep, psychological and eating patterns of overtraining syndrome: Results of the EROS study (EROS-PROFILE). J Sports Sci [Internet]. 2018 Aug 18 [cited 2022 Apr 10];36(16):1902–10. Available from: https://pubmed.ncbi.nlm.nih.gov/29313445/
Small E. Chronic musculoskeletal pain in young athletes. Pediatr Clin North Am [Internet]. 2002 [cited 2022 Apr 10];49(3):655–62. Available from: https://pubmed.ncbi.nlm.nih.gov/12119870/
Narla A, Kaiser K, Tannock LR. EXTREMELY LOW TESTOSTERONE DUE TO RELATIVE ENERGY DEFICIENCY IN SPORT: A CASE REPORT. AACE Clin case reports [Internet]. 2018 Mar 1 [cited 2022 Apr 10];5(2):e129–31. Available from: https://pubmed.ncbi.nlm.nih.gov/31967017/
Safarinejad MR, Azma K, Kolahi AA. The effects of intensive, long-term treadmill running on reproductive hormones, hypothalamus-pituitary-testis axis, and semen quality: a randomized controlled study. J Endocrinol [Internet]. 2009 [cited 2022 Apr 10];200(3):259–71. Available from: https://pubmed.ncbi.nlm.nih.gov/19066291/
Sharp NCC, Koutedakis Y. Sport and the overtraining syndrome: immunological aspects. Br Med Bull [Internet]. 1992 [cited 2022 Apr 10];48(3):518–33. Available from: https://pubmed.ncbi.nlm.nih.gov/1450881/
Mackinnon LT. Special feature for the Olympics: effects of exercise on the immune system: overtraining effects on immunity and performance in athletes. Immunol Cell Biol [Internet]. 2000 [cited 2022 Apr 10];78(5):502–9. Available from: https://pubmed.ncbi.nlm.nih.gov/11050533/
Plasma_amino_acid_concentrations_in_the.8 (1).pdf.
Bell L, Ruddock A, Maden-Wilkinson T, Hembrough D, Rogerson D. “Is It Overtraining or Just Work Ethic?”: Coaches’ Perceptions of Overtraining in High-Performance Strength Sports. Sport (Basel, Switzerland) [Internet]. 2021 Jun 1 [cited 2022 Apr 10];9(6). Available from: https://pubmed.ncbi.nlm.nih.gov/34200179/
Reardon CL, Factor RM. Sport psychiatry: a systematic review of diagnosis and medical treatment of mental illness in athletes. Sports Med [Internet]. 2010 [cited 2022 Apr 10];40(11):961–80. Available from: https://pubmed.ncbi.nlm.nih.gov/20942511/
Pearce PZ. A practical approach to the overtraining syndrome. Curr Sports Med Rep [Internet]. 2002 [cited 2022 Apr 11];1(3):179–83. Available from: https://pubmed.ncbi.nlm.nih.gov/12831711/
Choi E, Pyzocha NJ, Maurer DM. Tick-Borne Illnesses. Curr Sports Med Rep [Internet]. 2016 Mar 1 [cited 2022 Apr 10];15(2):98–104. Available from: https://pubmed.ncbi.nlm.nih.gov/26963018/
Souter G, Lewis R, Serrant L. Men, Mental Health and Elite Sport: a Narrative Review. Sport Med - open [Internet]. 2018 Dec 1 [cited 2022 Apr 10];4(1). Available from: https://pubmed.ncbi.nlm.nih.gov/30569248/
Buyse L, Decroix L, Timmermans N, Barbé K, Verrelst R, Meeusen R. Improving the Diagnosis of Nonfunctional Overreaching and Overtraining Syndrome. Med Sci Sports Exerc [Internet]. 2019 Dec 1 [cited 2022 Apr 10];51(12):2524–30. Available from: https://pubmed.ncbi.nlm.nih.gov/31274684/
Carrard J, Rigort AC, Appenzeller-Herzog C, Colledge F, Königstein K, Hinrichs T, Schmidt-Trucksäss A. Diagnosing Overtraining Syndrome: A Scoping Review. Sports Health [Internet]. 2021 [cited 2022 Apr 10]; Available from: https://pubmed.ncbi.nlm.nih.gov/34496702/
Cadegiani FA, Kater CE. Hormonal aspects of overtraining syndrome: a systematic review. BMC Sports Sci Med Rehabil [Internet]. 2017 Aug 2 [cited 2022 Apr 10];9(1). Available from: /pmc/articles/PMC5541747/
Meeusen R, Nederhof E, Buyse L, Roelands B, De Schutter G, Piacentini MF. Diagnosing overtraining in athletes using the two-bout exercise protocol. Br J Sports Med [Internet]. 2010 Jul [cited 2022 Apr 10];44(9):642–8. Available from: https://pubmed.ncbi.nlm.nih.gov/18703548/
Cadegiani FA, Kater CE. Basal Hormones and Biochemical Markers as Predictors of Overtraining Syndrome in Male Athletes: The EROS-BASAL Study. J Athl Train [Internet]. 2019 [cited 2022 Apr 10];54(8):906–14. Available from: https://pubmed.ncbi.nlm.nih.gov/31386577/
Ushiki K, Tsunekawa K, Shoho Y, Martha L, Ishigaki H, Matsumoto R, Yanagawa Y, Nakazawa A, Yoshida A, Nakajima K, Araki O, Kimura T, Murakami M. Assessment of exercise-induced stress by automated measurement of salivary cortisol concentrations within the circadian rhythm in Japanese female long-distance runners. Sport Med - open [Internet]. 2020 Dec 1 [cited 2022 Apr 10];6(1). Available from: https://pubmed.ncbi.nlm.nih.gov/32804358/
Mackinnon L, Hooper S. Mucosal (secretory) immune system responses to exercise of varying intensity and during overtraining. Int J Sports Med [Internet]. 1994 [cited 2022 Apr 10];15 Suppl 3(SUPPL. 3). Available from: https://pubmed.ncbi.nlm.nih.gov/7883401/
Ferlazzo N, Currò M, Saija C, Naccari F, Ientile R, Di Mauro D, Trimarchi F, Caccamo D. Saliva testing as noninvasive way for monitoring exercise-dependent response in teenage elite water polo players: A cohort study. Medicine (Baltimore) [Internet]. 2021 Nov 19 [cited 2022 Apr 10];100(46):e27847. Available from: https://pubmed.ncbi.nlm.nih.gov/34797320/
Papacosta E, Nassis GP. Saliva as a tool for monitoring steroid, peptide and immune markers in sport and exercise science. J Sci Med Sport [Internet]. 2011 Sep [cited 2022 Apr 10];14(5):424–34. Available from: https://pubmed.ncbi.nlm.nih.gov/21474377/
Breitbach S, Tug S, Simon P. Circulating cell-free DNA: an up-coming molecular marker in exercise physiology. Sports Med [Internet]. 2012 [cited 2022 Apr 10];42(7):565–86. Available from: https://pubmed.ncbi.nlm.nih.gov/22694348/
Pokrywka A, Zembron-Lacny A, Baldy-Chudzik K, Orysiak J, Sitkowski D, Banach M. The influence of hypoxic physical activity on cfDNA as a new marker of vascular inflammation. Arch Med Sci [Internet]. 2015 Dec 1 [cited 2022 Apr 10];11(6):1156–63. Available from: https://pubmed.ncbi.nlm.nih.gov/26788076/
Susta D, Dudnik E, Glazachev OS. A programme based on repeated hypoxia-hyperoxia exposure and light exercise enhances performance in athletes with overtraining syndrome: a pilot study. Clin Physiol Funct Imaging [Internet]. 2017 May 1 [cited 2022 Apr 10];37(3):276–81. Available from: https://pubmed.ncbi.nlm.nih.gov/26443707/
Williams MH. Facts and fallacies of purported ergogenic amino acid supplements. Clin Sports Med [Internet]. 1999 [cited 2022 Apr 11];18(3):633–49. Available from: https://pubmed.ncbi.nlm.nih.gov/10410846/
Abel T, Knechtle B, Perret C, Eser P, Von Arx P, Knecht H. Influence of chronic supplementation of arginine aspartate in endurance athletes on performance and substrate metabolism - a randomized, double-blind, placebo-controlled study. Int J Sports Med [Internet]. 2005 Jun [cited 2022 Apr 11];26(5):344–9. Available from: https://pubmed.ncbi.nlm.nih.gov/15895316/
Cadegiani FA, Kater CE. Eating, Sleep, and Social Patterns as Independent Predictors of Clinical, Metabolic, and Biochemical Behaviors Among Elite Male Athletes: The EROS-PREDICTORS Study. Front Endocrinol (Lausanne) [Internet]. 2020 Jun 26 [cited 2022 Apr 11];11. Available from: https://pubmed.ncbi.nlm.nih.gov/32670198/
Cardoos N. Overtraining syndrome. Curr Sports Med Rep [Internet]. 2015 May 4 [cited 2022 Apr 11];14(3):157–8. Available from: https://journals.lww.com/acsm-csmr/Fulltext/2015/05000/Overtraining_Syndrome.7.aspx
Solomon ML, Weiss Kelly AK. Approach to the Underperforming Athlete. Pediatr Ann [Internet]. 2016 Mar 1 [cited 2022 Apr 11];45(3):e91–6. Available from: https://pubmed.ncbi.nlm.nih.gov/27031317/
Solomon ML, Briskin SM, Sabatina N, Steinhoff JE. The Pediatric Endurance Athlete. Curr Sports Med Rep [Internet]. 2017 Nov 1 [cited 2022 Apr 11];16(6):428–34. Available from: https://pubmed.ncbi.nlm.nih.gov/29135641/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Łukasz Bryliński, Filip Woliński, Piotr Duda, Paulina Drożak, Katarzyna Kostelecka, Jacek Baj
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 654
Number of citations: 0